Another Government ‘Fag packet’ proposal for Benefit Sanctions & Cuts ?

/ jaynel62

Rarely do I come across a Tory Policy proposal that makes me both Smile (albeit at the irony) and Shudder (with fear); but today’s report in the Telegraph does exactly this; “Hundreds of thousands of benefit claimants face being stripped of their state allowances if they refuse to undergo treatment for anxiety and depression“, this worries me on several levels.

The article quotes their source as saying “We know that depression and anxiety are treatable conditions. Cognitive behavioural therapies work and they get people stable again but you can’t mandate people to take that treatment“; I totally agree with the closing proviso but the apparent claim CBT works for depression and anxiety is False.

Firstly Depression is not a ‘one size fits all’ disorder, there are different types of this debilitating illness, and a notion it can be conveniently summed up to enforce potentially damaging treatment is downright dangerous as well as being futile.  This position applies equally to Anxiety, again there are different types of Anxiety disorders which require different specialist treatments; therefore this all embracing decision, being discussed by Politicians based upon saving money is, to me, terrifying.

Cognitive Behaviour Therapy works to enable people understand the relationships between their feelings, thinking, behaviours and environment, and to identify ways in which these can become problems; ergo CBT only works when depression and, or anxiety arises from internal conflict. Personally I have found CBT to be of little or no use when clinical issues, i.e. schizophrenia, is  the primary causes of the disorder; further where external factors are reinforcing the disorders, I personally have found CBT only has limited benefits.  I am not purporting CBT has no use in supporting depressive or anxiety sufferers, but it is not the only form of treatment necessary for enabling improved mental health. Given the mandate for this scheme is the ” loads of people who claim ESA (for Depression and Anxiety) who undergo no treatment whatsoever“, it is difficult to understand how the Government is to utilise fully trained CBT workers anyway?

Minsters are already piloting different ways of implementing this scheme, four JobCentres are currently “combining “talking therapies” with employment support“; soon we will witness  “group work” to help build the “resilience” of individuals who are out of work and suffering with poor mental health” the “hiring specialist private organisations outside the NHS and welfare system to take control of providing a combination of psychological and employment support to claimants” and finally “online tests and therapies at improving individuals’ health and job prospects“. These four trials will then be assessed, presumably with cost effectiveness, being the primary focus’ so no prizes for guessing which ‘approach’ the Government will adopt – more work for the nudge unit coming up?

These trials are a joint effort between the DWP & Dept of Health, and emerge from the report Talking Therapies: a four year plan of action  and initially was targeted at people 18-65  as an “economic case on which it was based showed that providing therapy could benefit not only the individual but also the nation, by helping people come off sick pay and benefits and stay in or return to work“. There we have it another quick fix based on Finance First and presumably will form the basis of yet another area of Cuts in Welfare; but once again aimed at sick and disabled people

As I acknowledge at the beginning of this post, the Government Ministers making these decisions about how mental health sufferers should be treated, deny participation in these trials will be mandatory, seeming to recognise willingness to participate is central any talking treatment working. However the Telegraph states “Conservatives could include the proposal for mandatory treatments in the party manifesto next year as part of the next phase of reforms to the welfare state” and I can’t help but think they are probably accurate in this.

Will this turn out to be yet another example of how the Government says one thing and then does another? If you agree with me in this Join the TRUTH campaign

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53 thoughts on “Another Government ‘Fag packet’ proposal for Benefit Sanctions & Cuts ?”

  1. These plans from ministers worry me for a few reasons. Firstly, as you mention in the article, depression and many other mental illnesses are not a one size fits all. The severity of them tends to be on a continuum and can be long lasting or fleeting. Secondly, it appears (unless I have missed it somewhere else in the article) only certain treatments will be approved and to help those with mental illness under these plans. I am not going to criticise people who use anti-depressants or any other type of drug to help them if experiencing mental illness as that is their choice. But I chose to use yoga and meditation to help with my depression and anxiety. What happens if this form of treatment is not on the approved list of treatments? What happens then if I refuse to go down the psychiatric drug route?

    Lastly, mental health is not linear nor chronological and te same is true of mental illness. A person can have good days and bad days. Certain things in life they have to avoid as they could trigger the illness. Now admittedly I have to research on this. But my fear is that the treatment within these plans devised by ministers for this is too simplistic and could be on the lines of treating it across the lines of physical illness. That won’t just be unhelpful, but also detrimental to the person themselves.

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    • totally agree, I have had depression for many years and with varying degrees of it returning… i refuse to take Anti-depressant drugs as I have seen first hand as a child a close friend of mine reduced to a mindless drone without any idea of who i or his family was…
      plus with other medication I have been on and am on I just feel I would rather I tackle the problem by a more natural and productive means I personally to me feel that would boost my self esteem and help strengthen the fight against the issues should i need to face them again..

