Hitting the wall

The government's welfare reform bill fails to break down the barriers preventing people with mental illness from returning to work, says Jane Harris

The government has gone ahead with its welfare reform bill, even though its own research reports that there is "no statistically significant evidence" that the Pathways to Work pilot has any impact on people with mental illness.

This is pretty bad news given that 40% of people on incapacity benefit have a mental illness. Added to this, Pathways has so far cost in the region of £150m, and is set to cost a further £150m a year for the next three years.

So what has gone wrong? And what can the government do better to help people with mental illness get back to work?

The first step is to realise that 35% of people with mental illness want to work - that's the highest "want to work" rate of any disability group. So there is no need for the Department for Work and Pensions to waste money on pushing people towards work.

The second step for the government is to realise that people returning to work are met with a brick wall of its own making: the tax and benefits system.

The cumulative effect of losing housing benefit, council tax benefit, national insurance deductions and passported benefits such as free prescriptions and free school lunches means that disabled people going into employment lose far more of their new wage than lone parents or families. The Treasury doesn't even publish tax benefit model tables for disabled people any more, perhaps because the facts are so shameful.

The Pathways pilot has tried to address this problem by introducing a £40 a week return to work credit for a year. This is a significant sum for people returning to work, but an insufficient response to a major systems failure.

And that's not the only brick wall. The very people who are meant to help with a return to work can be blocks in the system.

Advisers in Pathways areas say they lack training, knowledge and experience of mental illness. They are simply not equipped to help 40% of the people they are paid to support, and the government has not announced any measures to train this workforce.

Yet these very people will soon have to make difficult judgements about whether people have complied sufficiently with the new regime of work-focused interviews and action plans to deserve benefit payments.

Without a real knowledge of mental illness, how can an adviser determine whether someone has simply failed to turn up for an interview or has genuinely been unable to because of worsening symptoms?

The welfare reform bill proposes to contract out some of these services to the voluntary sector, which could really help. Mental health charities have expertise and experience of mental illness that Jobcentre Plus staff do not.

Still, the major barrier for people with severe mental illness is not in the tax system or in Jobcentre Plus. The main problem is the lack of jobs, not because of economic problems but because of the prejudice, ignorance and fear that surround severe mental illness.

Only 40% of employers say they would employ someone with a mental illness, while 75% of employers say that employing someone with schizophrenia would be impossible or very difficult.

The work and pensions select committee described the government's current initiatives with employers as "wholly inadequate". The latest announcements remain wholly inadequate. New Zealand and Scotland have put in place impressive programmes to reduce the stigma of mental illness, spending 25 times and 8 times more per head than this government to address this massive problem.

If the government doesn't take similar action soon, it could find its own proposals hitting a brick wall.

· Jane Harris is campaigns manager for the mental health charity Rethink

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