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Hundreds of thousands of employment and support allowance (ESA) claimants face being stripped of their benefits if they refuse to undergo treatment for anxiety and depression, under radical plans being proposed by ministers.

Existing welfare rules mean it is not possible to require claimants to have treatment, such as therapy or counselling, as a condition of receiving ESA. However, it has emerged that the roll-out of further mandatory pilot schemes are planned over the next few weeks.

One trial began last month, looking at combining “talking therapies” with employment support. Three further trials being launched this summer are intended to test different ways of linking mental health services with support for benefit claimants seeking work:

  • Using group work "to build self-efficacy and resilience to setbacks" faced by job seekers

  • Providing access to online mental health and work assessment and support

  • Third parties, commissioned by Jobcentre Plus, to provide telephone-based psychological and employment-related support

The aim is to get people with mental health problems off benefits and back into work, so saving the government crucial spending on the welfare bill.

The proposal will, however, raise ethical questions about whether the state should have the power to force patients to undergo treatment. According to the statistics, 46% of ESA claimants have mental health problems.

The Telegraph claims a senior government source told them:
“We know that depression and anxiety are treatable conditions. Cognitive behavioural therapies work and they get people stable again but you can’t mandate people to take that treatment.
“But there are loads of people who claim ESA who undergo no treatment whatsoever. It is bizarre. This is a real problem because we want people to get better.
“These are areas we need to explore. The taxpayer has committed a lot of money but the idea was never to sustain them for years and years on benefit. We think it’s time for a rethink.”

Tom Pollard, policy and campaigns manager at Mind, the mental health charity, said:
"If people are not getting access to the support they need, the government should address levels of funding for mental health services rather than putting even more pressure on those supported by benefits and not currently well enough to work.
"Talking therapies can be effective, but it is often a combination of treatments which allow people to best manage their symptoms and engaging in therapy should be voluntary."

Norman Lamb, the Lib Dem health minister, said mandating mental health treatment for benefit claimants would not work and was "not a sensible idea".
"The idea that you frogmarch someone into therapy with the threat of a loss of benefits simply won't work," he said. "It is not a question of whether tough love is a good concept.
"You actually need someone to go into therapy willingly."

Read the full story in The Telegraph

Comments  

#26 sarpat 2015-03-19 19:59
I have to add - I know someone who was hounded out of a job which lead to moderate - severe depression. Now she is being hounded by the Job Centre, who really aren't making things a lot better.
#25 sarpat 2015-03-19 19:58
With six month plus waiting lists to see Counsellors and cuts throughout the industry - despite promises otherwise - how are they going to execute these grand plans when the people aren't there to be able to execute them. It's treating Mental Health problems as if they are just "Dirty Clothes" that will become clean in one wash! Appalling attitude by a waste of space Government.
#24 Blackcat 2014-07-30 19:53
Back in the mid 80's I got embroiled in the first 'Work Programme' it was called 'Restart' it was the brain child of one tory minister called Norman Fowler. They had TEC's [Training & Enterprise Councils] which were the forerunners of 'Work Programme' training providers. I was and still am a qualified Woodwork Instructor at City & Guilds Level. [I am not telling anybody on these training companies that] I had five men under me all of them with alternative takes on life. Robin was in daily contact with the R.A.F about flying saucers, and he kept badgers in his flat etc he had to have injections every month, one day Robin had an epileptic fit in a garden we were digging, the gulf war was on, and what was bothering the lady of the house ? why Cats! She was advised to bury pots of ammonia in her garden to deter the cats. I asked if I could telephone for assistance, she replied that she would do it 'because my hands are much cleaner than yours' So if any Iraqis or anybody else who was involved in the Gulf, Gulf War Syndrome ,PTSD etc the advice from Little England is this,got a cat problem,bury pots of Ammonia,brings it all into perspective.
Fast forward to 2014, I have just had sanctions placed on me,which will probably not stick, I go to my supermarket and treat myself to Fish & Chips,they are under pressure so there is a bit of a queue, what is bothering 'Little England' ? the wait is making modoms tea go strong. I am just as bad I am trying to get 40 points on my Nectar Card to get Large eggs I went to Customer Service and asked if they were in stock,a colleague came down with me,well nobody told me the boxes were a different colour than those on the slip.I get a full 11p of my next shop. Sorry about all this Gaza, it is a British thing. I doubt if CBT will help us. I don't know if I really want to go and see Freud on Capt Ian Duncan- Smiths say so,actually Pavlov ripped off Twitmeyer. As for Skinner,fancy keeping your daughter in a glass box for a year.
#23 ramorkus5 2014-07-21 04:16
An absolute joke!! I suffer from PTSD and get lower rate DLA. I have been begging for therapy now for over 18 months and apart from 2 assessments (one with a mental health nurse who needed to go back to school to improve his written English and who cancelled my 1 of 2 assessment appointmenst no less than 3 times & put the phone down on me when I got stressed & upset over lack of progress) and another with a very nice phsychiatrist who refferred me for urgent therapy last March. I am still waiting!!)
There is barely no treatment available (not in Derbyshire anyway). How on earth do they think they are going to either supply the therapy ??!! I've certainly had no luck so far after the cut backs! Idiots!
+1 #22 carruthers 2014-07-17 07:19
Plans to strip benefits from the mentally ill unless they agree to treatment were savaged as "complete tosh” today – by an influential TORY MP.

