May 262017

This is a follow up of a previous article on the Health and Work Conversation: Claiming ESA under Universal Credit: Nobody is unfit for work anymore. Click here to read the article

During the Health and Work Conversation, claimants will be asked to fill a questionnaire[1].  It is important to know that this questionnaire can be filled at home and not straight away.

This questionnaire asked questions to help claimants to have a better conversation with their work coaches, and to help them find the best support for claimants according to DWP. What follow are the comments of a Consultant clinical psychologist Dr Jay Watts on the unsuitability of this questionnaire for people with mental health conditions:

JW: It is important to read this new demand on claimants with the wider context in mind. This context is one where the DWP is experienced as punitive, willing to sanction claimants at every turn, with little understanding of the nature of mental health problems, and professionals linking the rise of suicides and mental health epidemic with an austerity regime that belittles and scapegoats disabled people. Professionals like me lack confidence in the DWP’s capacity, or interest in, excluding a wide enough proportion of ‘vulnerable adults’ from this process, who may be made suicidal by yet another requirement. This process is to occur before claimants have their WCA and is mandatory. FOIs tell us that the DWP will presume claimants are fit to work before the WCA, though this demand will be damaging to many. It is likely to increase the time claimants are left waiting before their WCA verdict, leaving claimants in a purgatory that is damaging to mental health.

Some thoughts on the form.

This is not a ‘conversation’ because the terms of reference have been predecided.

DWP: “It’s about helping you get into work when you’re able to in the future.”

It should not be ‘when’ it should be ‘if’. To set up a ‘when’ and indeed to insist on this ‘conversation’ is deeply damaging – it sets up failure in comparison to a (newly created neoliberal) norm. There are many people with mental health problems who will never be able to work. This form is yet another method of equating worklessness with worthlessness, and undermining the other ways disabled people contribute to society.


DWP: You and your work coach will use simple tools to talk about an action that you want to do, and plan how you can do it.


JW: The ‘simple tools’ are not proveably based on positive psychology. But the language of positive psychology runs through every word of this document. One of the core principles of psychology is that intervention should only occur when recipients are able to consent freely. This process is mandatory, and It thus represents a misuse, dare I say it abuse, of power. This is even more problematic in the wider context where many disabled people have been cut off from mental health support and social care. How can it be ethical to deny someone with a history of sexual abuse desperately needed and asked for therapy via the NHS on one hand, whilst insisting they comply with a forced exercise under conditions of extreme stress to return them to work with the other.


What if there is no “action” the claimant wants to do, or is capable of. Not dying is a big enough task these days. Work coaches are to have minimal training, with FOIs suggesting courses will run for 1.5 days max. This is inadequate to understand the complex nature of mental health problems.


DWP: “There are no right or wrong answers”.

JW: Nonsense. There clearly are. What are the consequences of this? Will a copy of the ‘work conversation’ be shared at JobCentre+? If yes, even if these are explicitly not supposed to be used for sanctioning, not having the ‘right attitude’ during the work conversation will bias people to sanction.


DWP:  ‘Do you need to take part? Yes

JW: Why yes to ‘do you need to take part’. For many people work is impossible and the idea they should work can feed in to or trigger mental health deterioration. Having to do this could quite literally produce the conditions that make suicide the only option.


DWP: What kinds of things do you like doing in your life and at work?

JW:  The inability to like anything, to enjoy life, to feel pleasure or anything but emptiness, is a core symptom of many mental health problems. This is made worse by people’s material circumstances for example poor housing, and poverty. Shining a light on what people like, or the lack thereof, can therefore be dangerous especially in a context where claimants feel obliged to perform. Claimants tell mental health professionals again and again that they simply do not feel safe enough to complete DWP forms openly. These types of questions situate claimants as performing dogs, a task that can be the final straw for many. Liking anything obviously a distant country when in mental distress/poverty. It is an absurd question and most people will not be able to fill in this form as they actually feel due to being so scared of the DWP taking away means to live. Ditto ‘what are you good at?’


DWP: ‘How does your health affect your life and your ability to work?’

JW: This is a very difficult question; people do not have the answer to this easily accessible. Claimants are likely to underestimate the effects of health on life, because guilt fuelled by the ‘striver or skiver’ discourse means people emphasise the good days, leading to inappropriate work plans which will place further pressure on claimants. Work coaches will be under huge pressure to produce encouraging statistics for their supervisors and the DWP, shaping how they ask questions ad hear answers.


DWP: ‘What work have you done in the past, if any?

