We learnt recently, from comments made by Work and Pensions Secretary Liz Kendall, that the Government may be planning to trial job coach visits for ‘seriously ill patients’ on mental health wards. This story has received a lot of attention and lots of people are rightly concerned. We’re writing this update to our initial response on social media to clarify what we know, what we don’t know, and what we believe.
Liz Kendall’s comments were made to the BBC, in an article published on the 16th of October 2024. The Secretary alluded to results from unspecified trials to claim that job coaching could produce ‘dramatic results’ for mental health inpatients, but no evidence or further details have been given at the time of writing. While it’s important to remember that this is not currently part of a formal plan, and a wider roll out has not been confirmed, we do not need to wait for an official government document, or confirmation of whether the initiative would be ‘voluntary’ or not, in order to point out what’s wrong with this proposal.
The idea that people who are experiencing enough distress to find themselves on mental health wards should spend time talking through their CVs with a job coach, instead of being offered the personalised support they need, is absurd.
Many among us who have spent time on inpatient wards have been speaking up for a long time about the deep and systemic flaws in mental health care provision in the UK, where cultures of abuse and coercion persist. These flaws, as well as chronic underfunding and staff shortages, mean that personalised mental health care that focuses on giving people choice and autonomy is increasingly difficult to come by. In this context, it feels even more insulting that, instead of so much as acknowledging these longstanding problems, the Government would rather spend time and resources turning mental health wards into job centres.
For us, this issue – and the wider obsession of the new Government with pushing people into work and reducing the ‘benefits bill’ – boils down to how the Government views and values our lives and, by extension, how it understands the role of health care. If Liz Kendall and her colleagues recognise the inherent value of human life, they should also recognise that people deserve to be cared for simply because they are people. However, if they see people’s value as dependent on their capacity to work, it would make sense for them to treat health care as a tool to ensure economic productivity. When Kendall laments the fact that the UK’s employment rate ‘has not gone back to pre-pandemic levels’ in a conversation about mental health inpatients, it’s hard to believe she isn’t in the latter camp.
Crucially, good mental health care should be about dignity and choice. It should recognise our right to influence how we are cared for, include the provision of well-resourced alternatives to psychiatric care, and acknowledge different experiences of mental ill-health, distress and trauma. It should not seek to ensure productivity at the expense of our health, and it certainly should not turn inpatient wards into training centres for the workplace.
We are disappointed to see a lack of strong resistance from the mental health charity sector. It’s very straightforward: no matter how ‘dramatic’ the trial results that Liz Kendall may or may not eventually produce to back up her recent comments, work is not – and should never be – the priority when it comes to people experiencing ill-health of any kind, especially while they are in hospital.
Update
30/10/2024: Minister of State (Department for Work and Pensions) Alison McGovern has responded to two written questions (one on 22/10/2024 and one on 28/10/2024) in a way that suggests that there are no plans to introduce work coaches into mental health hospitals, and that Liz Kendall was actually referring to the Individual Placement and Support (IPS) scheme which offers employment support mainly to “outpatients who live in the community” and would “rarely if ever visit a ward, and would only ever do so if they had specifically been asked to make such a visit by an inpatient”.