UK Workforce Hit by Mental Illness, Stories Tell More

What is going on in the UK when it comes to the massive rise in benefit claims related to mental health? It's complicated, that much is certain.

Understanding the causes of mental health-related economic inactivity and what to do about it is at the top of the UK government's policy agenda. It recently set out plans in a green paper to improve access to effective employment support for people with mental health problems. At the same time, controversial reforms to health and disability benefits were central to Chancellor Rachel Reeves's spring statement .

As a social researcher, listening closely to people's lived experiences has taught me that while their distress is genuine, significant and at times severe, it is rarely the whole story of what is constraining their ability to find and stay in work.

Mental distress is almost invariably bound up in other challenging circumstances that also pose barriers to work - issues such as homelessness, violence and abuse, caring commitments, lone parenthood, poverty, involvement with the criminal justice system, and the obstacles caused by inflexible employers and insecure work .

This has made me wonder if the system's very narrow focus on health as a barrier to work is part of the problem.

It's not that the mental health conversation has gone too far - but it may have become too narrow . While it is essential to respond to people's distress, we can't understand their capacity for work, or support their steps back into employment, unless we pay attention to all the other factors that limit their opportunities for work.

The work capability assessment (WCA) was introduced 17 years ago to determine how far and in what ways someone's disability, illness or health condition limits them from working. Since then, welfare support has been narrowed down to questions of obligation and conditionality - with health as the central focus.

But this narrow approach, and the exclusive link between ill health and work-related obligations, has crowded out the full range of challenges, constraints and contingencies that affect people's capacity for work. When health is the only thing the system is interested in, it's the only thing claimants can discuss.

So now, with the UK government's plan to scrap the WCA and introduce a new kind of "support conversation", there is an opportunity to bring this broader range of factors back into the picture.

In a positive shift, the government has recognised that discussions about work need to include a better understanding of people's goals and aspirations, and that these conversations should also facilitate access to support for debt, housing, careers, training and social connection.

How this might be done is a question that needs careful thought and experimentation. The government is seeking responses on how this "support conversation" should be designed and delivered.

In a recent workshop , we explored the opportunities and challenges that might arise from a more holistic approach to assessing capacity for work. Participants in our workshop felt there was potential for more positive experiences and effective support.

But they also envisaged risks both for claimants and welfare services, including the potential for claimants to be retraumatised, as well as extra admin and the possibility of raising unrealistic expectations.

Better support for people who want to work

As the government's Pathways to Work green paper recognises, there are many people for whom formal paid employment may never be possible. But there are some people in the health-related benefits group who would like to work.

In my most recent research project , I met people living with mental health difficulties and neurodivergence who were keen to work but felt frustrated at the lack of personalised support. Here are a few examples of what they told me:

In my experience, they don't help you, they just tell you to do this, that and the other. But they're not supporting you through the process of finding a job. They're just throwing these jobs at you. (female, 26)

I do want to work. It's just, I want to be able to work and then keep the job. And right now, I just I don't feel like I've got the right things in place to help me with that … I don't want to use it as just an excuse … What I want is: 'Oh, I've got ADHD, can you please take that into account?' (male, 33)

I really don't know what [job] to go for … A lot of my issues have been connected to frustration and feeling stuck, and not being able to find a pathway into sustainable employment - and things related to education. It's all kind of linked in a bundle (male, 38)

Shifting the balance towards personalised and holistic support is a step in the right direction. But the spectre of welfare conditionality , and the threat of sanctions if someone is unable to fulfil work-related activities, will always be a block on engaging those who might be able to work, given the appropriate time and support.

While the green paper describes sanctions as a "last resort", it does not go far enough on removing compliance from people's encounters with the system.

The goal should be to make a safe space for people to go beyond the health conversation. The new "support conversation" must allow people to talk about their health and non-health constraints, and the full range of support they need to move into appropriate work.

We do need to talk about mental health - the reality of people's distress must never be undermined. But we need to talk about more than just mental health, and approach people's work-related challenges with an appreciation that mental health problems rarely arise out of nowhere. We cannot understand capacity for work without understanding people's wider social context .

Lastly, we really need to ditch the "any job" approach . It is the fit of a particular workplace and particular job with a person's unique life circumstances that makes the difference as to whether work is feasible, fulfilling and sustainable.

Annie Louise Irvine has received research funding from the Economic and Social Research Council. She is affiliated with the ESRC Centre for Society and Mental Health, the University of York School for Business and Society, and serves as a non-executive Director for the organisation Better Connect.