‘The bleakest thing I’ve seen’. These were the words of a researcher, an ethnographer who spends their life working with people in fairly raw circumstances. Yet the lives of people out of work because of ill health in one of England’s most destitute wards are devoid of hope and purpose. Here, where more than half of working age people are on benefits through ill health, our expensive system of support is utterly failing. For the state it is a costly failure with money ploughed into a benefit system that changes little. For the individuals concerned their lives are frankly awful.
These aren’t the benefits scroungers from the TV. These are people who have worked, would work again but whose lives have taken a turn for the worse, sometimes slowly over time, sometimes brought on by a life changing episode. We aren’t talking about a handful of troubled families, whose lives will be turned around by a sustained intervention. We are talking about hundreds and thousands of people, almost all of whom have some form of mental health issue, either the cause of the circumstances, or if not, brought on by them.
These are people whose condition is not so serious that they qualify for a medical psychiatric intervention. They’ve seen their GP, they may be on medication or counselling and they arrive at a job centre with a sick note. They have been identified as unfit to work. There, their contact with the health system may end or become minimal. Now they are ‘managed’ by job centre staff, who honestly, diligently and with real concern attempt to help them through a system designed supposedly to support them, to get them back where they and the state want them to be, in some form of employment.
But it is a system that is broken into separate parts with incomplete connections and incomplete signposting. In such a system, people navigate through myth, urban legend and fear, not rational and logical thought. If they could do that they wouldn’t be there in the first place. The letters from DWP explaining changes to the system, offering appointments to help, informing people about their benefits lie unopened on tables or on the floor in the hall. People are terrified of opening them, convinced that each one might rip apart what is left of their fragile existence. This is a system designed wholly lacking in an understanding of how a person, ashamed, scared, and hurting, in deeply broken circumstances might turn their lives around. It relies on a system of incentives and sanctions. These are simply posh words for carrots and sticks.
The sort of deep personal change that is needed when you are stuck here cannot happen if people do not recognise their circumstances, recognise how this is slowly killing them and most important of all, believe they could actually do something about it. The steps necessary for this to happen are not built into the way we ‘process’ claimants. If these happen it is because we have some truly exceptional frontline staff.
And so we turn our heads away, label people as benefits cheats, blame every other profession for not engaging us while at the same time we fail to engage them. Such an approach is cynical, an avoidance of the issue that locks people into deteriorating situations. We need to stop the isolation that is driven by a flagship policy like the work programme or programmes of clinical excellence. This is a situation that needs new and radical approaches to change it. That won’t come by pretending everything is ok, by saying our policies and approaches have it sorted. They haven’t and they haven’t because their underlying philosophy is fundamentally flawed. It is time we recognised that.
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