Through our work with Trust for London, NSUN recently consulted with our members in the city where inequalities may be most visible, and where living costs are the highest of anywhere in the country: London. The experiences we heard about from almost 700 individual comments – a total of nearly 20,000 words – paint a bleak picture of needs going unmet right now in work, housing, and the benefits system, as well as a vicious cycle of poverty that traps communities and generations in circles of deprivation and poor mental health.
Work and lack of work is a huge part of the poverty cycle, especially for those with mental health difficulties.
Dozens of respondents to our survey told us about being out of work due to mental ill-health and getting insufficient sick pay and/or finding it almost impossible to get back into work – this can play on your wellbeing, you don’t eat or sleep properly, you spend huge amounts of emotional energy on applications, and your mental health worsens. You don’t have the money for luxuries or even occasional treats to bring you joy. You think about money, day and night: “it’s an all-consuming state of mind” – the stress of it makes your mental health worse.
“It’s a catch 22. In order to work I need to be well. To get well I need treatment and support. Over a decade of being fobbed off and abused by CMHT hasn’t helped me get back into employment. Not having work leaves stigma and negative connotations and is debilitating.”
“Everything becomes about not spending unless completely unavoidable, poverty is alienating and isolating, problems I suffer with anyway due to my condition. Structure and connections are lost. Self esteem hits rock bottom.
“I grew up in extreme poverty and had mental illness my entire life but it affected me worse as soon as I became independent. I was homeless for a time. I’ve been admitted to wards multiple times. I fell into the benefits trap and couldn’t get out as I’m too unwell. My illness and not having a good work record crushed my confidence, being on benefits for years is an awful feeling, being a pariah, stigma in society makes me more unwell and I’m stuck. It shouldn’t be like that. There’s no hope.”
Others told us that they’re in work, but that staying there is hard. They said they were vulnerable to being exploited or discriminated against, or didn’t have their disclosures of mental health problems taken seriously or accommodated for. Finding suitable and manageable work can seem impossible, meaning a stable income to pay for food, bills, and safe housing becomes out of reach. The ability to go to the theatre or out for a nice lunch, spend money on “self care”, or do anything that has a positive impact on the enjoyment of life without worrying that it will come back to bite you later is reduced.
Having barely enough money for survival creates environments in which people cannot recover from physical or mental health issues, or it creates those issues in the first place, setting the cycle in motion. And yet right now, as levels of mental distress are predicted to continue to worsen, the furlough scheme is still coming to its planned end and youth unemployment may be on course to triple.
“It is really difficult because I feel like a burden, guilty for not working for so many years, and people can’t see my disability, many seem very critical and don’t understand or think I am lying when I say I can’t work because of my mental illness.”
Housing becomes an even more critical part of our wellbeing during a pandemic that’s seen us confined to our homes.
Lockdown has not seen us all “in the same boat”. 4.3 million homes in the country do not meet requirements defined by the government’s “Decent Homes Standard” and there are 800,000 people living in overcrowded accommodation. Our members told us about folk with mental health problems stuck in mouldy, unsafe bedsits, asylum seekers unable to get out of these situations because of the need for a guarantor who owns property, people who felt too ashamed to invite friends and family over (pre-pandemic), certain communities destined to stay in small and overcrowded estates, poorly-maintained council housing, and tower blocks where sexually inappropriate conduct towards younger members of the family is a known and normalised issue. One boy, supported by a community group in our network, couldn’t even get one hour of uninterrupted time and space to study for a course that would open doors in his future. People get stuck in poor housing, and it stops them bettering their lives and their mental health.
“I have recently moved into a flat on my own, thanks to help from a family member, but previously I was living in a crowded house share with strangers which was horrific and worsened my mental health no end.”
The benefits system continues to fail the most vulnerable in our society.
Our members spoke extensively about their experience with the inadequate and insufficient support offered by the social security system, a system that over the last decade has left Disabled adults four times worse off financially than non-Disabled adults. The system and its assessments was described as a trap (with recipients unable to take on full time training or education), as a hostile, punitive and complex system, and as something that caused indescribable amounts of stress, despair, anxiety, and fear.
