Mental Health of the Long Term Unemployed

Would you welcome behaviourial management and intervention staff training for frontline staff?
It appears that staff are often exposed to clients with a range of mental health issues and a) are not sure what signs to look for and b) do not necessarily know what to do with the client if /when it presents itself.

(These are the clients who are often classed as hardest to help, difficult,time wasters etc the ones who the system fails)

The majority of welfare to work services are targetted on job outcomes and this has therefore seen an increased pressure on job entries for clients and staff. With depression now quickly becoming the second most common illness in the UK coupled with the soaring unemployment figures (with the overt link between the two) it is now imperative we have more of an understanding on how to help these people. Do you think if staff could identify the barriers candidates face that they would benefit from mental health training in addition to having a broader knowledge of mental health?

I welcome your feedback on this topic

There's something of a leading question in there, but I'd certainly imagine that support in improving mental health and associated job readiness (confidence, presentation, communication skills etc.) is important. The barriers highlighted by the ippr report don't just include a need for training though. The major barrier is that adviser caseloads are simply too high, through a combination of increasing numbers of customers and very tight budgets. This makes personalised service very difficult to implement.

I appreciate your viewpoint on this Daniel, however if staff caseloads are increasing and they are missing the very crucial point in being able to recognise when a client in front of them is clearly sufering from some form of mental issue whether mild moderate or critical surely training could be part of the solution to assist EA to identify which clients are indeed clogging up the system (the hardest to help) and therefore needing to be signposted to other relevant and or appropriate agencies before being in the job ready market.
p.s I'm not sure what you mean when you say a personalised service? the training has to address client facing staff.

Personalised support involves empowering client facing staff to create a tailored package of support that meet the individual needs of each customer. For this to work, they need both the skills and resources. My assumption was that your question linked into this, but looking at it again, you seem to be advocating for mental health training separately from that wider agenda. Apologies for the misunderstanding.

I'm aware of several providers that have given mental health training to their staff, but don't know how useful they've found it. Does anyone with actual experience care to comment?

North East London Mental Health Trust did some work with their local jobcentre district in training their advisors in this way. The whole thing has been cited as good practice a few times but the evaluation (done the London Development Centre Care Services Improvement Partnership) wasn't that conclusive because data protection issues meant outcome data couldn't be shared.

I was astonished to read a suggestion that JSP advisors should know clients are experiencing mental health issues just by looking them . How ignorant are you!!!!!

Many JSP staff and are intitutionalised.Training in mental health isses would probably go over their heads.Perhaps if you spent time networking with organisations like Hearing Voices or (this is the bit that gets me because no one every considers it) ask people who are expereincing mental heath issues, 'how they would like to be helped'into work then you would have a clear answer !!!!!!Simple!!

This is a subject I am passionate about.

That passion definitely comes through. The suggestion that started this topic, to which I think you refer, is about spotting mental health problems during an interview. I suspect it takes a certain amount of time and relationship building to uncover many mental health problems, but there are other ones that may be readily apparent in the course of a brief conversation.

Mandy, thanks for your comments. This topic was posted to invite comments such as yours and also to raise a platform to a healthy discussion. The suggestion that JCP staff couldn't or wouldn't undertand mental health training is I suppose quite shortsighted,dependant on how the training/coaching was levelled. Obviously, training around mental health needs not to be so technical that you need to be a therapist to take on board your learning but merely to be able to assist you to help your clients.Surely its so that people like yourself are equipped to do your job to the best of your abilities (knowing that you care and genuinely want to help) and having been provided with the tools, awareness and a level of understanding to identify different courses of action that could be taken with the client in front of you. I think asking clients what they would prefer is equally valuable but it's worth acknowledging that you as Advisors still have these clients coming through your doors everyday. If a client has a form of mental illness IS IT appropriate to be having a conversation with them about getting a job? Surley, this is probably far from ideal for them too. So its about having an awareness of Mental Illness commonalities that you as Advisors can pick up on, how it presents itself what signs and potentially what symptoms on a very basic level could you lookout for in order to recognise that traits can you look out for that would indicate that actually 'I need to change direction with the conversation that I'm having' and maybe some signposting to a relevant agency would be more fitting at this stage. With the ever increasing targets that your working under this does not fill a job entry at this stage but you are helping your client to be in the right place for his/her emotional state at this point and eventually with the appropriate intervention when they are next with you cause thats almost a certainty there are closer to the labour market than they were and your not left frustrated with clients that appear lazy or clearly misunderstood.

