3. 1 The impact on people’s mental health of the welfare reforms 2. The way welfare reforms fail to address the needs of people with mental health problems 2

4. Bill introduced in February 2011 Moved within parliament Became an Act in March 2012 3

5. Mental health needs to be a key consideration Light on detail/ vague definitions – inadequate scrutiny Heavy focus on increased severity of conditionality & sanctions Problems with time limits and benefit caps People missing out and an increased pressure on services 4

6. People inaccurately assessed Causing a lot of trauma Exacerbates mental health = Debt, Hardship, potential Homelessness Appeals increase (Up to 40% overturned) = All above compounded by re-assessment 5

7. Benefit assessments do not address needs of those with mental health problems = ‘Descriptors’ are inadequate = Do not factor in Fluctuating Conditions = No system to seek, secure and analyse additional medical evidence = People placed in wrong benefit group = Lack of/ inappropriate support into work 6

8. More detailed monitoring of some of aspects of the WCA as it changes over time Greater use of additional evidence from applicant’s medical and support staff in the assessment Assessors with specific expertise in mental health assigned to applicants with mental health problems A more considered approach to the rate of reassessment, taking into account the impact of the WCA on claimants A detailed examination of the role of welfare advisers and the impact they have on claimants receiving a fair assessment A fundamental review of what is meant by ‘work’ and how the assessment gauges applicant’s ability to work 7

9. Recommendations Improved information-sharing between NHS and DWP A summary of information from the claimant's medical records Fitness to Work statement submitted as part of the claim process before the WCA is carried out ESA50 questionnaire as an alert to DWP to people affected by mental illness who could face difficulty collating their own evidence. 8

10. The next government: Must recognise the extra costs disabled people are forced to pay, and take steps to tackle this financial disadvantage in the longer term. Must recognise the extra costs disabled people are forced to pay, and take steps to tackle this financial disadvantage in the longer term. Should ensure appropriate support for disabled people to work, and security for those who cannot. Should ensure appropriate support for disabled people to work, and security for those who cannot. Should take a lead role in changing the way society talks about welfare. Should take a lead role in changing the way society talks about welfare. Should ensure overall spending on financial support for disabled people is allocated on the basis of need, not pre-determined limits to avoid disabled people losing the support they need in years to come. Should ensure overall spending on financial support for disabled people is allocated on the basis of need, not pre-determined limits to avoid disabled people losing the support they need in years to come. Should take action to ensure that a person’s disability does not mean that they are disproportionately affected by policy decisions. 9 Should take action to ensure that a person’s disability does not mean that they are disproportionately affected by policy decisions. 9

11. Royal College of Psychiatrists Social Inclusion pages: http://www.rcpsych.ac.uk/policyandparliamentary/socialinclusion.aspx Masood Khan Policy Analyst mkhan@rcpsych.ac.uk x 10

13. A model for cost-effective, MH services to support recovery Peer Support Workers (50%?) Treatments (medical and psychological for both mental and physical health) Recovery College(s) Employment (IPS) Housing Social integration, local anti-stigma Specialist teams (EI, crisis teams) Inpatient wards (‘No Force First’, Joint Crisis planning) Family support Money (PHBs, welfare advice)