      I have chronic back pains/joint pains, mild arthritis… not to mention acid re-flux, IBS & migraines so have to take meds for the stomach and head…
      was on Tramadol for the back and Joint pains but that just zoned me so far out and took most of my life away which doesn’t help with depression at all…
      so i removed my self from the Tramadol… I am doing martial arts particularly freestyle karate which is helping with pain management, and depression also I get to vent any excess anger issues i may experience and channel it into that without harming anyone…
      in turn it teaches control and humility too but yes I agree each solution is not for everyone but would recommend though that before people be forced onto medicated states they be allowed to be able to try something… some cases a simple hobby can help

      as something simple that can be able to take your mind away for a time, allow you to relax and reoccupy you with anything but what stresses you out is a great idea… but its hard to do when costs of living are at an all time high and just trying to find money to eat is difficult…

      I am lucky really I have great supportive friends and the family (wifes side, and only few of mine) but there are those out there who aren’t as lucky….

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  2. Jayne, it is cost, cost, cost first and foremost in all ‘policy’ decisions. CBT is usually offered in 6 sessions, or 12 at most. It’s cheap. This is supposed to be a ‘cure’ and if you’re not cured at the end of it then the fault is assumed to lie with the individual, not the treatment. CBT is also recommended by NICE, because, unlike other talking therapies, they can supposedly use RCTs, the ‘gold standard’ of clinical evaluation, to assess its effectiveness.

    All of this is about cost and tick box exercises at the expense of genuine effectiveness. And blaming the individual rather than using models of social responsibility and solidarity as the key to good practice. Personal Health Budgets are another piece in this reprehensible jigsaw.

    GPs know that, increasingly, social factors are very much to blame for many cases of depression, which can be rooted in the genuine sense of helplessness and loss of autonomy when job losses lead to benefit which is cut followed by relationship breakdown…on and on in a downward spiral. There’s no drug or CBT in existence that can change that and promulgating the idea that it is your own negative thought processes that creates and maintains your situation is just another way of saying that poverty is the fault of the poor.

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    • All of this is about cost and tick box exercises at the expense of genuine effectiveness.
      and one ticks the boxes in an ever improving manner (saying things are a little better each week when not) because the counsellor doesnt understand english and one cant be bothered to argue or explain week in week out what one means

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  7. “hiring specialist private organisations outside the NHS and welfare system to take control of providing a combination of psychological and employment support to claimants” and finally “online tests and therapies at improving individuals’ health and job prospects“

    ATOS perhaps? We know how good they are at assessing claimants for WCA (cough, splutter).

    Depression can have biochemical causes and no amount of CBT or other “talking therapy” will help. Unfortunately the only treatment available is usually by anti-depressant drugs. Fortunately earlier brutal “therapies” for depression, electro-convulsive therapy and lobotomy, have proved ineffective and have been consigned to the medical history books.

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    • I spotted that little nugget and had the same disturbing premonition about ATOS.

      One wonders if, in cases where CBT is “suggested” (i.e. required/forced) and is ineffective, the more brutal therapies might be resurrected? After all ECT is probably cheaper for the Government to fund than paying benefits, and what better way of creating mindless, subservient drones than a good old fashioned lobotomy? Lets face it, when it comes to “Welfare Reform” (cost cutting by any other name would smell as sweet), for the DWP it is a case of mind over matter – they don’t mind who gets hurt by their actions, and we, the public, sure as hell don’t matter!

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  12. As someone who runs a forum for people with depression and mental health illness this terrifies me. Already I hear from people who are in such a state due to the various stages of trying to claim benefits when their depression is so dark that even trying to get the forms can be too much… CBT does work for some people, yes that’s true. Medication works for some, once people have endured the side effects and the “trial and error” to find the meds at the right dose to help but it’s just not the case for all. Plans like this do no more than harm anyone with mental health illness who could be ill enough to just about manage to get up. I work so hard among others to fight to help break the stigma of mental health illness and all that plans like this do is paint people with the “they don’t want to get better” brush.. As an aside currently in some parts of the country there is a 12 – 18 month wait for an assessment for talking therapy and then a similar wait until you start that therapy, notice how plans to put money and training into the mental health system haven’t been announced….

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  13. CBT actually made me even more unwell. I have rapid cycling bipolar affective disorder and when I couldn’t follow the plan as suggested by CBT on trying to change my way of thinking and perception, I felt a failure and went in to an even further tailspin. For some it may help them but for others it can cause really serious mental damage.

