Liz is Australian, though grew up in India. A journalism career led to TV presenting and PR, which led to a five year spell of depression. Following this, Liz resumed her career working on government policy on mental health and social exclusion.
Pyjama Girl and the hidden costs of going back to work
13th December 2007
A glance at those books tells you why: mental health problems are costing the Government £2 billion a year in Incapacity Benefit, a hefty proportion of the total £12.5 billion they pay out.
It's not that those with mental health problems are shirking, campaigners insist. "People who have experienced severe mental illness have the highest want-to-work rate of any disability group, but have the lowest in-work rate," says Jane Harris, head of campaigns at Rethink. She points out there are two likely hurdles: the unwillingness of employers to take on people with mental health problems; and the hidden costs of going back to work.
In trying to gain support for the new changes to IB, government has been briefing that getting off benefits and back to work will swell your bank account as well as increase your sense of wellbeing. But we are unable to look at government profiling to see how they have worked these figures out and for whom it applies.
Other government figures are freely available to look at.
Harris says that though government publishes annual tax benefit model tables that show the relationship between incremental wage increases for lone parents, for example, they don't do this for people with disabilities.
We spoke to the Department of Work and Pensions (DWP). They told us that to publish model tables for people on disability benefits would be too complicated because of the number of scenarios that would need plotting.
The published tax benefit model illustrates the effect on net income of gross income, rent, marital status, number of children, tax credits, tax and National Insurance Contributions, they explained. "A model that looked at disability benefits would be a very complex table as there are so many factors involved in working out an individuals' entitlement. For example, not only would it have to take into account the information that is contained in the current model but it would also need additional information such as: type of disability, length of time on benefit, type of disability benefits customers are in receipt of, what rate of benefit they are in receipt of i.e. higher or lower."
While the DWP have pledged long-term Incapacity Benefit claimants will be at least £25 a week better off in work, this figure may cover little more than the travel costs that they will now incur through being off IB and in employment. But employment brings more costs than that, costs that could ultimately prove dangerous to people with mental health problems.
Those in the know can buy a pre-paid prescription card for just under £100 a year or about £27 for three months, which covers unlimited prescriptions. But most people aren't aware of this, and continue to shell out £6.85 an item when they start paying for medication.
"Nobody told me that I could pay a set amount up front - not my psychiatrist, not the pharmacist," Kay told us. "I don't think the doctor knew. No one in the mental health system expects you to be paying, they blithely make the assumption that you can afford to keep taking the pills." She points out two ironies. If she hadn't taken the medication she would have been back in hospital where it would have been free, and if she had epilepsy, the other condition treated by the same medication, she wouldn't have paid for the pills.
Sara is still doing the sums over what medication has cost her in the decade since she was diagnosed.
Increasingly the Government will offer short-term talking therapies for people with minor mental health problems to enable a swift return to work. But those with ongoing mental health problems will often need longer-term therapy, and while this might be available on the NHS, it is almost exclusively within normal working hours. As it is difficult to take time out of the working day for ongoing talking therapy, people either quit or find themselves paying for private therapy out of hours at a ballpark £30-40 a session.
Julian swims and works out at a local leisure centre as he finds exercise helps to keep his depression at bay, but no longer gets a discount. "I pay about £30 a month more than when I was on benefits," he says. "It might have been less if I could use the gym off peak, but that's the thing about going back to work - every bit of help or discount is geared towards people who don't work."
he has a prescription card but calculates the price of going back to work will be around £2000 this year.
Andy Bell, head of public affairs at the Sainsbury Centre for Mental Health, says that services must stop being "predicated on the notion that you are out of work". "If you support someone when they are out of work and forget about them when they get back to work there's a chance they will fall out of work again," he warns.
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