Universal Credit and Mental Health

– in the Scottish Parliament on 28th May 2019.

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Photo of Christine Grahame Christine Grahame Scottish National Party

The final item of business is a members’ business debate on motion S5M-17352, in the name of Mary Fee, on the Scottish Association for Mental Health report on universal credit and mental health. The debate will be concluded without any question being put.

Motion debated,

That the Parliament welcomes the publication of the SAMH report,

‘It Was A Confusion’ Universal Credit and Mental Health: Recommendations for Change

; notes that the report explores the experiences of people with mental health problems engaging with the universal credit system; believes that the system has created new barriers and added pressures for people with mental health problems; notes that the report contains eight recommendations for the UK Government, DWP and Scottish Government, with an overall message that no person on legacy benefits should be transferred to universal credit while it exists in its current form, and believes that the social security system should act as a safety net for all and support people in the West Scotland region, and across Scotland, and not make anyone poorer and more disadvantaged, regardless of circumstances.

Photo of Mary Fee Mary Fee Labour

Our social security system should be available to all in times of need. It should guarantee a level of economic safety and assistance to people who cannot work, people who find themselves out of work and people who are struggling to make ends meet.

Instead, under a cruel and unfeeling Tory Government, the system offers neither safety nor assistance.

The Scottish Association for Mental Health report on universal credit and mental health gives us a significant insight into what is happening to the very people whom the social security system was designed to protect. I thank all my MSP colleagues who signed the motion, allowing us to have this debate. The issues that are raised in the report are not party political; they are the concerns and fears of many people with poor mental health. My sincere thanks go to SAMH and those behind the case studies that are discussed in the report. With their valuable input, the human impact of universal credit implementation is made clear.

The motion on the SAMH report gives a brief summary—it tells us clearly that universal credit is creating new and additional barriers for people with poor mental health. Those barriers, which include digital by default, the work capability assessment, the payment period and the sanction regime, are leaving people with more stress, more anxiety and more pressure on their mental health.

Rightly, we want people who are able to work to do so. However, any system that pushes people further from employment is not fit for purpose. The report makes a number of recommendations on changing the system, and I hope that the cabinet secretary will respond to the single recommendation that is aimed at the Scottish Government.

SAMH tells us that it welcomed the principle behind universal credit to simplify the complex United Kingdom social security system but that, unfortunately for many people, the aims

“have been undermined through its structure and delivery.”

The report’s first recommendation calls for the scrapping of the digital by default policy. The Scottish household survey found that only two thirds of households with incomes of £15,000 or less per year have internet access. Citizens Advice Scotland found that

“68% of people seeking to claim a disability benefit ... require assistance to make an online claim” and research by the Department for Work and Pensions found that

“24% of people with long term conditions could not register a Universal Credit claim online”, that 53 per cent needed support to set up a claim, and that 38 per cent of claimants need on-going support. That is a burden for many, particularly for those with disabilities and mental health problems, because telephone applications for universal credit are limited and claimants must provide evidence that they are digitally excluded. Of course, for some, libraries are an option. However, with many libraries closing or restricting hours in recent years, and given the mental health of claimants, applying online is an extremely difficult barrier to overcome.

SAMH highlights that the work capability assessment does not work for people with mental health problems. The assessors cannot adequately judge claimants’ mental health because they lack a full understanding of the wide range of mental health conditions and how they can impact on job searching and the ability to work.

While claimants are waiting for assessment, they may be required to undertake work-related activities and job searching. SAMH reports:

“This can be as much as 35 hours of job searching per week.”

If they do not do that, they can be threatened with sanctions. That is quite simply unjust and unfair for people with complex mental health problems, especially if those problems are coupled with physical problems.

Delays to assessments and lengthy waits can cause further distress and anxiety. In June 2018, the median waiting time from applying for universal credit to a final decision was 15 weeks. The report paints a clear picture that the process of applying for universal credit is flawed.

The process of managing the claim provides even more barriers for people with mental health problems. The first payment comes after five weeks and that delay is believed to be a deliberate choice by the DWP. I fully support SAMH’s recommendation that the unjustified five-week waiting period should be abolished.

