Danny Taggart, Ellen Clifford, Jaimini Mehta and Ewen Speed report on their research which points to fundamental issues with the welfare system

In 2015, a collaborative research project was initiated between academics at the University of Essex and Inclusion London, a disabled people’s user-led organisation (DPULO). The research investigated how disabled people in the ESA WRAG experienced the welfare system as claimants, with particular attention to their experiences of processes of conditionality and sanctioning. Our study was designed, supervised, analysed and disseminated jointly by a disabled activist and policy director at the DPULO and a trainee clinical psychologist working with a clinical psychology academic supervisor. It was a qualitative study and 15 ESA WRAG claimants were interviewed.

While the methodology and topic of our project was similar to aspects of the WelCond study, it is also distinct in two particular ways that can, we hope, complement the wider research being undertaken in the field. The first is the participatory, collaborative nature of the study design and implementation. To our knowledge our study is the first UK based research concerning the impact of welfare reform to be entirely collaboratively undertaken in a partnership between a DPULO and a team of academic researchers. This has had important implications for the way the study has been conducted and particularly for the scale and form of dissemination (we discuss this later in the blog). Secondly, the study paid particular attention to the reported psychological impacts of being a disabled claimant in the welfare system. The research considered the consequences of sanctioning and conditionality, both in terms of how this was built into the process, and the intended and unintended psychological consequences for disabled claimants.

Findings

Our research showed that conditionality and sanctions are ineffective in incentivising disabled people to engage in work-related activity. Instead they create a range of punitive and often perverse incentives that can be detrimental to health. Given that conditional incentives are at the heart of the welfare reform agenda, it seems important that they should be implemented in ways that support activity in a work related direction, but our research suggests, as we can see below, it can leave people feeling like it’s too much of a risk to take:

‘After 13 weeks I have to go and put a new claim in. After 13 weeks if the job doesn’t last, or if I get made redundant, or if I get terminated or the contract stops, I then have to go into starting all over again. Reassessment etc. So, I’m worse off.’

All participants in our study reported that engagement with the ESA WRAG has had significantly detrimental effects on their mental health. This is strikingly similar to the results from the Welcond study. As can be seen below, in some cases it led to not only an increase in existing levels of mental distress but also the emergence of new forms of mental distress requiring treatment:

‘I can’t sleep without the sleeping pills. I never took sleeping pills in my life. Simply because it goes round and round in your head and you can’t plan for the future ‘cause you don’t know what’s going to happen, and you think of the worst scenarios.’

For some participants, the impact of sanctions was life threatening. This is a very serious and worrying finding. It raises significant ethical questions about the appropriateness of using psychological theory and interventions to influence claimant behaviour in these ways, with no risk assessment or safeguarding procedures being undertaken in advance to prevent the sort of catastrophic harm described here:

‘So yeah that was part, the sanction was one of the reasons that triggered the mental health and problems I’m having now … it was awful and I ended up trying to commit suicide … to me that was the last straw and I went home and I just emptied the drawer of tablets or whatever and I ended up in A&E for a couple of days after they’d pumped my stomach out.’

Much of the theoretical underpinning for the use of conditionality and sanctioning is based on the idea of incentivising behavioural change, through the application of psychological theory drawn from the field of Behavioural Economics. As such, we felt it was important for this study to examine the psychological impact of attempts at incentivised behaviour change (through the use of sanctions). The underlying fear instilled by the threat of sanctions meant many participants reported living in a state of constant anxiety. This state of chronic fear did not enable people to engage in work related activity and so it would seem that this is an ineffective psychological intervention. None of our participants reported job centre staff undertaking any risk assessment or safeguarding practices to ascertain claimant’s particular circumstances. They also talked about how pressure was applied on them through the implied threat of the application of conditionality and sanctions.

‘Your whole time, everything you’re doing revolves around the Job Centre and what they require from you… So, you’re constantly adapting to them rather than them adapting to your needs.’

The final theme we identified focused on participants’ descriptions about how their experiences had led them to take action and to stand up against how they were being treated. This active participation and willingness to work on behalf of others belies the idea of the passive welfare recipient in need of intervention and activation that underpins much of the policy concerning welfare reform. Furthermore, it points to the potential resources that disabled people can draw on if they were able to be worked with rather than on:

‘I’ve done my own research on ESA, so more familiarity than the average person would be with the system… I’m still able to use my skills in a way they don’t approve of. I suppose that’s important for my identity as well. To be able to use the skills I feel are important is important for my self-esteem whether the DWP likes it or not.’

Conclusions

It is our view that the principles of behavioural and psychological change that are at the heart of the current conditionality and sanctioning regime needs to be subjected to the sort of scrutiny applied to other forms of psychological intervention. Our qualitative interviews with disabled people shows that there is no evidence that the application of negative incentives can change how disabled people think and act to be more vocationally focused. On the basis of our findings not only is the current system ineffective, it is actually harmful and traumatising for some disabled people. As such, we conclude that it is an unethical and harmful psychological intervention for disabled people in the ESA WRAG and should be stopped immediately.

These findings are of particular relevance for the roll out of Universal Credit given how activation and conditionality are core features of that system. On the basis of our study and the larger WelCond findings, the damaging impact and highly risky use of conditionality and sanctioning with vulnerable people with no apparent mechanism for assessing risk will only be amplified if applied to the wider population. This presents the real risk of a public health crisis arising from the application of psychologically informed interventions and risks the unethical use of psychological science.

This research also recommends more active engagement with DPULOs to develop alternative ways of engaging disabled people in work related activity. It is through genuine partnership with DPULOs that the complex needs of disabled people in the welfare system can be fully understood and as evidenced by the collaborative nature of this project, such joint working can produce new forms of evidence that can complement academic research.

A full report of our findings can be found here: https://www.inclusionlondon.org.uk/wp-content/uploads/2018/10/ESA-WRAG-Report.pdf