Firstly, I am not JSA but, have worked in the mental health system for 15yrs; advocate for 4yrs and teach the subject. Depending on the severity of mental ill health (long term or short term) and on the persons attitude: refusal or acceptance that they have an imparment (revolving door sydrome) then this can make it difficult to prepare people for work from the onset ;even before any unknowing advisor attemps to engage them.

With this in mind, I think JSA need time to develop a rapport and trust with this specific group.I do not suggest developing a dependancy culture. Yet, believe me, asking someone 'how they would like to be helped' back to work really does work !! In so doing, your sending out a message that you really want to help them into work...

I guess I am lucky that my extensive knowledge of mental health makes it easy for me to engage with studnets'/job seekers.

Hang on a second - I thought jobcentre plus folk were there to help people into work and not try to diagnose mental ill health disorders? Unless the customer self-identifies they have a mental health issue they feel impacts on their ability to work, then it really isn't the jobcentre plus advisors place to try to make this diagnosis. And on what basis would they make these kind of judgements? And also what is the benefit? This seems really intrusive - I'm with Mandy, the questions we should be asking anyone is whether they want help into work and if so, what sort of help do they want?
And - why wouldn't it be appropriate for a JCP advisor to talk to someone about a job? It's the jobcentre, that's what they are there for! I would have thought that that would be far more appropriate than intimiating to someone that you don't think they are 'normal' and could benefit from mental health care!

Job Centre Plus ARE looking at getting people into work, however to optimise the chances of doing this a client clearly needs to be job ready. If a client is facing multiple barriers, why would it hurt for an advisor to have basic knowledge to try to constructively challenge an attitude or at least have access to relevant organisations who can help? You talk about asking people who matter. I work in the welfare to work arena and have asked a multitude of my clients whether they would feel better knowing the organisation they were attending had staff trained to understand their illness and have the right idea how to best deal with them. Every one of them said they would.

The problem we have is that too many people are ignorant to mental illness which means they have neither the patience or the inclination to deal with it accordingly. If you take depression as an example, failure to attend an appointment (which can often be down to despondent moods) is misconstrued as a lack of motivation or even laziness resulting in a unhelpful and inappropriate course of action being taken against somebody who actually is in real need of some help and guidance.

I know a lot of JCP advisers that go out of their way to help jobseekers that suffer with depression and other forms of mental health. On the subject of NON-ATTENDANCE however it seems a lot of these people never seem to miss their appointments at the jobcentre when it relates to getting their benefits no matter what despondent mood they are in.

try home visits

If they're been diagnosed as suffering from mental health issues, then surely they would no be claiming JSA but another benefit such as Incapacity?

The sentiment that every jobseeker who is diagnosed with a mental health issue (they can be extremely mild and controlled to different degrees)automatically wants to go onto an incap benefit is a rather naive one. This is definitely not true. I have witnessed many many times people unwilling to declare all sorts of 'barriers' on the grounds that they feel it may result in discrimination and prevent them from getting a fair chance at vacancies. Its therefore important that advisors, and people in general I might add, have an understanding of as many barriers people face as possible so they are able to empathise and reassure the people they are working with.

I have been on and have commissioned training for advisors on many 'barriers', including mental health, and would advocate anything that improves and promotes understanding and learning for people in these roles. What is essential though is that any training given to staff in client facing roles is undertaken by their managers/ supervisors too, so the staff have their support and understanding for what they are going through themselves.

Also, the use of the word 'normal' in one of the comments above reinforces the need for more education in this area - "I would have thought that that would be far more appropriate than intimating to someone that you don't think they are 'normal' and could benefit from mental health care!"

Define 'normal'?

What we can't do is put front line staff in a position where they feel they have to be able to diagnose mental health issues and make a referral on the back of it; instead we should be looking at providing them with the tools to facilitate the persons own acknowledgement of their potential barriers and then providing the appropriate advice on where they might find extra support - should they wish to pursue it. If however this is not forthcoming from the person then at least the advisor is equipped to build rapport and maintain the relationship.

