Mental Health and Social Inclusion

Title: An examination of social exclusion policy and its effect on adults of a working age with serious mental health problems To begin, this essay will briefly define the term social exclusion and its historical background. It will then move on to the political history of social exclusion in the United Kingdom. Particularly the essay will focus on the reasons behind unemployment, and the resulting effect of excluding people from society.

The policies around employment and the benefit system will be discussed in some detail, and their consequences on working age adults, including those with serious long term mental health issues. The French socialist government termed the phrase ‘social exclusion’ in the 1980’s; it was used to define a group of people living on the edge of society whom did not have access to the system of social insurance (Room, 1995 citied in Percy-Smith 2000). The concept of social exclusion has been defined in many different ways since then.

The European commission defines social exclusion as referring to the “multiple and changing factors resulting in people being excluded from the normal exchanges, practices and rights of modern society” (Commission of the European Communities, 1993 quoted in Percy-Smith 2000 p. 3). This was a move away from using the term underclass in the UK, which was not an acceptable phrase to some, as it was more related to poverty (Lavallette et al, 2001). The term social exclusion pointed at a much more complicated problem rather than just money, if you were excluded something or someone was excluding you and that could be sorted out.

Although for some this new phrase just represented a ‘new’ form of the word poverty (Room, 1995 citied in Lavallette). In the UK the New Labour government set up the interdepartmental social exclusion unit in 1997 (Percy-Smith, 2000). Its aims were to “to find joined-up solutions to the joined-up problems of social exclusion” (No10 Website, 2004). The social exclusion task force works within a number of government departments such as work and pension, children school and family and the ministry of justice (No10 Website, 2004)

The social exclusion unit published a series of reports in 1997 that criticised the way both central and local government had failed deprived groups and areas (Batty, 2002). It found that deprived area’s had fewer basic services such as GP surgeries and that little effort had been made to reintegrate some who had been excluded through unemployment (Batty, 2002). Unemployment is seen as one of the main causes of social exclusion (Percy-Smith, 2000). Being unemployed can have serious effects on a person’s confidence, sense of purpose and motivation (Percy-Smith, 2000).

The person who works is seen as a full citizen, paying tax and contributing to society (Baldock et al, 1999). Unemployment can also be linked to mental health; a person is twice as likely to suffer from depression if they are not working. (Department of health, 1999). The period since the 1960’s saw a distinct decline in the British manufacturing industry leading to a shift in the type of work available, the service sector and office based jobs replaced the manual jobs and altered the pattern of demand in the labour market. Baldock et al, 1999) The unemployment rate for semi skilled / unskilled workers if four times that compared to managerial / professional workers (Percy-Smith, 2000). Those people who live in area’s with low demand for low skilled workers are highly likely to be unemployed for a very long time, leading to a near permanence in exclusion from the labour market (Percy-Smith, 2000). Welfare to work policies were the answer from the Labour government in 1997, `They set out plans to encourage people back into the labour market.

Labour came up with the New Deal family of policies. These where aimed at specific groups. For example young people, adults and new deal for people with a disability (Percy-Smith, 2000). One of the results of this policy was to create Job centre plus from a merger of the Employment Service and the Benefits Agency. (Hoben, no date given) The Tories previously had set up the job seekers allowance, which had changed the Insurance-based unemployment benefit. (Baldock et al, 1999).

With this allowance you had to prove you were actively seeking employment or you would not get your allowance. People who became unemployed would have to go for an initial interview where an adviser prepares an action plan, then short interviews are conducted every two weeks to review the claimants success at gaining new employment and to look at new job vacancies (Percy-Smith, 2000). New deal gateway is aimed at 18 – 24 year olds who had been out of work for 6 months. This offers subsidised work experience within the voluntary sector or with an employer with a ? 0 a week incentive. Also full time education/training is offered to those who did not have sufficient qualifications up the recognized NVQ level two. Young people also have an allocated personal advisor who offers assistance around job seeking, careers advice and in some circumstances drugs/homelessness advice (Percy-Smith, 2000). Anyone who refuses to take up these incentives will have their benefit cut. As Gordon Brown put it (the then Chancellor of the Exchequer) there will be no option “to stay at home in bed and watch television” (Baldock et al, 1999 p149).