Dr Sarah Wollaston, the chair of the Health Select Committee, said the proposal was “unethical, unworkable nonsense” and “fundamentally flawed”.

Work and Pensions Secretary Iain Duncan Smith is looking at forcing claimants with depression or anxiety to undergo therapy as a condition of getting sickness benefits.

But Dr Wollaston said: “Presumably this complete tosh planted by someone who has no understanding of consent to treatment.”

Posting on Twitter, she added: “When I say it’s a ‘no brainer’ I mean this unethical, unworkable kite flying comes from someone with no brain.”

Lib Dem health minister Norman Lamb also blasted the plan.
He said: “The idea that you frogmarch someone into therapy with the threat of a loss of benefits simply won’t work. You actually need someone to go into therapy willingly.”

Despite the criticisms, a trial scheme is expected to begin this year.

Pasted from
#21 Matata2011 2014-07-16 17:00
Also point of information,som e mental health problems are a direct side effect of coping & managing chronic illness, that is if any idiot in IDS team know anything about incurables!!?so suddenly they can find cures!!!Alterna tively why cant they draw blood from the ill & inject them into their own veins to understand what it is like!!!Most important, illness is not a choice anyone can get seriously ill, walk out of your door & get hit by a car, life changes immediately & trust me it's the hardest path to walk!!!
#20 Matata2011 2014-07-16 16:49
Good luck to IDS & the Work providers & DWP that he is bullying into committing forcing clinically mental patients into risk taking activities in the name of statistics without taking any risk assessments to both parties!!Legall y Clinically mentally ill most have tried all treatments & not everybody can suddenly get cured, some of their reasons are most likely deep rooted in their past life or trauma, worse some have psychosis, their doctors know best not ignorant IDS. Are they next going to re introduce mental asylum or chains?Mental patients need compassion, not hounding, if pushed they can respond with some serious damage to any aggressor or suicide & by law they will not be liable esp if the aggressor knowingly pushed them too far,they do not even have capacity to contract under contract law.I listen to IDS ignorant propaganda which is expected with pity to his stupidity esp of him.Besides glad he has refused to move, to the wise electorate who are the majority know he has basically put the final nail to Tory not winning.The disabled & the old that he is self destroying will ensure they do not get in & there are many,so am not worried.Another thing what hold or blackmail has his got on Cameron? There is more to it than what meets the eye knowing IDS it won't Suprise the nation one day & very soon.
+3 #19 San100 2014-07-16 13:20
So between the lines the anonymous government official is saying that people suffering with mental illness have only themselves to blame as they can't even be ars'd to undergo therapy and therefore mental illness is a 'lifestyle choice' which leads to living on benefits which is of course as we all know (sarcasm) is another 'lifestyle choice. These people (mentally ill) obviously lack motivation and therefore the government intends to be cruel to be kind and force them into treatment. My response to this is firstly I must inform my psychiatrist and the Royal College of Psychiatry that there is a 90% cure available of which she and they must be unaware (sarcasm). Secondly why dose this government think that being in paid work is the only way a person can make a contribution to society? Thirdly being treated like rubbish is likely to be internalized by many people with depression and low self esteem. This means that all the bullying all the nastiness, all the spitefulness that is being dished out by the government, the DWP and the media is swallowed by the depressed person who thinks that as they are being treated like scum they must be scum and so the downward spiral of depression with accompanying emotional pain and misery and sadly sometimes leading to suicide. When is someone going to be held responsible for the emotional and physical harm that this government are inflicting on citizens of this country? :sad:
+1 #18 Paul Richards 2014-07-15 22:21
Hi all,
And - something that I forgot to add earlier - Michael Gove is going to be the 'voice' of this rotten Coalition Government on TV to explain and put forward and also further, their 'Conservative' ideas ahead of the General Election! He has been effectively demoted to 'Chief Whip'.
After his disaster in the Education department and his rubbing up of the wrong way of the Education & Lecturers Union - Huh - What a joke!
I really hope that it backfires on him and this dreadful 'Government'
+2 #17 carruthers 2014-07-15 22:06
Quoting Jim Allison:
There is no evidence that it works for many physical medical conditions, including Diabetes type 1 or 2, and from personal experience CBT doesn't work for for neurological diseases such as MS, or musculoskeletal diseases such as arthritis.