Citizens Advice Scotland has found that, in areas where universal credit has been fully rolled out, there has been a 15 per cent rise in rent arrears and an 87 per cent increase in crisis grant awards. In two areas, there have been rises of 40 per cent and 70 per cent in advice on food banks. People with mental health problems should not have to face increasing poverty and debt. The report tells us that 86 per cent of people with mental health problems believe that their financial situation heavily influences their mental health. The social security system should not be designed to put people into debt and poverty. Advance payments are available, but those worsen financial problems because they are loans. It is sickening that those who are in the most desperate need are pushed further into financial hardship. There is absolutely no morality in that.

I could spend the rest of the evening going through the many informative recommendations and conclusions of the SAMH report and how people with mental health problems are being let down by a system that should support them. However, in the time that I have left I want to discuss the section of the report on the Scottish flexibilities. I hope that the Scottish Government can make progress on the recommendation in the report, and I hope to hear more from the cabinet secretary on that.

Some aspects of the delivery of universal credit are devolved, such as the frequency of payment, the ability to pay the housing element of universal credit to a landlord and the ability to split payments between members of a household. SAMH welcomes those choices and comments that they

“will assist people in managing their money and avoiding financial hardship.”

However, the report calls on the DWP and the Scottish Government to

“work together to urgently correct issues over the delivery of the Scottish Choices to provide assurance to Universal Credit claimants and landlords”.

People with mental health problems need assurances that those choices will in no way impact on their mental health.

The report tells us that the administration of Scottish choices

“has caused some problems to social landlords”, because payments to landlords are made in arrears and do not match the monthly schedule for payments to claimants. I hope that no person with mental health problems is caused unnecessary stress and anxiety because of those administrative problems.

I thank SAMH and the individuals involved in the case studies for the informative and valuable report. Due to the volume of information that it contains, I have not been able to reflect on the information directly from the case studies. However, if those individuals are listening to the debate, my message to them is that I hear them and I will be in their corner, and the corner of all those who find themselves in the social security system. We need a system that respects people throughout their claim and into work, and one that provides security and assistance, especially for people with mental health problems and physical disabilities.

The Deputy Presiding Officer:

I call Elaine Smith, who will be followed by Bill Kidd.

Photo of Elaine Smith Elaine Smith Labour

Thank you, Presiding Officer, for calling me early in the debate. I may have to leave before the final speeches and I apologise to Mary Fee and other members for that.

I thank Mary Fee for bringing the issue to the chamber. Most members will have assisted constituents who are suffering under universal credit and will want to challenge this unfair system and the way that it is working. Thanks are also due to the Scottish Association for Mental Health for the work that it has done to highlight the effect of universal credit and the processes that are involved in claiming it on the mental health of claimants. I should also mention Citizens Advice Scotland and thank it for its work.

The issue reveals yet another aspect of welfare reform that has been poorly planned and badly implemented and that penalises the most vulnerable in society. As the motion notes, the universal credit system

“has created new barriers and added pressures for people with mental health problems”.

Shockingly, it is not that long since we began to consider mental health to be of the same importance as physical health. It is therefore unacceptable that our social security system is now actively contributing to mental health problems.

Being assessed for an entitlement causes anxiety for any claimant, but the impact on those with mental health problems is particularly harsh. One of the most harmful aspects of the application process is the work capability assessment. SAMH’s report notes that the median time from application to final decision following a work capability assessment is 15 weeks, but there are cases where it has been significantly longer. It is easy to understand that such a timescale will cause distress and anxiety for some of the most vulnerable claimants.

Another issue is that of the online application, which can cause further stress and anxiety, particularly for people with no easy access to the internet—Mary Fee outlined the figures on that. The report shows that the DWP itself has found that 24 per cent of people with long-term conditions were not able to register for universal credit online.

A society can be judged by how it treats its vulnerable citizens, and the UK should be judged harshly for implementing a reformed system that piles anxiety on to people with existing health issues. Last week, Professor Philip Alston, the United Nations special rapporteur on extreme poverty and human rights, released his final report about his visit to the UK. He said:

“Much of the glue that has held British society together since the Second World War has been deliberately removed and replaced with a harsh and uncaring ethos.”

He also highlighted personal stories that he had collected that matched the growing body of research, such as SAMH’s report, about the negative impact of universal credit on mental health.