For people aged twenty five and above who have been on job seekers allowance for over six months then become eligible for a different set of measures, before becoming eligible for the ‘New Deal’. This is called ‘restart’. Work trials are offered as well as help with interview techniques and CV’s writing skills. After twelve months if the individual has not found work they attend a five-day ‘job plan workshop’ to assess the individuals job prospects. This happens again at eighteen months. If after two years they are still unemployed this is when ‘New Deal’ applies. New Deal’ offers training grants as well as an employment credit similar to that of the new deal gateway of sixty pounds a week and the benefit of a personal advisor. The budget for this was ? 250 million for the three years between 1999 and 2002 (Percy-Smith, 2000) It can be argued that jobseekers allowance forces people back to work or forces them to appear to be looking for work in a desperate attempt to keep their benefit. It can be seen as punitive (Percy-Smith, 2000) and with no option to opt out, and it does not actually increase the amount of jobs available.

Without the creation of a sufficient number of jobs, people may lose their benefit, though not through lack of trying (Baldock et al, 1999). Also critics have commented on the cost of the new deal strategy with some say this money could be better used creating more jobs. (Percy-Smith, 2000) Other arguments against new deal look at the timescale difference between the young people and adult services, it cost a lot less to intervene early when someone becomes unemployed so why wait for two years in the case of the adult new deal. (Percy-Smith, 2000).

The new deal policy has been quite effective, particularly at getting young people back into the labour market. However, for people with long term significant mental health problems finding paid work can be very difficult. (Layard, 2005) If social exclusion can be linked to unemployment then for people with mental health issues they are excluded by default, with not only unemployment but with the social stigma associated with their mental health difficulties (Layard, 2005). “There are now more mentally ill people on incapacity benefit than there are unemployed people on jobseekers allowance” (Layard, 2005 p1).

Evidence suggests that work can be very therapeutic for people with mental health problems, but it seems doctors are sceptical about their patients finding and holding down jobs. (Layard, 2005) The problem gets worse the longer the person is on benefits, and as time passes social isolation increases and motivation decreases (Layard, 2005). Ninety percent of people on incapacity benefit say they would like to return to work but would find it very hard to find a job that pays as much as the benefit they receive (Layard, 2005).

However, it has been an underlying trend in welfare policy that low paid work should always be the better option than state handouts. This goes way back to the poor law of 1832 where the workhouse provided the last option for very poor families, providing food and shelter for the exchange of labour. For most of those who lived in these workhouses life expectancy significantly dropped upon entering these desperate places (Higginbotham, 2008). In current times, however, sacrificing benefits and returning to work may mean a compromise in quality of life.

People receiving incapacity benefit may also claim housing benefit, council tax benefit, free prescriptions and discretionary loans from the social fund to buy large more expensive items (Alcock, 2003). With all this help in place it is quite easy to see why people with a mental illness are unlikely to want to go back to full time employment and run the risk of losing money. This is known as the benefit trap. There is another problem, people who have been on benefits for a long time lack the right qualifications to join the labour market (Dummigan, 2007), increasing social exclusion.

If a mentally ill person wanted to find a job but had little or no skills, the choices are very narrow normally leading to a low wage job, again making it unlikely for the individual to want to come off his/her benefits (Dummigan, 2007). The government has tried to rectify this problem by offering further incentives to get people back to work, such as disability tax credits that offer a tax break should some one find work but there is limited awareness of the financial incentives to return to work (Percy-Smith, 2000).

Pathways to work is a recent government initiative with the aim of getting the recipients of incapacity benefit back to work, the claimant will have to take a personal capability assessment which is used to determine whether or not the person is eligable for the benefit, but will focus on “what the customer can do rather than what they cant” (Department of work and pensions, 2007).

A mandatory work focused interview will also take place eight weeks after making the intial claim followed by a screening tool to establish who will have to have more work focused interviews and those who will be exempt from further manditory participation (Department of work and pensions, 2007). Pathways to work will offer a range of programmes to support the “customer” in preparing for work with a fourty pounds a week incentive or credit for twelve months if their salary is below fifteen thousand pounds a year (Department of work and pensions, 2007).

Pathways to work is currently operating in fourty percent of the country. In an interesting move, the remaining sixty percent of pathway to work providers will be from the public sector leading to critism that the government is privatising the welfare system. The government’s chief welfare to work adviser, David Freud, said recently: “I worked out that it is economically rational to spend up to sixty thousand pounds on getting the average person on incapacity benefit into work, somebody will see a gap in the market and make their fortune. ” (Quoted in Vaux, 2008).

