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The Government’s Reforms to Work Capability Benefits Assessment Could Worsen the Mental Health Crisis for Already Vulnerable People

The proposed changes ‘are symptomatic of the continued systematic violation of disabled folk’

Photo: Matthew Horwood/Alamy

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“It feels like part of Conservative Party ideology to continue marginalising the most vulnerable members of society, like us people with disabilities,” Julie told Byline Times

The 48-year-old has had M.E. since she was a teenager. She is among the 1.2 million people claiming disability benefits exempting her from employment, and one of the many concerned about the Government’s proposed short-term changes to the Work Capability Assessments – the test used to determine to what extent a claimant is “fit for work”.

Earlier this year, the Department for Work and Pensions announced its plans to eventually eradicate the WCA. However, since 2019, the Government has reported a dramatic increase in people classified through this assessment as being in a ‘limited capability for work and work-related activity group’ (LCWRA). The individuals in this group are not required to work or prepare for employment. 

This year, the DWP launched a consultation on interim changes to existing WCA criteria, ultimately reducing the number of people judged to belong to the LCWRA group. These proposed changes affect four WCA activity groups, going so far as to potentially remove the ‘substantial risk’ group, which protects the most vulnerable people.

Amid a collapsing NHS and the cost of living crisis, these changes to disability assessments could push more people into mental health crises. The consequences will be fewer people with access to the LCWRA group, leading to a benefit loss of £390.06 a month for some, and the possibility of sanctions and work mandates imposed on those who may previously have been deemed too unwell to work. 

Dr Jay Watts, a consultant clinical psychiatrist from London, believes the impacts could be severe. She told Byline Times: “These proposed changes are symptomatic of the continued systematic violation of disabled folk. They are ruthless and will cause a tsunami of mental health issues as people would be pressured into work-preparation activities for which they are unsuited and/or unready. This would increase the likelihood of not only being sanctioned but exert a huge psychological toll.”

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Dr Watts is particularly concerned with the possible erasure of the “substantial risk” category, which previously protected her clients at risk of suicide or severe mental health deterioration. She worries the removal of this lifeline could push people into a relapse. 

A study published in the British Medical Journal has previously linked the WCA process to increases in suicides, self-reported mental health problems and increased uptake of antidepressants.

Louise Rubin, head of policy and campaigns at disability equality charity Scope, also raised concerns. She said: “The Work Capability Assessment is already degrading, stressful and adversarial and has a terrible impact on people’s mental health. Threatening disabled people with more sanctions will not lead to more disabled people getting into and staying in work.”

Amy, 25, who was assigned to the LCWRA group after a mental health crisis, said the WCA was a traumatic experience. She worries this will be made worse by the Government’s plans.

“I felt this constant need to prove I was ill enough – I had to recount some of my darkest moments, such as my suicide attempt, in-depth,” she told Byline Times. “I worry the stress of proving yourself will get worse and more terrifying.”

Julie similarly recounted: “I fear people are going to be pushed into desperation and poverty if they are no longer able to access the benefits they need. The process is already highly stressful – people with disabilities who previously did not have a mental illness may develop a mental illness.”

The Link Between Austerity and Mental Health Issues

In his conference speech this year, Prime Minister Rishi Sunak, referencing the increased benefits claims, asked: “Are people three times sicker today than they were a decade ago? No, of course not… it is not fair on taxpayers who have to pick up the bill.”

Yet, this is at odds with sources showing that the UK faces increasingly ill health and health inequalities.

Research by the Office for National Statistics published in April confirmed that sickness absences from work had reached levels last seen in 2004. The Institute for Fiscal Studies also reported that the working-age population’s health has been slowly decreasing, with a rise in all major health conditions. 

Sunak claims a primary goal of these changes is to encourage people to re-enter work, framing it as a “tragedy” for those out of long-term employment. However, Dr Watts is unconvinced that this is an adequate approach and believes it instead denies the reality that work is not an option for some. She worries this will escalate the shame and stigma surrounding benefit claiming. 

The DWP’s proposed WCA reforms also fail to address the rise in long-term unemployment, assuming that economic inactivity from rising sickness rates can be partly blamed on an erroneous assessment system.

So, what are the causes?

The continued individualisation of ill health fails to recognise the broader societal causes of the mental and physical health epidemic – most obviously, the COVID-19 pandemic, which has seen an estimated 1.5 million people suffering from Long COVID symptoms severe enough to inhibit everyday activities. 


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The pandemic saw an escalation in mental health issues, as reported by 2022 Government findings and charities such as Mind UK. The NHS is also facing an escalating crisis under the Conservative Government. The well-reported spiralling staffing crisis and progressively unmanageable waiting times for elective care are predicted to reach eight million by the summer of 2024, which means people are waiting longer for care, which could prevent serious health issues.

In August, the British Medical Society urgently reported the need for mental health funding from the Government to prevent further damage. 

Dr Watts is clear: “If Sunak has any interest in reducing the rates of disability benefits, then wider issues leading to poor health outcomes must be addressed. The stress of society is making us ill or iller, and until people are given adequate infrastructure such as decent housing, healthcare and financial stability, the crisis will worsen.”

For Julie, the situation is desperate: “The demonisation of disabled people continues, and we are failing to be heard and seen. If the Government wants to reduce the number of people out of work, fund the NHS, give us better housing, mental health support and listen to us rather than take away our benefits. If not, more people will die.” 

A DWP spokesperson told Byline Times that the proposed reforms “are about helping people to improve their lives – ensuring they are not unnecessarily excluded from support or encouragement to access the health, wellbeing and financial benefits that work provides”.

We know one in five of those in the LCWRA group want to work with the right support – and the safety of vulnerable customers who may need additional health and wellbeing support remains a top priority,” they added. “We will continue to have appropriate safeguards in place to protect them.”

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