Mental health discrimination ‘built into' Work Capability Assessment



Work capability assessments discriminate against people with mental health problems and should be ‘redesigned entirely', according to a new report from Heriot-Watt University.

The assessments, the report shows, are carried out by assessors, the majority of who do not have mental health expertise; work against people's efforts to improve their wellbeing through volunteering; cause deterioration in people's mental health and, in worst cases, lead to thoughts of suicide.

The work capability assessments are fundamentally discriminatory to people with mental health conditions.

Professor Abigail Marks, Heriot-Watt University's Centre for Research on Work and Wellbeing

Professor Abigail Marks and Dr Sue Cowan from Heriot-Watt University, and Dr Gavin Maclean from Edinburgh Napier University interviewed 30 individuals with mental health conditions who had undergone work capability assessments (WCAs). The team also interviewed individuals from advocacy organisations, Citizens Advice Bureau and a former employee of Ingeus, one of the private Work Programme providers.

Professor Abigail Marks, from the university's Centre for Research on Work and Wellbeing, said: “The work capability assessments are fundamentally discriminatory to people with mental health conditions.  

“It is unacceptable that healthcare professionals who act as assessors for the WCA, for example, physiotherapists, nurses, occupational therapists are not fully qualified or trained to assess mental health conditions, yet they seem to be able to override participants' own GPs, community psychiatric nurses, and therapists.

“The WCA must be entirely redesigned, and focus on the potential barriers to work for both physical and mental health problems.”    

The report also highlighted that WCAs make non-Work Programme work experience, or other voluntary work, almost ‘impossible' for people with mental health conditions. 

Dr Gavin Maclean, research assistant at Edinburgh Napier University, said: “Many of the participants in the study found the experience of the WCA so damaging that they stopped engaging in work-based activity and did not return to it. This could further reduce their long-term employability and potentially increase their dependency on benefits.

The perception from WCA assessors that if someone can undertake voluntary work they can also manage paid work was ‘naïve', according to Dr Sue Cowan.

Dr Sue Cowan, assistant professor of psychology in the School of Social Sciences, said: “For people with severe and enduring mental health conditions, voluntary work may be as ‘good as it gets', as one of our participants stated. This does not mean a failure to obtain more. Rather, it is a recognition that an individual is making a choice, and the current system does not recognise or support that in any way.

“The assumption that engaging in voluntary work means an individual is fit for employment should be scrapped; there has to be much greater flexibility about undertaking training while on ESA and much greater value must be placed on voluntary work and work-preparation activity.”

Dr Sue Cowan concluded: “As control over the Work Programme and Work Choice is devolved to Scotland, the Scottish Government must develop better programmes that work in parallel with the benefits system, but are appropriate to people with mental health problems.”

The report, Mental Health and Unemployment in Scotland: Understanding the impact of welfare reforms in Scotland for individuals with mental health conditions, is based on research funded by the Carnegie Trust for the Universities of Scotland.