I think Job Centre Plus should employ JSA who have worked in the Mental Health system. It is the most logical step. Job Centre Plus should also be employing people who have specific skills such as: building, catering...........etc etc.
Although this is off topic, many users of Job Centre Plus can often feel as though they are knocking their head against a brick wall talking to someone who has no knowledge about their area of expertise.This is where the system fails! highly qualified people entering Job Centre are often left to 'get on with it'.

Refering back to my previous point about employing JSA with specific occupational knowledge; one advantage is, these people will already be at the 'coal face' so, you would expect that they can easily negotiate with job seekers who are looking for jobs in their vocational/accademic area of expertise.
Another advantage is, these groups of JSA will have established network ; thus, enabling people back into employment much more quickly.

JSA managers, many of your employees are at entry 3 so would benefit from literacy classes.

This may be a silly question but what is the Mental Health System doing themselves to sort this problem out before they get to the point at JCP when they need to be sent to things under direction. If what they are doing is failing then should we not try a another approach.

If we trained up the JCP to deal with Mental Health Issues as suggested then would we not eventually put the Mental Health Service out of work?

Would it not be better for us all to work together on this, ie Mental health Service dealing with health issues and JCP staff working on getting people in to work with some inter agency communication between the 2.

A lot of the work being done by the ippr personal advisers project hinges on the idea that there will be increasing crossover between the different 'silos' of expertise in the future. That is, having different advisers dealing with housing, debt, benefits, job search, training, mental health, physical health, disability support, criminal rehabilitation, drug abuse and so on is potentially a barrier to getting a good, joined up service.

There are a number of ways of taking it forward, but getting advisers across the piece to develop a basic shared knowledge of the skillsets from other types of support *seems* like a useful starting point to providing a more integrated service.

Seeing as its hard to even get accurate advice from the JCP on matters the JCP are meant to be experts in, what realistic hope is their of them being able to provide more specialist help?

Whilst a basic understanding of mental health issues would help somewhat, the staff should never be put in a postition of diagnosis, or expected to advise people with mental health issues, nor issue sanctions etc to people with mental health conditions.

I feel, that if they want to be ethical, fair and do the right thing, in circumstances say when a client has been told they are capable of work by ATOS, yet the JCP staff thinks the person still has problems, they should report their concerns officially to management, and put in a complaint to ATOS. They can also raise the issue with the General medical council should ATOS continue to keep sending people back to the JCP as having no problems when its clear to the JCP advisor they do have problems.

That is the only way, force ATOS and the DWP and even the GMC to deal with the issue once and for all, do not try to muddle through, do not try as a non medical mental health specialist to try to use your own feelings on the subject, you are quite likely to make that persons mental health deteriorate. Its only a matter of time (if its not already happening) before deaths occur.

Management should also be encouraging this, and strongly opposing any moves to make JCP staff take the job of medical diagnosis in any form,as at the end of the day, it really is only a matter of time before someone takes the DWP to court and gets someone very senior jailed under the corporate manslaughter act (not a expert on this, it would not suprise me if they have specifically managed to exclude themselves from this charge somehow by legislation, but if not then they should worry).

If the actions of the JCP or ATOS lead to a death, and its directly linked to the treatment/diagnosis, then not only will it look bad on the companies/departments, it could possibly lead, as I say to jail time.

ATOS HCP staff are meant to be trained to deal with these issues, but look at the failure rates and see how many are overturned at appeal, proving that even these so called specialists get it wrong very often.

Now the test has been apparently made harder to pass on purpose, even more people will fail, and as is being stated in the comments, its obvious its failing many genuine claimaints who need the benefit.

Ps, I would also say the same should apply to the providers/trainers, they should be complaining and reporting officially any people they get who have clear mental (or physical) problems - if you get anyone who its felt should not have in your opinion passed the medical, then its vital you also act as a safety net and report your concerns, again failure to do so, knowingly carrying on working with someone not fit for work is a breach of health and safety, human rights and is morally, ethically wrong. Stuff the fact you may lose a bit money on that claimaint, report it - make a fuss, or risk the bad publicity that one day will hit the fan, and maybe even risk jail time under the corporate manslaughter act.