One of SAMH’s recommendations is that the DWP publish sanction statistics disaggregated by disability and medical condition. However, the report quotes a SAMH service user who said:

“The fear of being sanctioned is enough to ruin your life without [actually] being sanctioned.”

We need those figures, but we must also bear in mind the fact that the fear of being sanctioned can take a toll on people’s health.

There is no evidence that benefit sanctions incentivise people with mental health issues to get employment—I am not sure that they do that for anyone, but there is certainly no evidence that they do so for people with mental ill health. However, there is compelling evidence that they take a toll on mental and physical health. We need to re-emphasise the fact that, as Mary Fee said, a mental health problem does not manifest itself only as a mental health problem but also affects physical health.

Another point that I wish to highlight is the inadequate collection of data with regard to eligible claimants. If we do not know who is entitled to receive universal credit, how can we best ensure that everyone eligible receives it? That issue was recently highlighted by the Resolution Foundation. I would be interested to hear from the minister—although I might not be here to hear it in person—how the Scottish Government intends to increase uptake among particularly vulnerable groups, including those with mental health difficulties.

As the motion states, social security should exist as a safety net for the people of Scotland. It should not make them poorer or more disadvantaged and it certainly should not make a claimant’s health suffer due to the stress and anxiety that the system causes.

The SAMH report and the examples in it reveal yet another aspect of universal credit that is not fit for purpose, that penalises the vulnerable, that discourages applications and that needs reformed.

Photo of Bill Kidd Bill Kidd Scottish National Party

I thank Mary Fee for bringing this serious concern to the chamber.

I w elcome the report from SAMH, which details the ways in which universal credit does not accommodate the needs of people with mental health problems. Beyond that, the report recounts how the numerous changes to welfare are exacerbating pressures on a vulnerable group of people and are, in some cases, worsening the mental health problems that they face.

Today, we also debate in the context of the final version of the report by Professor Philip Alston, a UN special rapporteur, on poverty and the impact of universal credit in the UK. Professor Alston’s initial findings are referenced by SAMH. Over the past week, we have all seen the headlines and articles following that damning report on the extent of poverty. We have also seen the UK Government’s response of shrugged shoulders, and Amber Rudd’s point-blank denial of the report’s findings. The official DWP response implied that the report was unrepresentative. It said that, if the rapporteur had spent more time in the UK—which it described as one of the wealthiest and happiest countries in the world—it is likely that he would have reached a different conclusion.

The trouble with that denial is that it reveals a disconnection from the reality of poverty. Rudd’s response to the UN’s findings betrays an unbelievably disconnected thought process that leads to the belief that, somehow, the fact that some people live in comparative wealth negates the levels of destitution or extreme poverty in the UK. How else could her representatives suggest that a longer stay in the UK and exposure to different groups would change UN conclusions that were drawn in reaction to extreme poverty? The poverty still exists.

My Scottish National Party colleagues and I—indeed, the majority of elected representatives in this Parliament—see that the UN report’s findings are not false. I think that the UN and SAMH reports have laid bare the daily struggles and injustices that the poorest in society experience. I also think that the poorest are in that position not as a result of their own fault or poor money management; we live in a country in which there is a huge amount of not just inherited wealth but inherited poverty, which makes it hard for people to move out of the poverty into which they were born.

Over the past six years, universal credit has come to life—if we can call it that—under the Tories, following years of austerity and the benefits freeze. The implementation of universal credit has been accompanied by a rise in the number of food banks across the UK. That includes my constituency: four months after the roll-out of universal credit in Drumchapel, another food bank opened.

SAMH has shown in its report that delays and the digitalisation of universal credit, which Mary Fee and Elaine Smith mentioned, have caused significant stress to recipients who are already struggling with mental health issues.

We live in a prosperous, innovative and culturally rich nation. The most dramatic inequality in society today is the extreme wealth inequality. We have a responsibility to people who face the hardship of poverty and the mental health issues often related to it, to recognise our ability as elected representatives to tackle poverty head on.

I am proud to represent a party and a Parliament that have used the powers available to us to prioritise tackling child poverty. Indeed, in talking about our new social security system, Professor Alston talked about

“ambitious schemes ... guided by the principles of dignity and social security as a human right”.

