New government figures show key policy at heart of disability employment strategy ‘will not work’

A key treatment that ministers have placed at the heart of their strategy for pushing people with mental distress and ill-health into paid work has only a tiny impact on the probability of them securing jobs, government figures have shown. 

Disabled people’s mental health groups say the figures destroy the government’s case for “using mental health interventions as a stick to enforce work” and have called on ministers to rethink their “harmful” disability employment strategy. 

The government placed an expansion of NHS Talking Therapies – which already costs hundreds of millions of pounds a year – at the centre of last month’s Get Britain Working white paper.

The white paper announced: “To tackle poor mental health, the leading driver of ill health-related inactivity, the government has committed to continuing to expand access to NHS Talking Therapies for adults with common mental health conditions in England.”

The white paper claimed that “extensive literature and studies” showed that NHS Talking Therapies improved employment outcomes.

The last Conservative government had also placed a massive expansion of NHS Talking Therapies at the heart of its own Back to Work Plan last year.

Last month, the new Labour government’s white paper mentioned a forthcoming evaluation of the impact of NHS Talking Therapies.

But when that research was published last week by the Office for National Statistics (ONS), there was no mention of it on the Department for Work and Pensions (DWP) website, and no press release issued by work and pensions secretary Liz Kendall.

What the ONS research showed – based on analysis of nearly 600,000 people* with “common mental disorders like anxiety and depression” who completed NHS talking therapy – was that this treatment had almost no impact on the probability of being in work after seven years.

After three years, there was an increase of just 1.4 percentage points in the probability of someone being a paid employee, and after seven years that had increased to only 1.5 percentage points.

To qualify as being a “paid employee” in the study, someone only needed to have earned more than £0 in a month.

After three years, the average increase in monthly earnings for someone who had completed the treatment was just £17.

The impact of the therapy was even lower for disabled people who had not been working before the therapy began, with the probability of being a paid employee even decreasing in the first couple of years after treatment, and then only rising by 0.1 percentage points by the sixth year, although it increased by 0.6 percentage points after seven years.

The research also found that average monthly earnings fell after talking therapy for disabled people who had not been working before the treatment started, dropping by nearly £16 in the first year and as much as £23 a month by the seventh year.

Amy Wells, senior communications and membership manager for National Survivor User Network, said: “It becomes ever more transparent and worrying that our government is intent on pushing disabled people — and those living with mental ill-health — back into work, in place of genuine, comprehensive support. 

“Little regard is being paid to whether it is possible or beneficial for disabled people to get ‘back into work’, furthering the rhetoric that people are not valuable beyond their contributions to the economy.

“The majority of investment for these plans is being funnelled into talking therapies, with the expectation of its ability to ‘support’ people back to work, which has now been shown to have a very insignificant impact on individual employment status.

“What this new data shows is that the government’s plans are not only harmful, but that they also will not work. 

“We find these developments incredibly disappointing and call for a rethink of the government’s strategy around disability employment.” 

Rick Burgess, a spokesperson for the grassroots, user-led mental health group Recovery in the Bin, said the ONS data “destroys the government’s case for using mental health interventions as a stick to enforce work” which instead was “just a fig leaf for cuts”. 

He said: “The tiny statistical positive effect does not justify the polluting of healthcare with coercive work requirements.”

He also pointed to the ONS research stating that only Asian and white ethnic groups saw statistically significant positive impacts from the therapy on their monthly pay and chances of being in paid work, which he said shows the policy is “racist” and that DWP is “proposing a policy that discriminates”. 

And he said there was “growing scepticism of the efficacy and suitability of cognitive behavioural therapy**” within the talking therapies programme. 

He said: “This leaves Liz Kendall yet again claiming policy success while evidence proves the opposite, and trying to hide £3 billion in cuts. 

“There is simply no future in the DWP’s approach, yet they flog this dead horse because the suffering is borne not by them, but by us, as the prevention of future deaths reports mount up.”

Asked if the ONS figures destroyed Kendall’s strategy of placing an ever-increasing reliance on talking therapies to push people with mental ill-health into work, and whether the tiny increases reported by ONS justified the substantial investment in NHS Talking Therapies, a DWP spokesperson said: “We are confident NHS Talking Therapies is a beneficial service that has a positive impact on those at risk of falling out of work due to ill health, with several studies demonstrating its health and economic benefits.

“Along with the expansion of Talking Therapies to an extra 380,000 patients, our £240 million Get Britain Working white paper gives local leaders the power they need to join up local work, health and skills support so more people can get into work.”

DWP also pointed to the government’s plans to invest £26 million in opening new mental health crisis centres as part of last month’s budget.

*Individuals referred to NHS Talking Therapies between 1 April 2016 and 31 March 2020; who attended at least one therapy session; were considered to be a “clinical case” for anxiety, depression or both; were between the ages of 25 and 60 years on the day of the referral; and were resident in England

**One of the most common talking therapies used in the programme

Credit for this article goes to the Disability News Service