Its not much to ask, for all concerned to raise genuine issues where its clear they need to be addressed, and failing to do so can, and does have terrible consequences for the long term health of those affected, and longer term will come back to bite the companies big time.

Its just my opinion, and its not one I really can see many people taking on board, as at the end of the day, most people seem more money orientated/frightened of looking like a troublemaker/unable to think and would rather take the money and to heck with the people they are supposed to be helping.

But I could be wrong, maybe people are decent? Only time will tell.

I wish someone would have thought to compare the mental health of someone prior to starting the New Deal program and what it was like at the end of the 13-weeks.

"they are missing the very crucial point in being able to recognise when a client in front of them is clearly sufering from some form of mental issue".

Hiding your problems and pretending like everything is fine (even to yourself as a protection mechanism) is a very common feature of depression/mental illness. I'd wager with a majority of sufferers, if they have decided to brave going out into the world there is no way any advisor would ever be able to tell.

The idea of agency staff being able to provide any real help is laughable, the idea of there even being any real help within the NHS is laughable. All training could usefully do is provide a basic outline of the facts around depression and encourage compassion.

"If a client has a form of mental illness IS IT appropriate to be having a conversation with them about getting a job?"

Is it appropriate for someone who thinks people with depression are, as a rule, incapable of working to be employed by JC+?

I am speaking from person experience here - I once knew someone who suffered from 'Manic Depression' inspite of having period where he was very very ill, never every claimed JSA. He used to sign on with local agencies, work for a while, then spiral back into depression. He never ever told agencies that he suffered from depression- he hid is well.

The moral of the story is that many people who have enduring mental health issues never claim JSA in the first place. Some don't even know how to make a claim it ... some don't even think they are entitled to it.

I'm sure the nature of the modern British economy, with an overabundance of short term insecure low paid temporary work means there are increasing numbers of employed people suffering from mental illness to varying degrees, even if they are not always aware of it.

Quick comment from a provider who provides exactly this service !! In West of England District we have been providing 2 services currently called mental health counselling and mental health assessment for mainstream ND/JSA customers since 1999. It works very well cos it opens up practitoners with the right training to JCP Advisors and their customers as part of their ND action plan (the customers that is). We've seen many hundreds of people with varying degrees of health conditions and it's been a fascinating and rewarding activity. FFI messages thru your friendly local site moderator I guess

Is the last posting appropriate, I think not!
This is an interesting debate and its worth hearing how staff would be best helped whilst they find themselves working with clients who have either mental health issues, low self esteem and no hope! to to the job of getting the long/short term unemployed back into work

Found out about a new project due to be launched in the North in 2 weeks - IAPT service /workers support people with enduring mental health issues back into work. Sounds very intresting, I wounder if this project works...

The DWP have a very intensive approach on the Pathways to Work programmed, via the use of PIGEEP: Preparation, Introduction, Explore, Evaluate, Plan. I heard from a local counseling charity that individuals that have been through the Pathways to Work programmed have been traumatized. The DWP approach also adopts the Solution Focused Approach that was developed by Steve de Shazer. From anecdotal evidence I gather that coercion has been used by the DWP to get people with mental health problem to take on work that is totally unsuitable. The Mind and CAB websites have got accounts of this; not sure if they are still there though. I doubt that the work that is being offered to people with mental health problems is sustainable well (enough to live on) long-term work, why would an employer employ someone with a know mental health issues, unless they can offer something more that a person without one.

PIGEEP is an interviewing structure adopted by JCP advisers Ive used it for many years both as an adviser and adviser manager for observational purposes both in JC and my team now . It is just an interview structure/ a framework - nothing scary -

You missed out G for the most important element which is GOAL - unlocking the goal technique is used throughout the interview -

Ive been an adviser since 1993 and without this structure the adviser is free wheeling I for one like the structure and the outcome I get with the customer . The interview is professionally carried out, meaningful and has a purpose, both parties understand what is required in the action planning process - any interview with our customers is only as good as the questioning technique adopted by the adviser and the influencing technique to formulate a plan if someone leaves traumatized its the advisers interviewing skills that are in question not the process.

Had anyone given thought to disabled people who are signed off incapacity will also have direct payments taken away ?? double wammy!!