Scotland has worked hard to secure the lowest levels of poverty in the UK, but, unlike some voices in Westminster, I will not say that profound poverty does not exist. It does. By tackling the injustice that is poverty, we can create a situation in which people are accorded value and dignity, as they should always be. That should be our goal at all times.

Photo of Michelle Ballantyne Michelle Ballantyne Conservative

For someone who is suffering from poor mental health, dealing with life is a challenge, even when things are going well and the person has all the support that they need.

I know from my nursing and psychiatric experience how mental health impacts on individuals’ ability to deal with stressful situations. Navigating the maze of benefits will never be anything but demanding.

For nine years, I headed a drug and alcohol unit. Many of my most vulnerable clients struggled with benefits and the lack of support that used to be the hallmark of jobcentres. It was left to voluntary agencies to get people financial assistance and opportunities to enter the job market. Alongside other agencies, SAMH provided excellent support in the Borders, so it is sad that it has had to close its doors in Galashiels.

The arrival of universal credit has seen major changes—not just in how benefits are delivered, but in how clients are supported in accessing help. SAMH’s report explores some of the challenges, and recognises the barriers that people with mental health issues might face. SAMH has provided an effective overview of the challenges and has made good recommendations. Nonetheless, it is essential to recognise that the supporting evidence for the report predates many of the changes that are being trialled, or which have already been implemented during 2018 and 2019.

A lot of work has gone into ensuring that jobcentres are welcoming, with carefully designed layouts that minimise the stress that individuals might experience. All departmental staff who work with claimants now complete extensive training that prepares them for their role. Specific training is provided on working with vulnerable groups, including claimants with mental health conditions. An enhanced mental health training package has been delivered to 19,755 staff, and plans are developed for delivery to 34,000 more staff across a number of directorates.

Following a review in 2018-19 of delivery of training, and work with stakeholders including work psychologists, further enhancements have been made to learning and development material. The material has been tested as part of the test-and-learn phase, prior to national roll-out from June 2019.

In addition, the DWP announced earlier this year that claimants with mental health problems would be fast-tracked to support from the jobcentre. Medical experts will be stationed in jobcentres to give on-the-spot assessments, and will have the power to refer people for treatment. That new approach is being trialled in a joint venture by the national health service and the DWP in Buckinghamshire and Milton Keynes. If it is successful, it will be rolled out across the UK.

Nearer to home, the DWP is trialling a virtual reality jobcentre in Glasgow to help people with autism or heightened sensory awareness to feel comfortable about accessing a jobcentre. Citizens Advice Scotland is now providing the help to claim service, which will support vulnerable claimants to ensure that they can navigate their entitlements and apply successfully. All claimants, including those with mental health conditions, receive continuous tailored support through their personal work coach.

I hope that colleagues across the chamber will welcome those developments, and that SAMH will watch them closely and report on their success in its next report. It is incumbent on all of us to ensure that all services that we provide are accessible and usable by all claimants. People who have mental health conditions need extra support and extra services. I, for one, am glad that people are taking notice of that, and are working to make sure that claimants get what they need.

Photo of Alison Johnstone Alison Johnstone Green

Our social security system should do what it says on the tin. It should be there for all of us when we need it, to provide support and security. However, too often, it does the opposite: it can foster insecurity, anxiety and—as the title of the report that we are debating today acknowledges—confusion.

That is bad enough for anyone, but it is of particular concern for people who experience mental health conditions. Universal credit increases the scope of benefit sanctions without any strong evidence that they work. In fact, as Elaine Smith noted, there is clear evidence that they can do much harm, especially for people with mental health conditions.

A five-year research project, which was a collaboration between six universities, examined sanctions and found that

“application of welfare conditionality exacerbates many disabled people’s existing illnesses and impairments. Its detrimental impact on those with mental health issues is a particular concern.”

For mental health issues to be taken into account in the claimant commitment, they need to be disclosed, but the SAMH report tells us that the need for disclosure is a significant source of distress for people with mental health conditions, who might not have the confidence to discuss their mental health at their first meeting with a work coach. It is also not clear that work coaches are able to provide the necessary support when mental health conditions are disclosed. The DWP’s research found that work coaches feel overwhelmed by the number of claimants with health conditions, and that they lack the time and training to identify vulnerable claimants confidently.