Some voluntary sector organizations have criticized the rather aggressive approach taken by the public sector organizations in winning the contracts, and feel that the voluntary sector would be in a better position to deliver the contracts (Vaux, 2008). Mind charity has criticized the pathways to work initiative stating it “places all the emphasis on the individual to find work”, yet, it said there was no obligation on employers to actively recruit people with mental health problems. It would also seem that if you disclose to an employer that you have a mental health problem you are more likely to be sacked before your sane colleagues.

Also there is a lack of support in the work place for mental health sufferers, which lead to higher sickness rate, which in turn puts off employers recruiting future pathways to work employees (Lombard, 2008). In the recent action plan on social exclusion “Reaching out” the government recognizes the need for encouragement in the workplace for recruiting people with mental health issues and supports employer based anti-stigma campaigns. It also states that the government alone cannot address social exclusion, and that the wider community has a role to play.

But most of all, the individual must want progress for themselves and those around them (Reaching Out, 2008). In the last five years mental health services have improved greatly (Layard, 2005) Better treatment and early intervention have empowered people to control their own lives, but though these services have improved the medical condition, mentally ill people still suffer from exclusion from society. The association with dependency that being on benefits brings leads to a segregation (Percy-Smith, 2000). In conclusion, social exclusion is a far reaching problem and not an easy task to overcome.

Evidence suggests that the government still identifies the problem with unemployment and poverty, and has taken a great deal of measures in providing policies that aim to get people back into the work place. Unfortunately for some, as has been shown, work is not always a viable or the best option, and people who fall under this category may stay on the boundaries of society due to no fault of their own, or be forced into working at the detriment of their health. The changes around the incapacity benefit rules may leave some people worse off than when on benefits and this may increase the chances of a relapse in mental ealth issues, which in turn will make them less employable, continuing the cycle of social exclusion. As we enter another recession and unemployment rises again, this is likely to be a huge focus, and the government will have to rethink existing policies around unemployment. Those who are recently unemployed must be given sufficient support to regain employment to avoid falling into the benefit trap in order to avoid the danger of becoming socially excluded. Bibliography Alcock, P (2003) Social policy in Britain, Basingstoke, Palgrave

Baldock J, Manning N, Miller S & Vickerstaff S (1999) Social Policy. Oxford University press, Oxford Lavalette,M & Pratt A (2001) Social Policy a conceptual and theoretical introduction. Sage publications London Percy-Smith, J (2000) Policy responses to social exclusion. Open university press. Oxford Batty, D (2002) Social exclusion: the issue explained (Online), available at http://www. guardian. co. uk/society/2002/jan/15/socialexclusion1 (accessed on 28/10/08) Department for work and pensions, (2008) Pathways to work process. (Online) Available at http://www. dwp. gov. k/welfarereform/pathways_process. asp (accessed on 5/12/08) Department of health, (1999) National service framework for mental health, modern standards and service models. (Online) available at http://www. dh. gov. uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4009598 (accessed on 1/12/08) Dummigan, G (2007) The benefit trap. (Online) available at http://news. bbc. co. uk/1/hi/programmes/politics_show/6403329. stm (accessed on 4/12/08) Higginbotham, P (2008) Poor laws (Online) available from http://www. workhouses. org. uk(accessed on 4/12/08)

Hoban,M & Thomas, J (No date given) DW response to welfare to work – discussion paper. (Online) available at http://www. voicefromthewheelchair. co. uk/pages/dw-response-to-welfare-to-work (accessed on 1/12/08) Layard, R (2005) Mental health: Britain’s biggest social problem? (Online) Available from http://cep. lse. ac. uk/textonly/research/mentalhealth/RL414d. pdf (accessed on 1/12/08) Lombard, D (2008) The replacement of incapacity benefit. (Online), available at http://www. communitycare. co. uk/Articles/2008/10/27/109795/incapacity-benefit-reform-will-leave-some-disabled-people-worse-off. tml (accessed on 5/12/08) Reaching out, (2006) An action plan on social exclusion (Online), available from http://www. cabinetoffice. gov. uk/media/cabinetoffice/social_exclusion_task_force/assets/reaching_out/chapter1. pdf (accessed on 28/10/08) Social exclusion trends show success (2004) Online, available from http://www. number10. gov. uk/page5544 (accessed on 28/10/08) Vaux, G (2008). Pathways to work, to help those unfit for work. (Online), available at http://www. communitycare. co. uk/Articles/Article. aspx? liArticleID=107551&PrinterFriendly=true (accessed on 1/12/08)

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