Mental health claimants more than twice as likely to lose their benefit than non-psychiatric claimant

Press release
23 January 2019

People who are mentally ill are 2.4 times more likely than a claimant with a non-psychiatric condition to lose their existing Disability Living Allowance entitlement following a Personal Independence Payment (PIP) eligibility assessment, research has found.

The research[i], to be published in the Royal College of Psychiatrists’ British Journal of Psychiatry Open, analysed government data of claimants moving from an existing Disability Living Allowance (DLA) entitlement to PIP between April 2013 and October 2016.

It found that of the 148,700 psychiatric claimants, 47,741 had their claims disallowed and 100,959 had other assessment outcomes – such as approved, increased or decreased - producing odds of 2.11 for a mentally ill patient having a claim disallowed.

Of the 178,300 physical claimants 29,323 had their claims disallowed and 148,977 had other assessment outcomes, producing odds of 5.08 for a physical health claim to be rejected.

The increased likelihood of a mentally ill patient losing their benefit was discovered by dividing the odds for physical claims (5.08) with that of psychiatric claims (2.11), producing an ‘odds ratio’ of 2.4.

Looking at specific mental illnesses, the researchers found that the ratio dropped to 1.97 for those claimants with alcohol and substance misuse problems but soared to 3.38 for those with ADHD.

The research team from the University of York - led by Katie Pybus - include Professors Richard Wilkinson and Kate Pickett, authors of the 2009 book, ‘The Spirit Level’, which looked at the effects of inequality and was lauded across the political spectrum.

Mrs Pybus, lead author from the University of York, said: “As far as we are aware, this is the first academic study to compare Personal Independence Payment eligibility assessment outcomes by health condition for existing Disability Living Allowance claimants.

“Our analysis shows that people with mental health conditions who are transferring from Disability Living Allowance to Personal Independence Payments are around 2.4 times more likely to have their payments discontinued following an eligibility assessment compared to claimants with some other health conditions.”

“Our intention is not to comment on the acceptability of eligibility assessment outcomes for claimants with the other health conditions included in the analysis, but rather to highlight areas of potential inequality that may need to be addressed to ensure parity of esteem."

The researchers say the reason for the discrepancies are unclear, but their findings support concerns raised in a Work and Pensions Select Committee report[ii] which found that PIP assessors had a lack of specialist mental health knowledge and used informal observations to make judgements on a claimants’ mental health condition. As of November 2017, only 16.6% of ATOS assessors had a clinical mental health background[iii].

The paper also argued that the potential loss of income amounts to £141.10 per week for people with the most severe mental health conditions. Such a reduction in financial entitlement has the potential to exacerbate existing mental health conditions, limit chances of recovery and put people who are three times more likely to be in debt than the general population[iv] into further financial hardship.

It comes ahead of a debate in the House of Commons today (Tuesday) when MPs will be debating mental health and the benefits assessment process.

Commenting on the research, Professor Wendy Burn, President of the Royal College of Psychiatrists, said: “We can provide the best treatment in the world for our patients but if they can’t afford accommodation, heating or food this will be ineffective.

“It is essential that clinicians know how to support their patients in applying for the benefits they are entitled to.”

The College has published written guidance for clinicians[v] to help mental health professionals provide robust clinical evidence for PIP claims.

In 2017 there was an outcry after 220,000 people had their PIP payments backdated following a landmark high court case, in which the judge ruled changes to the PIP assessment relating to mobility needs ‘blatantly discriminate’ against mental health patients and breached human rights.

Dr Jed Boardman, of the Royal College of Psychiatrists, who gave evidence during the high court case, said of the new study: “A benefits system that discriminates against people with mental ill health should not be tolerated. The push for parity between physical and mental health in the health service must be extended to the welfare system to give people the support they need and the best chance of recovery.”

[i] Pybus et al: Discrediting experiences: Outcomes of eligibility assessments for claimants with psychiatric compared to non-psychiatric conditions transferring to Personal Independence Payments in England.

[ii]  https://publications.parliament.uk/pa/cm201719/cmselect/cmworpen/355/355.pdf

[iii] Written evidence from ATOS IAS (PEA0447)

[iv] Fitch C, Chaplin R, Trend C. Debt and mental health: the role of psychiatrists. Adv Psychiatr Treat 2007; 13: 194–202.

[v] https://www.rcpsych.ac.uk/mental-health/work-and-mental-health/social-inclusion

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