Anno

Each JCP differs in the way they handle customers. For example,one JCP I had the misfortune to visit was a complete disaster. The attitude of some, not all, advisors was terrible.It bordered on the verge of bullying. I was also shocked to find written on pc screen a catalogue of jobs which I had supposedly been sign posted to.The only trouble was, I had not even heard of half of them...Odd,very odd indeed, perhaps the JCP fairy made them up, then decided to magically typed them onto the pc screen so that it didn't look blank upmmm ahem ahem

I've not had any help from JCP at all !!!! seems they don't know what to do with professionals...............

I should get a job working for DWP health sector, then again some of the managers don't even know as much as I do about mental health/health lol . I recently found myself at a conference giving advice to a senior relations manager earning 50 grand a year lol . ehhh perhaps I should apply for their job lol

Mandy wrote: "I was astonished to read a suggestion that JSP advisors should know clients are experiencing mental health issues just by looking them . How ignorant are you!!!!!"

Let me speak as a 'client' here. Having been reduced to crushing poverty and street homelessness, loss of every stick of property we ever had, uplift and crushing of our transport and only means of effective work as a contract elec foreman and complete cessation of my career through the maladministration, and general pig ignorance of one particular staff hack in 2003 and thereafter maintained in this condition by the combined collaborative denial of every DWP wonk I've ever had dealings since; I have been living with un-medicated chronic depression for five years.

It got so bad that against all instinct I had to resort eventually to a doctor who informed me that I was suffering with long term moderate to severe depression and prescribed Citalopram. For those who have never encountered this concoction it is a robust anti-depressant of the SSRI group whose side effects and contra indicators include reflexive and persistent yawning, streaming eyes, extreme mental dissociation, cognitive disruptions (the mind wanders off into a corner with its yo-yo)disruptions to motor function and co-ordination, tremor,and a fierce and alarming tachycardia. I was at the time preparing for a City and Guilds 2391 Elec. Inspection, Testing & Certification in the attempt to rebuild our life after the DWP's brain dead 'intervention' (you know; one of those REAL qualification things!) for which I HAD FOUND THE FUNDING WITH ABSOLUTELY NO ASSISTANCE WHATSOEVER FROM JC+. It is an incredibly intensive and technically demanding course and demands total concentration upon the subject. What do you suppose happened next?

Yep, that's right, I was informed by my whey faced NDPA during yet another of a string of utterly futile box-ticking WFI's (during which I'd consistently ripped her a new one and took apart the futility of The ND25+ 'program' in excruciating detail and asked her to justify her salary) that I must now attend a 'placement' with some contracted provider of group hugs called WorkFirst. 3 WEEKS DAYS BEFORE THE FINAL EXAM?!!! Well I sat there in front of this incompetent with eyes streaming, shaking like a ******* dog, sneezing reflexively after every uncontrollable yawn and practically bouncing out of the chair with the effects of the arythmia, did she notice something was amiss? No of course she didn't! Even when I apologised for taking three attempts to gather the psycho-motor memory needed to construct a legible signature she didn't acknowledge my condition. EVEN when I dropped the packet of tablets on the desk it still didn't register with her that something was seriously wrong!

What do you think the result was when I forgot to attend the follow up WFI because I was totally fixed on the achievement of this C&G (basically £2000 worth) yes folks, with the exam 7 days away and my missus in thefinal month of pregnancy she thought it best to apply a sanction as "an incentive".

To the Devil with the lot of them and all of their ilk. I despise all similarly unthinking, cretinous jobsworths with a passion uncontested! I suspect most of you fall into this description as although from reading these posts I guess most of you would profess to have the client's interests foremost in your professional thoughts experience tells me that you are be deluded, lying or most probably both.

