In recent months, the British Association for Behavioural and Cognitive Psychotherapies, British Association for Counselling and Psychotherapy, British Psychoanalytic Council, British Psychological Society and UK Council for Psychotherapy have met with officials from the Government's new Joint Health and Work Unit to scrutinise Government plans to help jobcentre clients who experience mental ill health.
Last year, concerns were raised in the media when the Government stated its intention to co-locate therapists in jobcentres. These concerns were principally that:
- the underpinning rationale was not for improving health, but rather for ideological purposes
- employment was being considered as a clinical outcome
- people would be coerced into therapy or face sanctions on their unemployment benefit payments
- people would have to access therapy in an unsuitable therapeutic environment
- there would be a lack of privacy in a job centre environment
In August 2015, we took the decision to engage with the Department for Work and Pensions, to ascertain the facts and to try to scrutinise and, if necessary, to influence plans. Our priority is patient or client health and wellbeing and the need to examine the underlying socio-economic causes of people suffering from mental ill-health, rather than stigmatise people suffering from mental ill health who happened to be unemployed.
We have relayed the above concerns and more to officials based at the Department and have additionally met with staff working in a job centre evaluating the feasibility of one of the proposed Government approaches. We have asked many questions, drilling down into the minutiae of the Government plans, and advocating above all that:
- plans must be aimed at improving mental health and wellbeing rather than as a means of getting people back to work
- there must be no conditionality or associated sanction on unemployment benefit
- clients must be treated compassionately
- clients must have their privacy respected
- client choice must be central to the method and location of delivery of therapy
We have been consistently advised that the Government has:
- ruled out any use of coercion or sanctions in relation to therapy
- opted to pursue a small-scale co-location feasibility trial which, importantly, will thoroughly evaluate privacy issues and mental health outcomes comparative to those achieved by therapy in other settings
In addition, following our discussions, the Government has agreed to also trial a number of alternatives, such as providing jobcentre clients with access to therapy in alternative community based, non-job centre settings.
We are acutely aware of the sensitivities around this issue and will continue to engage with the Joint Work and Health Unit to critically examine their ongoing work, to ensure that the full range of potential co-location options trialled are in the best interests of clients, and that the evaluations will be thorough and robust enough to pick up on all of our areas of concern. We are particularly aware that for the Government plans to be ethical, employment must at no time be seen as a clinical outcome, staff must not be involved in coercion, and client attendance must not be mandatory.