Personal Independence Payment (PIP) was introduced in April 2013, replacing Disability Living Allowance (DLA) as the main non-means tested disability benefit intended to assist with the additional costs associated with disability or long-term health conditions.
Changes in benefit policy such as this are challenging for many claimants, but through interviews with service users we found that this major welfare reform caused significant problems for people with mental health problems, and that policy implemented in a climate of austerity is particularly problematic. Our findings also reveal the impact it has on local government services.
All participants in our research reported increased anxiety as a result of the benefit change, problems with the PIP claims process and medical assessment, and difficulty communicating with staff from the Department of Work and Pensions (DWP). They also expressed difficulty in accurately reporting complex health problems on the PIP claim form.
There was also strong discontentment about the medical assessment which claimants must attend, and which are delivered by private contractors Atos and Capita. Participants felt that the medical assessments were inflexible and impersonal, and failed to acknowledge the true extent of mental health problems experienced.
They often expressed a feeling of being judged: 'It doesn’t seem right that the medical assessment is done by the same people if you have mental problems or not. I’m not sure they really got what I was trying to say to them.'
The communication difficulties centred on the DWP failing to provide clear and understandable information about the new criteria for PIP, and the practicalities of the medical assessment.
More positive experiences were reported. Research participants emphasised that PIP is a vital source of income, not only for disability-related expenditure but also for more general living costs such as food, utility bills, and transport. All respondents stated that they valued the support of professional welfare right advisers to help them to navigate through a complex process. For many, the experience of claiming PIP was associated with forging new links in the community with people experiencing similar challenges, often through online networks.
Our findings present several significant implications for local government. In broad terms, this research demonstrated that people with mental health problems can find periods of reform and transformation overwhelming. Language, messaging, and clarity around timescales were all identified as being important to people with mental health problems.
Local government staff should be mindful of avoiding a ‘test and learn’ approach when introducing new policies or initiatives which affect people with mental health problems. Too often people with mental health problems felt that their views were ignored or overlooked, and timely and meaningful equality impact assessments are crucial.
This research clearly demonstrated that for people with mental health problems the additional income provided by PIP is crucial. Where this source of income is lost or interrupted, claimants will, of course, often turn to local government for support. Whether this is through social services, housing support or discretionary funds such as the new Household Support Fund. Ensuring people with mental health problems are claiming the correct disability benefits is important to local residents and local government services.
Over the last decade we have witnessed significant cuts to both in-house local government advice services and voluntary sector agencies. This research demonstrates that people with mental health problems rely on expert, independent welfare benefits advice. Within the challenging landscape where local government has been hit with austerity measures and new COVID-19 pressures, it remains crucial that people with mental health problems are clearly signposted to local welfare rights services.
Finally, this research demonstrated that significant policy change is often underpinned with outsourced and digitalised services. These can work, but often people with mental health problems feel they are lost in systems which lack personalised support. Providing tailored services for people with mental health problems has always been important for local government, and this remains the case as we continue to see the long-term impact of a decade-long programme of welfare reform.
Richard Machin is Senior Lecturer in Social Work and Health at Nottingham Trent University
This research was carried out in conjunction with Fiona McCormack, Centre for Health and Development, Staffordshire University. Read the full paper here.
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