The best read currently on the site !! We are allowed to share our humanity
It's a system without a great deal of understanding sometimes. But you have a lot of understanding about your own situation which is a result
Good luck with the exam Dave

Reading Dave Clarke's post is the very reason we are now delivering staff training to companies in welfare to work and training provider organisations. how unfortunate for Dave and without any insignt into potential illnesses/ effects/symptoms etc of Mental Health is the staff memeber really incompetent or is there a lack of awareness training on the part of the organsiation. All too often frontline staff are exposed to sitauations without very little training/support. We also need to take on board comments made by a post that Mandy made which clearly point out that JCP sfaff and others shouldnt /can't be expected to diagnose Mental Health Issues in their clients This is NOT their job! however, surely staff and businesses are at an advantage if the staff can clearly identify some of the key elements that a client is portraying and is able to confidently have a discussion around the issues faced by the client as bariesr to employment.Recognition is surely a way forward to develop a constructive and realistic relationship with your client to either signpost or indeed acknowldege that maybe another intervention is more appropriate at that stage.

I dont alway log in correctly and remain anonymous I shouldnt really ! I have been reading this thread with some interest.

I too am taking citrilopram Dave and have been for a couple of years I am not a person on benefits I worked for the jobcentre for 20 years and now work for a prime delivering FND. I function! I keep a family have done the lone parent thing I work full time and am diagnosed with being clinically depressed Im a happy soul really but consider my self to have an underlying medical condition, my GP would prob class me as being under the DDA because Its over two years (am I right there? plase someone advise) I yawn but I put that down to working long hours and staring at stats on a computer screen I dont read the leaflet that comes with my tablets because I am also a closet hypocondriac and if I got symptoms from my tablets that effected me in such a way that I couldnt get out of bed to go to work in the morning I would seek medical advice and quick. I am only allowed 8 days a year off poorly so I have to drag my self out of bed to go to work come rain or shine or how miserable I feel . I get into work and get involved in the latest priority and I forget the black cloud that I woke up too if I didnt leave the house and see my colleagues and friends that cloud would prob stay with me all day and I would effect my loved ones when they come in from school and work and the world around me would be miserable. I take 40 mg of the happy pill daily if I dont I sink into a depressive state It allows me to live, breathe be a mother and friend and work bloody hard for a living . I dont care who knows my brain is missing a chemical Ive worked all my life since I was 16 . I was an adviser in the UBO when Maggie was in power and a positive outcome was signing a customer on to sickness benefits because they got off the dole queue and brought the figures down - I know loads of people who are on benefit that can work . A lot of what I am trying to say here is positive mental attitude and approach is the order of the day and I dont care who I upset there are too many on incap benefits that are shirking I know cos I signed em off and advised em to go and claim it ! pressure on of course got to get your positive outcomes

Morning Extra -18 Jan 2010 - The Investigation - Who Benefits?

Is the new replacement for Incapacity Benefit working?

BBC Scotland's social affairs reporter, Fiona Walker, uncovers claims of seriously ill patients being told they're fit enough to work and therefore denied the new Employment Support Allowance. Two former doctors for the private healthcare company Atos, which carries out the medical assessments, have expressed concerns that the checks are being done too quickly and that the system is biased towards declaring people fit for work.

http://www.bbc.co.uk/iplayer/episode/b00q08dd/Morning_Extra_The_Investigation_Who_Benefits/

I find this all rather alarming. The idea that jobcentre staff should recognize (effectively diagnose) people with mental health issues is incredible. Is this how bad things have become? If somebody has a 'mental health' problem they will choose whether or not to tell you about it, and tell you if they want your help. Otherwise it's none of your business, any more than any other aspect of their health is. Would you try to 'recognise' physical medical conditions in this way, without consent, and by guessing on the basis of a short training? There seems to be no awareness that the whole concept of 'mental health' and the way it can be socially constructed and politically manipulated is a highly controversial one, and the subject of much informed criticism from experts in the field.Many models of psychological function do not use such simplistic medical style labels, but they of course are less attractive to politicians and civil servants!

It is vital that job seekers are reffered to the right provision. JCP advisors need a good diagnostic tool. I understand they are about to undergo CBT training.

I'm not sure how having a group of enthusiastic amateurs trying to paper over the cracks of a persons mental state just long enough for them to get a job and be out of your hands is going to do them much good in the long run.

If you suspect someone of having mental health issues then surely the obvious thing to do would be to advise them to seek professional help instead of trying to muddle through yourself with the risk of making the condition worse?