Jim, consider the work of Rona Moss-Morris, who has made her career principally out of promoting the use of CBT in the treatment of people with ME/CFS - she is based at King's and can be considered part of the Wessely school. But not only ME.

"Rona won MS Research of the Year as part of the Multiple Sclerosis Society Awards 2013 for her randomised controlled trial Adjusting to MS, which compared CBT and supportive listening to help people adjust to early stages of multiple sclerosis (MS)" (Wikipedia)

No claims for a cure (unlike IBS, which can be cured by CBT, apparently), but CBT can help you adjust - which means you will then be able to make the transition back into work for many years.

Turn that over the Telegraph medical writers (I hypothesise) and you will have "CBT enables people with MS to go back into the workplace, if they have a short (cheap) course. This will benefit both them and the tax payer."

Meanwhile over at the Daily Mail, "Beating arthritis is all in your head: Pain of joint condition can be eased through counselling" (article specifies CBT). (28/6/12)

As for diabetes, "CBT has been effective in treating a variety of psychological disorders and by using it in diabetes, it may help patients improve their HbA1c by changing the way they think and behave." That's from a scholarly article - you can Google it.

And if you don't turn up for sessions of bullying they can withdraw your benefit. If it doesn't work, it's your fault.
+1 #16 Paul Richards 2014-07-15 20:51
Hi timmyjohnanners,
Yes, you are very right - Lord help the sick and disabled now!

Well, there we have it! - most probably IDS has stuck in his claws to remain in his DWP position - probably Cameron was afraid to sack him as he could be a loose cannon and may cause a lot of trouble! (But at least Esther McVey wasn't promoted to the DWP!)
My wife is very worried that he is still there as (unless something extraordinary happens soon) he will try to continue to push through his disastrous Welfare Reform programme, including UC and also WCA with whatever money hungry private company will willingly accept more millions of Government (nay - Taxpayer's money!!) The ESA threat is also trouble for them in the future.

However, I still feel that this Coalition is still slowly sinking, - trying to block up the holes (that they solely have created) as the water impinges, but the bilges are full, the rats are running and if not, slowly drowning, as Cameron tries to act as the dutiful and arrogant as ever, Captain trying to save his crew and also, not forgetting at the very least, his own neck.

What a rotten tramp steamer, - slowly running out of fuel and, if all goes well, also having to fight some Human Rights Court cases in the future - which, hopefully, they will also lose!
+2 #15 tazman 2014-07-15 18:04
I agree with just about everything posted here. My therapist told me last week that my sessions will be coming to an end because funding for mental health services have been cut by two thirds in this area. Mental illness runs deep in my family and it has taken me many years to understand that I cannot fight it. Just do my best to cope. CBT is of no use to me and would probably tip me over the edge. Currently, I am in an ok place, but know that when my next crisis comes, there will be nobody to turn to. I am on high doses of medication to help me cope, sleep etc. How much more blood do these creatures want on their ugly hands? And why is IDS still in the job? Because he knows where the bodies are buried in my opinion.
+4 #14 timmyjohnanners 2014-07-15 05:28
to Paul Richards...... Mate...... of course its a human rights issue!! but if your sick and on benefits this government does not class you as human!!!!!
+5 #13 tintack 2014-07-15 01:42
Quoting Jim Allison:
Attempting to force claimants to undergo treatment for mental illness or physical illness would not only infringe the rules of 'natural justice' but would also breach European Law laid down by the ECHR.