It also worth noting that, in contrast to the old system, conditionality can be imposed before health assessments are conducted. It is possible that someone might be subject to conditionality, and therefore to sanctions, while they are waiting for an assessment that will later exempt them from conditionality. In essence, they are presumed guilty until proven innocent. I was particularly proud to stand on a manifesto commitment to ensure that devolved employment programmes would be entirely free from sanctions, and even prouder to see that being implemented by the Scottish Government.

The report also makes it clear that the work capability assessments that are part of universal credit do not work for people with mental health conditions. As the SAMH report says, the assessments do not capture the impact of mental health and other fluctuating conditions, and assessors are not always aware of how mental health conditions impact on a person’s ability to work.

The WCA can make mental health conditions even more severe. A study from Heriot-Watt University and Edinburgh Napier University of 30 Scots claimants found that

“The WCA experience for many, caused a deterioration in people’s mental health which individuals did not recover from. In the worst cases, the WCA experience led to thoughts of suicide.”

That is made even worse by the fact that the WCA is, as the DWP admits, one of the major reasons for late payments, which disproportionately impact people with mental health conditions, and can leave people for months on end without certainty as to when they will get their full amount and what it will be, which itself can have an impact on mental health. That would be of concern to anyone.

Colleagues will have experience, as I have, of helping constituents who are worried sick about the WCA assessment. In many cases, it takes representations from members of the Scottish Parliament, MPs and welfare rights experts for pre-existing evidence to be considered properly, and for assessments that are a risk to health to be cancelled.

The report relates to UK universal credit, but there are clearly lessons to be learned for the new Scottish system, because a large number of people will be receiving a Scottish devolved payment in respect of a mental health condition. We have made a good start.

As a result of a Green amendment, the face-to-face assessments that caused so much stress will be banned unless they are the only way in which evidence can be found, or a person requests one. However, we need to do more. I hope that all Social Security Scotland staff who interact with applicants will receive training in how their work can impact on people with mental health conditions.

The assessment criteria for disability assistance must recognise that introduction of the personal independence payment has meant that more than 50 per cent of those receiving disability living allowance for the two most common mental health conditions have either been denied PIP or have been given a reduced award.

I thank Mary Fee for bringing this important debate to the chamber, and I hope that it urges the UK Government and the Scottish Government to put respect for mental health at the heart of the reserved and devolved social security systems.

Photo of Shirley-Anne Somerville Shirley-Anne Somerville Scottish National Party

I, too, thank Mary Fee for bringing this important matter to the chamber for debate. She said that social security should be available to all in times of need, but that the current system provides neither safety nor assistance. I could not agree more. It is sad but so very true that the current system does not do that.

The Scottish Association for Mental Health’s report into the impact of universal credit on people with mental health problems makes for stark reading. It clearly shows that universal credit is causing hardship and emotional distress for people with mental health problems, and rightly makes several recommendations for change. The report adds to the growing evidence, and to similar reports from other organisations, about the impact that universal credit is having on the people who are forced to rely on it.

I would like to tackle some of the issues that the report raises about universal credit, although, as we know, the list is far longer than I have time for this evening. The minimum five-week wait for the first payment is simply not acceptable, especially when there is no guarantee of the correct payment at the end of that five-week wait. Mary Fee rightly pointed out how long people have to wait in reality, which is much longer than the minimum of five weeks. Many people are therefore left with little option but to take up the DWP’s offer of an advance payment, which leaves them in debt from the very start of their claim, because they are required to pay that back at a rate of up to 40 per cent of their standard allowance each month. That has had a damaging impact on the levels of debt affecting individuals and of course, understandably, on their mental health.

Many speakers mentioned the punitive sanctions regime that underpins universal credit, which is causing profound anxiety and stress for many people. There is mounting evidence—Alison Johnstone discussed a recent five-year study—that the current approach to sanctions and conditionality is not only ineffective but is having an exceptionally damaging effect on people’s health and wellbeing, as well as pushing them further into poverty.