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    • I saw on TV recently a programme about PTSD in ex-servicemen, where CBT was given through a charity (in Wales, I think). The “therapist” had no formal training in psychology, and CBT training course of less than one week. She claimed to be able to “cure” PTSD in a few sessions. In fact she caused great harm. This is an example of how we might expect CBT to be bulldozed out over the ill. The proposal is not just for mental health issues, but all ESA claimants. It is central to the ideology of UNUUM and ATOS with their bastardised version of the social model of disability.

      The model and the “cures” are nothing more or less than the services offered by witchdoctors. The practice proposed is just a state-run disability denial factory. we can kiss goodbye our social security systems, where even the one-year contributory ESA is obviously too much for this government to countenance. They should just man up, and admit they are simply abolishing all disability and ill-health benefits. That way we would at least stop the money flowing onto the coffers of ATOS, Capita, Virgin and who know else.

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  14. I had CBT about 3 years ago after being diagnosed with one condition after another over a period of about 5 years…. it took over 6 months to get the first appointment. i had 5 sessions, first 3 were 2 weeks apart from each other. the latter 2 were 3 and 4 weeks apart… tbh by the time that first appointment arrived i had been doing some self help therapy. i.e. writing down all the ailments/conditions i had been diagnosed with and still had from the age of 40 to then (aged69), minor to major,and adding them up made me realise, yes, theres no wonder i wasnt coping..26 in all (3 more added on since then which i took much more in my stride)..felt much better once i realised it wasnt just me and not really all in my head.similarly, close family members were not understanding this either and made life difficult as they were not accepting that i was getting older, more disabled etc.(still dont), but at the time they stopped having goes at me. life was easier. until the CBT sessions stopped then it started again.. i cope better now and have learnt not to let things get to me as much but still are times when something will trigger a down day(one of my kids says i only get down days, refuses to call it depression)
    but back to how long it took to get that first appointment plus the longish time between each session, specially towards the end, i left thinking what a waste it had been in a way, especially my taxi fare to the venue of £14 per session. (ever noticed its us has to pay out for getting there??). there are not enough trained CBT specialists to put that into practice. and i don’t care what anyone says. i refuse to be made a zombie with antidepressants.a mate of mine was. put on 20mg when she wasn’t coping after her first hubby died. at some time later that was upped to 40 when she still wasn’t coping. then her 2nd partner died suddenly (we are talking 60-70 yr olds here) and they upped them to 60mg. i didn’t know she was on them till she was continually falling asleep at her home/talking on the phone etc. then whilst driving the car on the moors one day. only then did she tell me after i started asking questions about what meds was she on and realised what was going on. told her she had to get it sorted n try n come off them before she killed herself or someone else.. luckily she took note. saw her Dr and came off them.different woman entirely. i had never really known her as HER. SO NO. I REFUSE TO USE ANTIDEPRESSANTS.

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  15. This policy just makes me shudder, it is frightening

    If the government and NHS lived up to their promises regarding mental health provision then many more people would receive appropriate treatment which would actually help them. Instead they concoct a one size fits all scheme which common sense alone tells you will not only not work but is likely to make the situation much worse for many people.

    CBT is not a panacea or cure all. There is no one size fits all approach which is effective. If there was, especially given the budget cuts in mental health, surely if there was it would have been implemented by now. Even worse I can see this being delivered by pseudo counsellors (ATOS style staff) with all that entails. Is it too much to expect the government to have learnt from the last ‘psychological’ mess it created (pseudo questionnaire) and to realise the real harm policies like this causes.

    This is a scheme I fear that will be measured not by those ‘helped’ (current policies show just how ludicrous this help is really) back into work but by the real harm this could cause to peoples health.

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  16. Reblogged this on karenstoneblog and commented:
    I totally agree with your comments and depression and anxiety as you say is so not a one size fixes all and the idea that yet again the Government appears to be herding people’s illness be it mental or physical one or both, into a one label format turns my stomach , CBT. Is so not a cure all for anxiety,,, when you have a incur able physical body medical issue as I have had for 15 years and no meds work to solve the physical problem or operations, yes you suffer anxiety it’s only natural .but sitting in a chair or whatever doing CBT did not make my physical body illness go away. Talking about childhood talking at empty chairs pretending they are somehow going to cure said physical body illness is a joke.
    From my experience the NHS is not geared up enough anyway with trained Counsellors. I got a trainee who was not allowed a pager to her office and as my physical illness sometimes prevents me being able to walk there was no facility to contact her or for her office to pass messages on if I had to cancel. All this generalisation and cattling people into ‘neat one size fits all’ mentality is terribly worrying. As you say is this yet another case of the Government hurling out an idea into the ether to see what happens with no real planning or forward thinking? I rather think it is.
    So thanks for blogging this .