I fully expect the Tories to go into the next election with a manifesto promise to withdraw from the ECHR and scrap the Human Rights Act. It will be portrayed by the Tories and their friends in the press as "taking back control of our own laws". In reality, it will simply be removing one of the few remaining obstacles currently stopping them from doing whatever they like to sick and disabled people.
+1 #12 Jim Allison 2014-07-14 21:56
[quote name="Blackcat
"]This is a very worrying development. CBT is cleared by N.I.C.E, but there is another well publicised treatment which is trade marked so cannot be named which is officially listed as one of the top ten interventions which has a high 'Quack' factor.[ Just imagine you have a malignant tumour, well this therapy says you think that you are tying it to a balloon, and fly it out of the window to make it go away]

A B.B.C reporter had his cat registered as a Hypnotherapist [Google it].
Who is going to vet,the 'therapists' who is going to ensure quality controls are in place.

A lot of drugs companies will tell people that mental illness is down to chemical changes in the brain, so how can people be talked out of it?

CBT will not cure my Diabetes 2.

A lot of drugs companies will tell people that mental illness is down to chemical changes in the brain, so how can people be talked out of it?

CBT will not cure my Diabetes 2.

Some sufferers of depression, including my wife do have a chemical unbalance in the brain, usually serotonin. The group of drugs known as Selective Serotonin Re-uptake Intake Inhibitors (SSRI's) work well for most with clinical depression, but not for those with bipolar depression (aka manic depression)

The use of CBT is questionable although approved by NICE. I've had many clients where CBT has made them worse. There is no evidence that it works for many physical medical conditions, including Diabetes type 1 or 2, and from personal experience CBT doesn't work for for neurological diseases such as MS, or musculoskeletal diseases such as arthritis.

I believe it was Atos Health Care Professionals who advocated CBT for many medical conditions without any clinical trials or peer reviewed research. Atos pulled out of ESA medical assessments for no stated reason, perhaps they should have offered their HCP's CBT or other similar therapies where the success rate is very low to say the least. CBT is about changing how you react to life events, but it's of no use if you have a life threatening medical condition or terminal illness. See: Cognitive behavioural therapy - How it works
#11 Jim Allison 2014-07-14 21:51
Blackcat :
"]This is a very worrying development. CBT is cleared by N.I.C.E, but there is another well publicised treatment which is trade marked so cannot be named which is officially listed as one of the top ten interventions which has a high 'Quack' factor.[ Just imagine you have a malignant tumour, well this therapy says you think that you are tying it to a balloon, and fly it out of the window to make it go away]

A B.B.C reporter had his cat registered as a Hypnotherapist [Google it].
Who is going to vet,the 'therapists' who is going to ensure quality controls are in place.

A lot of drugs companies will tell people that mental illness is down to chemical changes in the brain, so how can people be talked out of it?

CBT will not cure my Diabetes 2.

Some sufferers of depression, including my wife do have a chemical unbalance in the brain, usually serotonin. The group of drugs known as Selective Serotonin Re-uptake Intake Inhibitors (SSRI's) work well for most with clinical depression, but not for those with bipolar depression (aka manic depression)

The use of CBT is questionable although approved by NICE. I've had many clients where CBT has made them worse. There is no evidence that it works for many physical medical conditions, including Diabetes type 1 or 2, and from personal experience CBT doesn't work for for neurological diseases such as MS, or musculoskeletal diseases such as arthritis.

