some people are ace
This week I almost took up stalking. I have been in love with the Psychologists Against Austerity for some time because they are ace and then this week they’ve invited us all to a party to celebrate a week of action against the DWP’s attempts to designate the whole country fit for compulsory work. Seriously, how lovely is that?
This week the government delivered yet another cat-n-pigeons situation by announcing a pilot to put Job Coaches into GP surgeries in Islington.
Don’t get me wrong, I like work but I’m not sure a 24 year old clinical psychologist on a zero hour contract and performance related pay dodging the question “what jobs exactly are you coaching me into?” is going to do my or their own mental health any good.
This initiative comes after years of independent reviews into disability assessments, attempts to put mental health services into job centres, complaints and evidence against the way in which fitness for work is assessed in the UK. A toxic combination of scripted assessments that don’t take mental illness seriously, quotas for sanctions, and the contracting out of the state’s responsibility to protect vulnerable people.
The proposal to put job coaches into doctor’s surgeries would be funny if you weren’t talking about actual human beings, including the poor sods that become the coaches. So here are some questions that the good people of Islington could ask their democratically elected leadership:
Question 1: Given that people who are out of work and hanging out in GP surgeries are likely to be feeling pretty vulnerable, how are you going to make sure they are treated with the respect, kindness and clinical help they actually need?
People are easily bullied and often blame themselves for everything. This makes us feel pretty shit about ourselves. Suicide is real and any system of ‘coaching’ has to include proper safeguards in the very likely scenario that someone turns up to talk to a job coach and just breaks down.
Question 2: If a private contractor gets this gig to provide job coaches how are they going to be managed?
As the Mental Health Taskforce report states very clearly- there’s virtually no monitoring of private providers in mental health at primary care level. It is estimated that 50% of private contractors don’t provide services that follow NICE guidelines, many of them providing non-clinical services under the title of ‘wellbeing’ or ‘resilience’. Next month the Commissioning Support Units that administer funds for services within Clinical Commissioning Groups (CCGs) are themselves going to be privatised. This is cowboy territory.
In the likely event that big contractors like Maximus, Atos or Virgin Healthcare move in to providing these services we can no longer ignore the impact this will have on people who sign up. Even my mum, who is no United-Marxist-Leninist, thinks they are evil.
This isn’t a political point I’m making – its a clinical one. If everyone believes that these companies deliver dumbed down services for profit there’s not much chance that their objective to build people’s confidence will be achieved.
Question 3: Who is actually going to manage this pilot programme so it doesn’t turn into another cynical attempt to pathologize people who are unemployed?
Given that these pilots have already been agreed, the best case scenario is that someone in Islington does the important job of setting up this pilot so that it’s transparent and set up in such a way that we might all learn something.
This will require some very close scrutiny of the contract and some realistic statements about:
– what is the primary aim of this initiative?
– how are the targets set and do they test the validity of the intervention?
– is this therapy or not?
– who holds clinical liability for the people that take up this service?
– what measurements are going to be used to evaluate these pilots?
– who is going to do the dog work of setting up this pilot so that it is open, honest and shows actual results?
Question 4: How are you going to make sure that the Job Coaches aren’t as vulnerable as their clients?
Not wishing to blind you with Industrial Relations science but there’s a high chance these are going to be crap jobs. We do not have a good experience of the young people working within the NHS’s mental health services. To make sure we don’t repeat this attack on decent work, we need clarity on what training and support they will receive, what contracts they will have and how they will be supervised. We also need absolute transparency on their targets, learning the lessons of the WCA and Maximus whistleblowers. If the job is to cut benefit claimants by 20% lets be clear about that from the onset.
One of the reasons why this initiative has had such a negative response is that its a service that can easily be used to bully already vulnerable people into giving up their rights to be cared for.
Given the state of mental health services in the UK its easy to feel a Siberian wind swirl around your heart making you want to live in a cabin in Ontario. But for those of us who are stuck here and likely to be sick/unemployed any time soon, we have to make the best of a bad lot.
The good news is that some people are ace. Being in contact with like minded people doesn’t mean you have to join a cult or lose your sense of humour. You just have to find other ace people.
For a list of useful information and networks go HERE
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