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  19. I suffer anxiety due to medication I take, it’s a side effect of it, so stopping the medication would in effect stop my anxiety but at the same time start my epileptic fits again, what do they want, to try and kill me

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  21. Terrifying. After several bouts of depression and anxiety, over many years where CBT worked to start with but was less effective later, I became a psychotherapist and treat people with this condition, without drugs.

    It is entirely different for many people, takes different lengths of time to recover and your article hit the nail on the head. Many people need to know where their issues come from as well as coping techniques. Box ticking CBT for 6 sessions or whatever the standard time is will likely cause much more emotional conflict, stress and self defeating behaviours… even suicide.

    Moronic knee jerk reactions have no place in good mental health care.

    Shared and tweeted.

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  23. I fully expect that this will involve a lucrative contract to a company that donates generously to party funds. Because obviously it’s a waste of money to provide such treatment through the NHS where nobody gets to make a profit. I predict it will be as effective as the DWP’s other outsourced programmes. As in it will do absolutely nothing for anyone but shareholders in the company that gets the contract.

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  25. i would love to know if CBT works for depression, but 2 years later and I am STILL on the waiting list with no idea if let alone when i will hear anything about an appointment!

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  26. Basically, this is just propaganda, put out to please Daily Mail readers, who, being rather thick, cannot tell the difference between serious mental health disorders. including paralysing depression and their own temporary and manageable mood disorders. How many of the 40+% of people lumped into the category of “Mental Health and Behaviour Disorders” actually have the kind of relatively mild depression that can be sorted by 6 weeks CBT? How many of the people with more serious conditions are desperate for treatments that aren’t available? What, exactly, is the treatment for those with Learning Disabilities, brain damage, etc.? Unemployment and poverty can CAUSE poor mental health, as can housing problems — any chance they might try tackling it from that end? Of course not. This is just flying a kite, as a further attempt to cast all ill and disabled people as scroungers.

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  28. I Knew my sessions with my CBT were going wrong when she banged two cow bell together and said she was going to teach me how to breath through my left foot….And no I’m not kidding

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  29. Reblogged this on Beastrabban’s Weblog and commented:
    Jayne provides further information on the complexities of anxiety and depression, and how Cognitive Behavioural Therapy is not the ‘one size fits all’ solution the DWP and the Department of Health clearly think it is. I am aghast at the effrontery of the government, who clearly know nothing about these disorders and the blatant ignorance this proposal demonstrates. The sooner they, and their SPADS and private advisors from business are cleaned out, the better.

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  30. I found CBT somewhat helpful the second time I had it, but you have to want to get better and the first time I was not ready, I think I was frankly not mature enough the first time being aged about 16 at the time. If you don’t want to get better no course is going to help long term. My other concern is where are all the extra CBT therapists supposed to come from to do this? We are already told there is a shortage of people fully trained in this therapy and a lot of people not yet having help for it may have tried to get help but there simply was no one in their area that did it.

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  33. My experience of CBT is now decades out of date, but then it felt indistinguishable from bullying. I understand that things have improved since then, at least when it’s delivered by trained therapists – or by therapists who know its limitations. Try treating someone who has ME/CFS with CBT and they may learn to handle their condition better, but it’s not going to make it go away. But when it doesn’t, the first recourse of the the True Believers in CBT is that it must be your fault for not committing to the process fully.

    That’s what happens with fully-trained psychotherapists. I think the DWP’s “take” on CBT is that you take a health professional – any health professional – and give them a fortnight’s training. They can then “deliver support and therapy” over a 6-week period, possibly by phone, which will mean that anyone who “really wants to improve” will do so.

    The DWP will be able to get away with this because they are “encouraging behavioural change”. If they try to start prescribing medicines on a similar basis, they will find themselves up against the BMA and the weight of the medical establishment. All sorts of people are licensed to mess with your head – your parents and your children to start off with, followed by churches, politicians and newspaper proprietors. But prescription medicine is for qualified medics only. I do not think anyone need worry about having anti-depressants forced on them.

    However, there are concerns that I have not seen mentioned here, or elsewhere.

    How often have we read or seen on the TV news that obesity is a major cause of ill-health? How often have we seen recently that exercise is a major health benefit?

    So what odds will you give me that the DWP apparatchiks will not think that anyone who is on long-term sickness benefits can be told that their benefit is conditional on their losing weight? Or attending regular exercise sessions (good for depression, too!)? Or giving up smoking? Or attending AA? All of these are steps which anyone can suggest to someone else. In the case of parents and children, you can even try to enforce it.

    Can’t you just see Esther McVey deciding that forced dieting is “tough love.” As I write we do not know whether, as is rumoured, she is getting the top job at the DWP, but if she is we need to start worrying all over again.

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