JW: Many mental health and physical disabilities start after a few more functional years of adult life. There has often been a period where activity was possible before breakdown. This question is potentially dangerous in that it asks people to reflect on potentially a lost time that can never be got back, forcing into relief the difference between now and then. This is likely to provoke a mourning, an increased depression, a shame, that causes a deterioration in mental health. It may make claimants feel ‘you are not what you were, you should be, and you are not wanted otherwise’ with devastating effects.


DWP: ‘What are some of the things that have made you proud in your life and at work?

JW: It is none of DWP business. Again it could be damaging if nothing comes to mind, or if something special is thought of which then gets connected with the DWP (so basically a good memory and, say, fear get tied together so the good memory gets polluted). This is not a safe conversation for this environment.


DWP: ‘Is there anything else in your life that makes it difficult for you to work?’

JW: Claimants could answer: not having treatment for my mental health issues due to NHS cutbacks, unstable housing, being continually threatened with sanctions and having my benefits cut by the DWP, but most people will feel too scared to say it as it is, or won’t have that awareness of quite how much say austerity is a causal factor because of the ongoing governmental agenda to make claimants feel it is they who are failing somehow as work is really a possibility for all.


DWP: Tell us how and what you want to do’.

JW: There is no freedom to answer this properly.


The stated aims of ‘My 4 steps’are to boost confidence and motivation to work again. This form will not help with this. It is more likely to undermine confidence and worth with potentially devastating consequences.


DWP: ‘Step 1 want’.

JW: What people want is often something like being able to leave the flat. This is something that work coaches are simply not qualified to help with. The whole four-step programme is again obviously based on ideas from CBT and Behavioual Therapy though not proveably. These should not be worked on outside a trusting therapeutic relationship, where power dynamics are considered, and when the person feels safe. All these requirements are not possible in a ‘work conversation’ DWP setting.


How are these work coaches going to be trained to work with disabled people? What are they going to do when suicidal material comes up? GPs and secondary services no longer have capacity to help when a referral cites suicide risk.


How are they going to screen for people who could be made suicidal by this task. Guilt and shame are central to so many mental health problems (and obviously the governmental discourse have made many claimants feel like this). This form will press on those emotions, making live more unbearable and increasing suicide risk. The suggestions in the form that this is not for now will not help. They set up a trajectory of moving to work which is not achievable for many, making people feel they do not have a worth otherwise. This is not only unethical but will end up increasing healthcare costs.


Some people want help to return to work. Claimants and professionals have repeatedly told the DWP that this should be made available outside the DWP setting, where informed consent is genuinely possible, and where hindrances can be explored safely. Making these ‘conversations’ mandatory is not only likely to be ineffective and damaging for those for whom work is impossible, but will place additional strain on claimants who already feel persecuted by the increasing number of hoops the DWP demand claimants jump through. Demanding claimants fit adhere with an ideal which is unrealistic for many, and which suggests other ways of living are undesirable and meaningless, will adversely affect the mental health of many claimants, increasing the number of suicides connected with an increasingly brutal governmental regime.






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 Posted by at 13:11

  12 Responses to “The health and Work Conversation questionnaire. Comments from an expert”

  1. DWP confirm it is not mandatory to complete the Health and Work Conversation questionnaire, or do the associated ‘my values’ exercise. So if all left at home, but the claimant engages in the interview/conversation…then no sanction…

  2. There is a deep rooted source of evil driving this conservative ‘government’ and the intent seems to be to sacrifice as many as it can in the name of an ideology which once claimed “Work will set you free”. This year we have a chance to vote against it, perhaps the last chance if disputing the government becomes an illegal act. Let’s all think carefully about what may walk into number ten.

  3. Totally agree that this government is evil. We need to do all we can to encourage people to vote them out.


  4. I don’t know why I find it hard to believe that the government could stoop even lower than it’s previous capacity for cruelty to disabled people. These measures demonstrate the depravity of a so-called government intent on dehumanising and victimising people who most need help, for the sake of saving a few quid and oh yes, trying to dismantle the welfare state. I have copied this consultant psychologist’s assessment of the hwc to my MP, who is an ambitious Tory. Let’s see if he comes back to me with the usual bland and cynical sound bites I have come to expect from him.

    Why isn’t this being shouted from the rooftops and spread all over the papers? I think we know the answers to that.

    Shame on them, for they know what they do.

