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The Progressive Policy Think Tank

In safe hands? Evaluating employment pathways for ESA claimants with mental health problems

This short briefing shines a spotlight on welfare-to-work pathways that are 'far from satisfactory' for people with mental health and behavioural problems.

It is estimated that 1.9 million people are receiving ESA, rising to 2.4 million in 2015. However, people with mental health problems, who make up 40 percent of those going through the work capability assessment (WCA) process, are being let down by a system that appears to be neither effective nor accurate in determining the appropriate level of financial or employment support for claimants with mental health problems. Equally, the system fails to provide the kind of support for claimants that is adequate or appropriate for people with mental health problems.

This paper makes recommendations focusing on:

  • collecting additional information and evidence about people who might be disadvantaged by the level of self-reporting that the WCA requires
  • additional training for assessors and decision-makers before they are allowed to handle applicants with mental and behavioural health problems
  • continuous monitoring of how the WCA is conducted to mitigate negative effects on the wellbeing of participants with mental health problems.

Beyond these specific areas of improvement, we propose two principles for wider reform of employment assessment and support.

  • The WCA should be about assessing support needed for a person to work, not policing a gateway to benefits: despite the rhetoric, the WCA is still a test of what people can't do, focused on benefits rather than employment.
  • Work support services should be about pursuing 'supported employment' strategies, not just supported job search: the current regime is too focused on labour market attachment, but other approaches are available, like the 'place, train and retain' approach used in Norway and Sweden.