On March 6th, 2025. Ms Liz Kendall. Secretary of State for Work and Pensions said “I think the only way that you can get the welfare bill on a more sustainable footing is to get people into work”. But this is likely to evoke a sense of foreboding amongst the disabled, often scarred by their encounters with the Department of Works and Pensions. The overwhelming majority of those on benefits would dearly love to be in work. It offers the possibility of achievement, social connection and financial freedom. From a governmental perspective, facilitating employment makes perfect sense at every level. But the way to hell is paved with good intentions.
Employers have for many years operated a phased return to work for those who have been off sick. There is an acknowledgement by employers to make ‘reasonable adjustments’ in the workplace for those with disability. Not to do so risks being taken to an Employment Tribunal (ET). But the consequences of an ET for a large employer are minimal.
Untrained staff are being drafted into Secondary Care to encourage those with severe and enduring mental illness into work. But as one such ‘conscript’ said to me “I feel I am an ‘imposter’, the clients are lovely, I am told to make a fit between the person and the job’ . Striving to meet key performance indicators she finds daunting, sounds like a recipe for burnout.
Many of those with mental health disabilities are outside primary and secondary provision. Some have been discharged from secondary care because they are deemed no longer at risk, some that have been refractory to NHS Talking Therapies are deemed not to meet the criteria for secondary care. Professionals have not had the skills to facilitate work engagement. If this enterprise is to work it requires treatments that tackle people’s psychological disorders, in such a way that they have at most mild symptoms of disorder. This doesn’t look like happening any time soon.
Mike
