The stories that show how fit-for-work assessments are destroying lives

Iain Duncan Smith - architect of fit-to-work assessment. David Adamson/Shutterstock.com

Michael O’Sullivan suffered from depression, anxiety and agoraphobia. Nonetheless, a government disability assessor decided that he was fit for work. The 60-year-old Londoner was taken off employment support and put on jobseeker’s allowance. Six months later, O'Sullivan took his own life.

The Conservative government’s ongoing overhaul of the welfare system is discriminating against some of the most vulnerable people in our society. Over the last few months, there has been a lot of interest in the effects of the government’s fit-for-work test, the Work Capability Assessment (WCA), on the health of benefits claimants. Some are calling for the Department for Work and Pensions (DWP), who run the scheme, to release data on its impact.

In a report to the DWP, a coroner said that O'Sullivan’s suicide had been triggered by the fit for work assessment. Some people say that his suicide is a tragic but isolated event. Our research, which will be published in a report early next year, suggests that although tragic, it’s certainly not an isolated case.

We interviewed 28 benefits claimants with mental health problems about their experiences of undergoing the WCA and how it has affected their lives and well-being. We also interviewed three mental health advocacy workers who have been closely involved in supporting and representing people subject to the WCA. Our findings suggest that the assessment and its outcomes place unnecessary stress on those whose mental health is already fragile, and that this can result in a downward spiral of deteriorating mental health and desperation.

Simon’s story

One of our interviewees, Simon (actual names have been changed to protect interviewees’ identities), was a builder with a history of depression. In his late 20s, he had a seizure at work. This was not his first seizure. He had had one many years before, while playing a computer game. Because his work involved working at height, he was “let go” by his employer.

After his dismissal, Simon’s health deteriorated further. His seizures became more frequent and he started to have mini strokes. His GP and consultant neurologist reported that he was unlikely to be able to work again. Yet, following his work assessment, he was told he was fit for work.

The judgement meant that Simon’s benefits were cut and he had to enrol on the government’s work programme (WP). This required him to make regular visits to the Job Centre to look for job vacancies on their computer.

Simon was told to use Job Centre computers even though they gave him seizures. BasPhoto/Shutterstock.com

Simon’s GP advised him not to use a computer because the screen flicker could induce a seizure. In spite of presenting a letter to this effect to staff at the Job Centre, he was told that he had to be seen to be actively looking for work, or he would face benefit sanctions. Simon told us: “I couldn’t handle it. It was playing with my head.”

Unable to comply with the requirements of the WP, Simon was sanctioned, and his benefits discontinued.

The impact on Simon was dramatic. With no form of income other than his benefits, he got into debt and turned to alcohol. This contributed to the breakdown of his marriage and led to court action, which stopped him from seeing his two young daughters.

Simon’s mental health deteriorated further and he began suffering from panic attacks.

With support, Simon successfully appealed his WCA decision and his employment and support allowance was reinstated. However, his mental health is still poor and he is terrified about his next WCA assessment in 2016. It plays on his mind constantly and he sees it as a major barrier to his recovery from depression.

The fear about their next WCA is pervasive among those we interviewed.

Not properly trained

Another man we spoke with, James, who suffered from a debilitating anxiety disorder had a panic attack during the assessment. Although this was noted in his WCA report, James was deemed to be fit for work. Indeed, the assessor mentioned in his report that he “was not rocking in his chair, which is the usual indication of anxiety and panic attacks”.

Andrew, one of the mental health advocacy workers we talked with, explained that he had seen “several reports about rocking”. WCA assessors see it as a “signifier” even though rocking is not a recognised clinical sign of anxiety.

Andrew explained that most WCA assessors have limited training in mental health issues. Assessors tend to focus on the impact of physical illnesses or disabilities on claimants’ everyday functioning, even though the impact of mental health problems can be just as debilitating.

On the basis of the records he has kept on hundreds of benefits claimants, Andrew estimates that around two-thirds have experienced a decline in their mental health, and an additional 15% become suicidal (none of whom had demonstrated suicidal tendencies prior to their WCA) and three have attempted suicide after their WCA. The others, he managed to get into hospital or into a crisis centre before they attempted to kill themselves.

Although these figures are estimates and have not been corroborated, they do point to a worrying trend.

Typical stories

Shambles. www.shutterstock

Andrew also mentioned a client whose benefits were wrongly stopped due to “lost paperwork” (lost paperwork is another common event). The client was so damaged by her assessment, and subsequent sanctioning, that she was unable to face undergoing another WCA. She struggled for six months with no benefits and no other source of income. She lost her house and stopped speaking with advocacy services. Andrew last heard of her six months ago. She was living on the streets.

These cases are not extreme examples. They are typical of the stories of around 80% of the claimants we interviewed. All present compelling evidence to indicate that the WCA has been damaging to their mental health.

The WCA doesn’t adequately assess claimants with mental health problems. Asking claimants whether they are able to cook or wash themselves does not capture the largely invisible and fluctuating nature of mental health problems. This, coupled with limited mental health training of WCA assessors, has placed people with mental health problems at a substantial disadvantage within the WCA process. They risk discrimination and a further decline in their mental health.

Correction: An earlier version of the article contained the sentence: “Nonetheless, a government disability assessor, employed by Atos, decided that he was fit for work.” A spokesperson for Atos wrote: “Atos, in its former role as a contractor to the DWP, did indeed undertake the WCA assessments, but at no stage did anyone within the company take or make any decisions on a person’s fitness to work.” The words: “employed by Atos” have been deleted.