  5. Cliff don’t give up we all need to fight this evil tory government

  6. I bet some say you have to fill it in while there, don’t be fooled by them saying this, They don’t know the rules. How many have had recorded assessments and there was no mics with the machine? It’s all part of them trying to control us. Why do you think the so called recording doesn’t follow the assessment report? Because the recording is blank! and recordings may be used just as a way of people thinking they are getting a fairer assessment.
    to see that the machines need the boundry mics

    • Spoke volumes to me that my WCA was cancelled 3 times, they blamed me for the cancellation because they couldn’t find and assessor who was willing to have it recorded. Finally called to the WCA and there was no recording machine in the room, I queried this and said I specifically requested it be recorded as was my right. They really weren’t happy about my asserting my right and made a big deal about wheeling it and setting it but what horrified me was that they were old Police Interview equipment…I mean seriously when did applying for support turn you into a criminal who has to prove their innocence over a presumption of guilt.
      I checked the recording when I got back, fortunately still had an old Walkman to play it on and whilst sound quality awful could still hear.
      Needless to say when the decision came back I was fit for work in 3 months and she had only recorded my minor conditions some of them so minor they were just listed on the front sheet of my medical notes such as familial hyperlipidaemia or plain old high cholesterol, for Spinal Stenosis, nerve root impingement and crumbling facet joints she wrote ‘painful back’, the Adhesions surrounding my bowels that rip when I have a no 2, she didn’t mention at all, nor the incontinence or sjogrens. ME none of it. So although it was a dodgy machine and it took ages and lots of stress to assert my right I’m so totally glad that I had the evidence to dispute her ridiculous assessment.
      I’m one of the few that had the decision overruled by a DWP DM who decided I would be fit in 16 months and a Mandatory Reconsideration that placed me in the Support Group…one of the few I think but then again they did conduct it before it had officially become part of the process of disability denial.

  7. This is why on the 8th June we all need to vote Labour & get Jeremy Corbyn elected & in no 10 it’s crucial that the Tories are not re-elected on 8th June as they will carry on the attcks on not only disabled people but now also Pensioner’s who have worked all their lifes.

    Get Theresa May out now enough is enough we need these hypercrits out now, it’s not a Britian for everyone only the wealthy few, please vote Labour on 8th June & give disabled & sick people their dignity Back.


  8. Every single step that the Tory’s make are increasingly created to litteraly murder disabled people. This health and work questionaire is another means of demolarising the claiment. I studied psychology at University, honors degree level. I thought I understood a little about Mental health. It wasn’t until I was diagnosed with Clinical depression that I fully realised what it felt like for a person with a Mental health condition. It genuinly opened up that litteral can of worms for me. Sorry to say the nhs treated me badly and I fell through the cracks. I think about suicide every single day and as the cuts bite even more that feeling of hopelessness and isolation is constant. Again when I think these evil sociopaths can’t do any worse, they do. This will continue, it really will. What has happened since the un report on systematic discrimination of disabled peopleseems to have fueled a full on onslaught by the Tory government and the media. Add to this a recent ruling that ?Doctors are allowed to let their patients die is a step in the direction of euthanasia. A little chipping away of legislation at a time results in the toppling of entrenched legislation that protects the disabled. I can’t see May’s face but her voice litteraly turns my stomache. There is no life in it. There is no truth in it. It is false. Almost like a Robot or a puppet controlled by strings. She has no soul, there is no passion or reality about her. That goes for many of the Tory party. They live in a world that is alien to the vast majority of us. They have no idea what it is like to sit down to the most basic of meals, giving to your children and going starving yourself. This is worse for anyone who is disabled. Believe me much worse. There are no words in the English dictionary that describes this sociopathic government or in any other language for their purposefull and evil discrimination towards the disabled. They know that a disabled person has in reality a 75% chance of working in this country and that is reducing daily. I know as I have been in that system and tried everything in my power to get a job. I mean everything. There is only one answer and that is to make it compulsary for employers to employ disabled people. That will never happen. The disability discrimination act is worthless. There are also disabled people who will never work. Give them a decent income, not the pittance we get or the and scrap the deliberate and discriminatory hoops we have to jump through to get a benefit that helps keep us alive.

  9. Perhaps the key to this Is to answer honestly. Not to try to give answers you think they want. When anyone asks me questions about my life before my illness I burst into tears. I would probably sob my way through this ridiculous invasion of my privacy. What do I want ? For all this to end & for sick & disabled people to be treated with respect.

  10. They close down renploy factorydown and there’s no work l sorry but the torys or trying to kill us all and mays a Christian her time will come

  11. I can totally agree with so many of the above comments & conclusions, my DLA & Pension credit have been drastically reduced which I feel is designed to force me to look for work, at 68 years of age & with disabilities this is not an option, all my past self harm & suicide attempts have been completely ignored, I can feel myself slipping deeper into depression & the future (or lack of it) is frightening.

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