NSUN responds: Mental health and benefits reform 

In recent months the Government has attempted to blame economic policy on Disabled people — including increasingly targeting those with lived experience of mental ill-health, distress, and trauma. Delivered under the guise of reforming the benefits system, these sentiments entrench stigma around Disabled lives, and propose reforms that will only serve to harm us by leaving people without support and forcing people into dangerous working conditions. 

In this statement, we outline the context of our position and identify our key concerns. We stand in solidarity with all Disabled people who are affected by recent events, as well as the numerous Disabled People’s Organisations who are also expressing concerns around these developments. We reject, in their entirety, attempts to use Disabled lives as pawns in attempts to shirk responsibility for failing economic policy. 

Context 

On 19th April Rishi Sunak’s gave an address, claiming that we live in a “sick note culture”. Here, Sunak raised concerns around a “spiralling” benefits bill, touting an array of welfare reforms that serve to reduce the support that Disabled people get, and force them back to work. On the same day, Mel Stride (Secretary of State for Work and Pensions) claimed that mental health culture has “gone too far”, saying that while it is good that more people than ever are able to talk about their distress, the so-called “normal” ups and downs of everyday life should not be used as an excuse not to work.

Proposals for reform include removing the ability for GPs to issue sick notes, changes to Work Capability Assessments, increasing the earnings threshold for receiving benefits, and reconsidering whether people living with mental ill-health should continue to receive Personal Independence Payments (PIP), with a Green Paper and consultation launched on the reform of PIP. These proposals have been described by other Disabled People’s Organisations as “chilling and threatening”. 

NSUN and our members have responded to many of these developments individually, including calling to halt changes to Work Capability Assessments (alongside over 100 other Disabled People’s Organisations), challenging the contents of the Government’s Spring Budget, and responding to claims that we live in a ‘sick note culture’

It is important to note that, at this stage, these reforms are simply proposals. Nothing has yet changed, changes are not guaranteed, and if they happen, they will take a considerable amount of time to come into effect. Nonetheless, they highlight dangerous attitudes toward Disabled people, and show how our lives are being weaponised to try to win voters ahead of a general election. Below, we emphasise our position on three key issues: disability as a burden, proposed reforms as good for the economy, and work as a substitute for proper mental healthcare. 

Disabled people are not a burden 

Tied up in the Government’s position is the idea that Disabled people are somehow, simply through their existence, detrimental to society as a whole. For example, Rishi Sunak has repeatedly positioned increased benefits claims by Disabled people as an “unfair burden” on society, prohibiting economic growth. In turn, he frames cruel and ill-conceived reforms as a “moral mission” — ostensibly motivated by a desire to support the taxpayer, rather than a stigmatising assault on the right of Disabled people to access support. Moreover, these dangerous rhetorics fail to value Disabled people beyond their contribution to the economy. 

In a crude and ironic move, the Government has also begun to weaponise our own concerns against us. For example, Mel Stride explicitly named concerns around over-medicalisation — this is something that the psychiatric survivor movement has long been concerned about.

This position lacks any self awareness. It fails to recognise how it is the Governments’ own economic policy, not just the “everyday ups and downs of life”, that leads more and more people into distress. In the context of a mental health system on its knees, people who are struggling under austerity are forced to seek medicalised interventions as their only option. Many of us would love to access care beyond the medical model, but in the current healthcare landscape, this is a luxury that many of us cannot afford.  

As Disability Rights UK have put it: 

“The problem is not Disabled people on benefits, it is not the fault of those left Disabled by the governments appalling handling of Covid […], failed economic policy and the cost-of-living crisis, the problem is the system itself and its long-term prejudices, a system able to blame anyone but itself”.

We must reject, unequivocally, attempts to scapegoat Disabled people and to blame us for the failures of this and previous governments.

Proposed reforms will not achieve their goals

This damaging rhetoric around Disabled people has been used to prop up proposed reforms to the welfare system (some of which we outlined above). We see these reforms as cruel attempts to deprive Disabled people of vital support and force them back into unsafe working conditions, with no analysis of why people are unable to work in the first place. 

These reforms are not only ethically dangerous, but could quite easily increase (rather than reduce) costs to the UK economy. One example is the well-known role of poverty and the violence of the current benefits system for Disabled people as a contributor to deaths by suicide (something that is recognised by the Government itself in its long-overdue 2023 Suicide Prevention Strategy). While the Government’s emphasis on “reducing” suicides is framed as an ethical enterprise, it is also very clearly an economic one: with recent research showing that deaths by suicide cost the UK economy at least £9.58 billion per year — around £2 million per individual suicide. By forcing people into poverty and/or unsafe working conditions, these reforms will only serve to worsen distress — likely increasing suicides and their associated costs, as well as increasing demand on our already struggling mental health services, two areas the Government claims to be concerned about. 

At NSUN, we reject all notions that mental healthcare is valuable because it saves money. People have a right to safe and timely care irrespective of the cost. However, highlighting the potential negative economic impact of these reforms allows us to see these proposals for what they are: not sound economic policy, but a cheap shot by a failing government. 

In the words of NSUN member Dr Veronica Heney

“It’s a tried and tested policy – blame sick people for being lazy, and draw attention away from a decade of Tory mismanagement… Mel Stride thinks we’ve gone too far, but just wait till he sees how far we’ll go”. 

Work is not inherently therapeutic 

Our third challenge to current developments is the idea that work is inherently and always therapeutic or beneficial to Disabled people. For example, Mel Stride argues that “as a culture we seem to have forgotten that work is good for mental health”, and Rishi Sunak claims that “self-worth [ . . . ] comes from feeling part of being something bigger than ourselves”. 

These sentiments build on a long-standing emphasis on work as therapeutic for the so-called “mentally ill”. These ideas, as well as concern around the cost of those in distress being out of work, were the founding principles of England’s NHS Talking Therapies (formerly IAPT) service, as outlined in a 2003 report by economist Richard Layard. The idea of the so-called “mentally ill” as burdensome and simply in need of a job continues to this day. For example, on the back of the pandemic, in which people living with mental ill-health were some of the hardest hit, the Government announced (on World Mental Health Day, no less) what it would do with the £122 million it promised for mental healthcare. This money was not directed toward increasing the capacity of the healthcare system, but instead spent on hiring “employment coaches” for people in distress. We must be clear — work is not, and will never be, a replacement for proper mental healthcare. 

While safe and meaningful work may be good for some people’s sense of self, this kind of work is in increasingly short supply. Instead, too many people are forced to accept work that no longer covers the basic costs of living, is increasingly precarious, in which reasonable adjustments are not met, and where they face stigma and inappropriate working conditions. In this context, we should not blame Disabled people for the “spiralling increase in the welfare bill” — instead we should explore and challenge the myriad ways people experiencing distress are harmed or excluded by work, as well as why so many people are struggling in the first place.  

Conclusion 

As an organisation led by and for people with experience of mental ill-health, distress, and trauma, we reject government attempts to scapegoat Disabled people as the cause of failing economic policy. 

In the face of these developments, we must continue to assert the value of Disabled people beyond economic arguments. We must continue to see these rhetorics for what they are: attempts to use Disabled people as a weapon in a culture war, designed to divide and agitate ahead of a long-awaited general election.