Agree with Mrs Tiddlewinkle. The job centre staff are probably targeted on getting people jobs whether they are suitable & sustainable jobs are another matter. I found 'Work Choice' made my mental health condition worse. The advisors didn't really listen to me & brushed off my problems. Some of the advice they gave me was highly questionable & unprofessional. They are more interested in 'ticking their boxes' than customer care.

The system doesn't recognise how devastating it can be if a person who is mentally ill is placed in a job (even one they wanted and love to do) and then it fails through their inability to get over 'bad days' when they don't get out of bed, personal care, don't eat etc.

There is first the impact of this failure on their mental well-being; this failure may take days, weeks, months to get over. Second for someone on benefits or, as with my family member, someone who has an income linked to benefits but paid by a private health insurance. It is difficult to put the financial affairs back into place - again - and then have a well-meaning advisor find the person a job - again - and then the whole circle - again.

When a GP, a community health team, a psychiatrist and an independent expert, supplied by an insurance company which has a vested interest in seeing the person back to work, all state categorically that (s)he is not fit for work I suggest that they should be listened to and the person in question not be put on any work programmes.

If the government wants to help the severely mentally ill then, please, more therapy and training for psychiatric teams and the ill person in how to handle their own condition.

There are plenty of able unemployed for the work programme providers to be helping.

I have worked with people with severe and enduring mental health conditions for over 10 years - often in the W2W sector.

One thing that worries me about training JCP/W2W staff in mental health issues, is that often a little bit of information can be dangerous!

I think it should be down to specific providers with expertise in this area to support clients.

Someone mentioned IAPT in the thread previously. In theory - it's a great service with the over arching theme of meaningful occupation/employment/sustaining it as the end goal....

However in our region, the project is totally over subscribed as the NHS decided that it should be self referral........

I often feel that some clients who present with MH issues could turn thier lives around with a little meaningful occupation BEFORE they are forcced in to applying for jobs that they a) don't want b) Wouldn't sustain due to current circumstances and c) probably won't get, and thus rejection will further fuel the depression and lack of self worth that often comes with being unemployed......let alone if you have a severe and enduring mental health condition.

For me...it's all about the Meaningful Occupation and building up confidence and a hollistic approach towards the person. Not just about barriers to employment.

I shall now step down from my soap box :)

Jobcentre staff or any other work agency, are not Psychiatrists, are not qualified to diagnose or work with individuals with mental health problems full stop...even the charlatens that do your medical assessments and take people off incap are not fully qualified only members of certain bodies which anyone can join based on a few months experience. Plus its all computerised type nonsense. the only reason so many services do work with issues such as these, is because the field is not regulated; and just to get money, they take the piss and play the fake it to make it game. Fear of losing out in the game of life. It's a joke to even suggest it. Jobcentre staff might receive a week, 2 weeks even 6 months mental health awareness training... sorry this does not mean this qualifies you to work with any kind of emotional, mental issue etc, only raises your awareness of the issue. Try 4 -8 years of specific training and years of experience as a psychologist,Psychotherapist or Psychiatrist. Or 3 -6 years training specifically as a mental health worker, just to work with individuals with any kind of impairment. The dwp is a joke, get people off benefits based on what they can do, this contradicts the whole process of recognising mental health issues; because one day they might be fine, the next not fine.. so the point of what they can do is??? Plus who are any of you to say that Mental health actually exists or even what a mental health issue is? and impose those beliefs on clients? what tells you this? because your network of agencies and where the money is says so, or some none qualified trainer tells you so... so it must be true, this is how naive and inexperienced most who comment on here are. Unbelievable. And I dont care if this has not been helpful; if you cant do your job, don't try and do others just to exist. If you want to be diagnosing train to be a Psychiatrist. But then I guess the gov will throw some money to train you up fast track style and get you qualified without doing much. Look at social workers....

p.s. I am qualified to know exactly what i'm talking about.

Society is changing and having a detrimental affect on people, change society and you will change peoples health, don't just make some adjustments based on the persons health issues, thats ignorant. Unless it is organismic. their health issue is a consequence and a symptom of society and the culture around them. it is not their problem or responsibility when it is imposed on them, it is the responsibilty of those who impose the catalist.

Two excellent posts Aqwaman. 8-)

At last some common sense prevails, thankyou Aquaman,brillient posts, pity your not in Government to show them what they should be doing!!!!!!!!!!