Elaine Smith and Mary Fee rightly pointed out concerns about the work capability assessment. Another issue is the digital by default policy. There can be nobody in this chamber who has not had heartbreaking constituency cases of individuals who have come to their surgeries who have no access to a computer, email or a mobile phone, and therefore no chance to apply, never mind keep their journal up to date. I am particularly struck—I am sure that others will be, too—by the individuals whom we have attempted to assist with that process. It is simply unacceptable that people are put in such a distressing position in the first place.

SAMH recommends that nobody should be transferred over to universal credit through the processes of natural or managed migration. The Scottish Government has repeatedly called on the UK Government to stop that from happening while the system is so clearly unable to cope. It is unacceptable that anyone should be forced to claim universal credit when it simply cannot provide them with the support that they require. We have raised those points and more with the UK Government countless times over the past few years. We know that universal credit is not fit for purpose, and yet people are still forced to rely on that broken system.

The report rightly recommends that the Scottish Government works with the DWP to overcome the administrative issues with the delivery of Scottish choices. I recognise that the DWP’s existing payment scheduling process for direct payments to social landlords, which is used for UC Scottish choices, can make it difficult for landlords to accurately manage their income.

Although the policy on direct payments to landlords is devolved, the systems sit solely with the DWP, and only it can make changes to them. We have repeatedly called for the DWP to move on the issue, and I am pleased to say that it has now confirmed that it will develop a replacement method of payment by the end of 2019. I hope that that alleviates the concerns of social landlords and their tenants, and that it will ensure that, under Scottish choices, landlords will be paid on the same day as their tenants.

I have spoken about the SAMH report adding to the growing evidence that universal credit is not working. Last week, the mountain of evidence grew further, as the United Nations special rapporteur on extreme poverty and human rights, Professor Philip Alston, published his final, damning report following his visit to the UK last year. It is exceptionally hard hitting and makes a very sobering read. Elaine Smith, Bill Kidd and other members have rightly mentioned its conclusions. Professor Alston was particularly scathing about universal credit, and he criticised many of the problems that the SAMH report raised. I know that Michelle Ballantyne tried to reassure members that a lot of work has taken place that the SAMH report perhaps did not take account of, but the United Nations rapporteur would certainly have been aware of all of that, and it would be fair to say that he is far from convinced on that argument.

The Scottish approach to the 11 benefits that we will take responsibility for in April 2020 could not be more different from the approach that we have seen with universal credit. We are building a system with people and we are listening to their experiences of the problems with the UK system, to ensure that we deliver a service that meets the needs of the people of Scotland. We see social security as a human right and an investment in the people of Scotland. Our system will be an inclusive and accessible one, and we will remove barriers for people, not put them in the way.

Members have picked up a number of particular points in the debate. For example, Elaine Smith spoke about the Scottish Government’s requirement to improve the take-up of benefits. She will, of course, be aware that we are obligated to do so through the Social Security (Scotland) Act 2018. We will develop the take-up strategy, which is due for publication this autumn. That is not just because that is in the legislation; ensuring that those who are eligible are encouraged and supported to take up their eligibility is the right thing to do.

I want to pick up the point that Michelle Ballantyne raised about the practice of virtual jobcentres, which the DWP is introducing. That approach may work for some people, but I say with the greatest respect to Michelle Ballantyne that people need to have a real jobcentre to go to after that, that the closures of jobcentres in Glasgow and other areas make it increasingly difficult for people to be able to access what they are eligible for, and that that is causing extreme hardship and distress for many. I am afraid that virtual jobcentres simply do not cut it.

Alison Johnstone mentioned training staff for Social Security Scotland. I reassure her that the agency and I are taking that very seriously. That is training not just on mental health, but on all issues, to ensure that everyone who works for Social Security Scotland—not just client advisers—has an understanding of the barriers that people face and the challenges that people will face in even approaching or thinking about approaching the agency. I will, of course, keep the Social Security Committee, of which Alison Johnstone is a member, fully updated on our work on that issue.

I conclude by quoting the report. It says:

“structural issues with Universal Credit ... are direct obstacles to people with mental health problems accessing essential support and financial security.”

I could not agree more. I fully support the motion and urge the UK Government to consider the report very carefully along with the countless others and their findings, and finally to make the changes that universal credit so desperately requires.

Meeting closed at 17:39.