I believe it was Atos Health Care Professionals who advocated CBT for many medical conditions without any clinical trials or peer reviewed research. Atos pulled out of ESA medical assessments for no stated reason, perhaps they should have offered their HCP's CBT or other similar therapies where the success rate is very low to say the least. CBT is about changing how you react to life events, but it's of no use if you have a life threatening medical condition or terminal illness. See: Cognitive behavioural therapy - How it works
+2 #10 Jim Allison 2014-07-14 20:47
Attempting to force claimants to undergo treatment for mental illness or physical illness would not only infringe the rules of 'natural justice' but would also breach European Law laid down by the ECHR.

Informed consent applies when a person can be said to have given consent based on a clear appreciation and understanding of the facts, and the implications and consequences of an action. English law necessitates that before any medical professional can examine or treat a patient, they must obtain informed consent to do so.[1]

Consent can be either explicit (specific consent to carry out a specific action) or implied (not expressly given by a patient, but inferred from their actions, the facts and circumstances of a particular situation, and sometimes a patient's silence or inaction).

Generally there is no legal requirement to obtain written consent but it may be advisable in some circumstances.

A consent form documents that some discussion about the procedure or investigation has taken place but is only evidence of a process, not the process itself. Any discussion should be recorded in the patient's medical notes.

The Mental Capacity Act (2005) formalises the area assessing whether the patient is mentally capable of making the decision, and the Mental Health Acts (1983 and amended in 2007) describe the very limited circumstances when a patient can be forced to be hospitalised for assessment and/or treatment against their wishes.[2][3] Full details Consent To Treatment (Mental Capacity and Mental Health Legislation)
+3 #9 Elaine Burrows 2014-07-14 19:52
I can think of a number of practical and ethical issues that would arise:
1] Anxiety and depression is a broad spectrum. Some people are so severely depressed that they need medication to stabilise their condition before they are able to benefit from the talking therapies.
2] Some people suffer from anxiety and depression as a result of childhood trama such as abuse.Being forced into treatment which is unlikely to be appropriate to their needs could make a bad situation even worse.
3] Some people fail to respond to therapy and drop out for a number of reasons - the therapist could have failed to establish rapport/trust, the therapist could have been trying to abuse them or been trying to pressurise the patient into making faster progress than they feel able.No doubt this would give the DWP yet another excuse - if they ever needed one - to sanction people's benefits.
4] I note that group work is one of the options being piloted [probably because it's cheaper than one -to-one.] Have they taken into account that people with social phobia will not be able to access this? I doubt it. It will be one size fits all as usual.
5] The whole issue of confidentiality between patient and therapist is also an area of doubt. If the therapist feels that the patient is not cooperating [for whatever] reason] will they be obliged to tell the DWP and so have thepatient's benefits stopped benefits stopped? If this is the case then it makes it impossible for a relationship of trust to be established - thus resulting in the whole exercise being a waste of time and money.
Convicted criminals now have more rights than benefit claimants. Has it really come to this, that a convicted murderer, rapist or child sex abuser is regarded as somehow more deserving than a benefit claimant?
+1 #8 tintack 2014-07-14 16:29
What a marvellous idea. Nothing is more likely to improve the mental state of someone with mental health problems than threatening them with removal of benefit and being driven into destitution. I wonder why no-one thought of it before.

What happens if someone is already being treated by a properly qualified professional on the NHS, who takes the view that their patient's mental health is likely to be made worse if they are forced to comply with this ludicrous piece of Orwellian lunacy? Will the government and/or the private company concerned (almost certainly the likes of Atos, Capita, etc.) be legally accountable for any adverse consequences? Or will it be like the present situation with the WCA, in which no-one at either Atos or the DWP is ever held accountable, even when someone dies? I think we can guess the answer to that one.
+2 #7 LibbyWick 2014-07-14 15:53
Surely it would be cheaper in the long run to pay ESA to those who need it rather than giving private companies billions trying to enforce this? Will this leave us open to contact by every quack in the land if the NHS sell off our records? I was getting great benefit from a psychotherapist when I was employed and could afford to go privately but to receive treatment on the NHS there was a 15 month waiting list.. or allow myself to be sectioned.

This Government is full of contradictions and wasting money right, left and centre.... the armed services come to mind. Cut the budget, lay-off thousands of service men and women, resulting in a standing Army unable to do their job.... Then announcing billions of spending on high tech armament but we'll have no one to use it... Ahh just thought.... any incidents will be handled by one person in a bunker somewhere with drones.

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