This very pertinent statement was put out by the Partners for Counselling & Psychotherapy
On Monday 10th October 2022, World Mental Health Day, the Government announced £122 million of funding for mental health. But the bitter reality is that this money is not being spent on in-patient beds, community mental health initiatives or trained counsellors and psychotherapists for public mental health services.
Instead the Government is using this money to recruit and train 700 ‘employment advisers’ to work alongside therapists in the NHS’s flagship Improving Access to Psychological Therapies (IAPT) programme, which will help drive the highly contested policy of wellbeing conditionality that targets the poorest and most deserving sections of our society at a time when they need the greatest help.
Despite the press releases, this money is not being used to build mental health support. Instead it is an expansion of an existing IAPT-based scheme providing, as the announcement states, ‘combined psychological treatment and employment support to help [people] to remain in, return to or find work and improve their mental health’. The linking of work and mental health, however, is deeply problematic. In 2015, hundreds of counsellors, psychotherapists and academics opposed the pilot scheme that first put Jobcentre employment advisors and IAPT therapists together, a scheme that in a letter to the Guardian they denounced as anti-therapeutic and professionally unethical.
Nothing has changed except that this policy now threatens to force a greater number of people into a system of psychological treatment and employability interventions in order to avoid welfare sanctions, including the main disability grants. As the highly contested Universal Credit programme is rolled out across the UK in response to rapidly growing low pay and job insecurity, many more people will be unable to secure living wages and will be forced into claiming welfare benefits and will therefore be subject to these pressures.
What is the role of therapists in such a system? For us, work is not a health outcome. Employment is not an expected or even inherently desirable result of genuine counselling and psychotherapy. Real therapy does not aim to return individuals to the workplace or to keep them in jobs that may be economically insecure, psychologically toxic, systemically oppressive and personally damaging.
The linking of State therapy and employment advice, particularly if connected in any way with a punitive benefits system that has the power to ‘sanction’ claimants for their perceived failures to find work by withdrawing their income, must surely contaminate some of the central tenets of good therapy – not least the autonomy and right to self-determination of the person undertaking it. The rolled-out scheme may be trailed as ‘voluntary’ but if ‘employment advisers and therapists will work together so that a person can return to or find work easier and faster’, as the Government say, then the non-coercive integrity of the therapy cannot realistically be maintained.
Given that the Government statement is at pains to point out how the overall aim of the project is ‘driving economic growth’, we also have to ask therapists whether they can – ethically and in good faith – align their practices with such an agenda. The therapist’s job is not to work from an assumption that ‘work is good’ or to aim to reduce the number of people receiving benefits, including disability benefits which are increasingly claimed on the basis of mental illness, but to provide an opportunity for reflection on all aspects of a person’s life.
As a network of organisations representing counsellors and psychotherapists, we believe that this announcement on World Mental Health Day is a cynical attempt to reduce government spending at the expense of people who most need genuine therapeutic support during an unprecedented period of economic crisis. We reject the financial logic that underpins the linking of employment and wellbeing services as it is a profound attack on the principles of talking therapies and will lead to a cruel and measurable deepening of the UK’s mental health crisis.
Partners for Counselling & Psychotherapy