People are living in terror of their benefits being cut, describing feeling sick every time a brown envelope comes through the door, and feeling “lesser” than other people due to the “sheer amount of justification required to prove I was worth helping”. The “dehumanising and humiliating” application process, a test or exam “they want you to fail”, can change the way you perceive and value yourself, and you “see yourself in a negative light, as a burden, as everything you can’t do, rather than for what you can do and can offer the world. This only serves to escalate existing mental health issues.”
“I had a letter to tell me I was being investigated for benefits fraud. They harassed me and stopped my payments. I felt threatened and scared. I wanted to die. It took a long time (years) until I had a tribunal. My confidence is the lowest it’s ever been even though I won it and they paid what I was owed. I’ll never recover from all they put me through. It was a living nightmare. They treat mentally ill people like criminals and stigmatise us. It ends up I am more dependent on community & inpatient mental health services than I ever was before.”
“Being on benefits is shameful, degrading & stigmatising due to a pervasive negative attitude in society engineered by the government.”
“I haven’t applied for what I’m owed exactly because the process of applying and constant harassment from the gov while on benefits is so hostile that it might just kill me, and the pitiful amount they offer is worth it. I am privileged to be in a position where my parent is willing and able to support me, and that they are not then abusive, and should the situation change I genuinely don’t know what I’ll do.”
Members told us that throughout the pandemic, getting support around benefits has been harder than ever. It has been near impossible for some to speak with anyone for support on filling out the forms, and it was already hard enough to know what you might be entitled to: “no one person gives the same answer… causes my anxiety levels to rise and paranoia that I am doing something incorrect and my benefits will be cut”.
“The forms are so lengthy and complicated, even when I’m feeling well and am doing it for my partner they are difficult but when I was trying to do it when I was really unwell they are impossible.”
Debt continues to drag people down and crush hopes of a better future.
Debt is another trapping part of the poverty cycle. We heard from people who felt debt or even just the fear of debt destroyed their sense of personal freedom, limited future options, choices and possibilities that brought them hope, and made being well impossible. Living day to day stops people dreaming of or planning for a future. The fear of debt was described as “debilitating”, causing you to bury your head in the sand, which only ended up making matters worse and continuing the cycle. The fear of getting into debt can stop people from living comfortably, inevitably impacting on physical and emotional wellbeing:
“I am so terrified of debt I would rather go cold than run up heating bills. I have not used my gas boiler to run the central heating in about 15 years because the cost goes up and up every year. I wear a coat, hat, gloves, slippers in doors when it gets cold, or go to bed with a hot water bottle. I have no one who could or would help me if I got into debt so I just do not spend any money if I am fearful of not having enough.”
England’s capital city, where the very decisions that throw communities into poverty are made, has some of the most deprived areas of the country, but also the highest cost of living.
While we in northern cities often feel neglected and under-resourced by a London-centric government, those closer to it are not thriving unless they are wealthy. As for whether the higher living costs and poorer housing in London make for an especially acute experience of the poverty cycle, the insights we collected provided a clear answer, with people speaking of decades of no change and new excuses:
“All of these things are worse in London, the benefits don’t go as far, the housing is more likely to be higher cost, insecure and overcrowded. The pay, if you can work, is not going to be enough to cover your costs so depend on benefits to make ends meet… no one can live with the stress and pressure of these conditions long term…”
“Poverty is extreme, debt is disabling, housing is unsafe, landlords need to be held to account for taking advantage of people who are desperate. Jobs are there, but difficult to get beyond a 0 hour contract. We need a diverse, creative and vibrant city in which communities can thrive. This is one important way to protect mental health. High housing costs are crushing the life out of the city.”
Business as usual, whatever that is, clearly does not work for millions of people in England right now, and the pandemic has only grown existing inequalities. Rising levels of poverty and inequity must be recognised as a driving force of mental ill health and distress. We should be striving for a new normal in which people can thrive and are given the best chances to be happy, well, safe and secure, now more than ever.