The Economics of Crisis

One of the fathers of international trade unionism, Edo Fimmen, wrote the first ‘how to’ books about international solidarity just after the first world war. His argument in Labour’s Alternative was that international solidarity between working people had become a necessity after the emergence of ‘combines’ during the first world war – where economic actors combined their powers to dominate core sectors. 

Conflict always has economic winners. Ahead of the neo-liberal curve he identified the emergence of multinational corporations and the strategic monopolisation of public goods and it turns out not much has changed in the last one hundred years. 

Those who profit from disarray and lack of governance become visible in such times and nothing could be more true of the mental health industry. Far from a state level response to the genuine need for deep care and empathy that the human cost of the virus requires, we’re only just starting to see what happens when you don’t govern the providers of care.

Last week tucked away amongst the top-tips-digital-mania-survival-lite-!!!! on social media, an article from the Guardian in January was recirculated about the mental health and wellbeing contractor Health Assured. This company provides a big chunk of digital and phone counselling to big employers’ Employee Assistance Programmes (EAPs) as well as NHS contracts for gambling addiction. 

Health Assured is owned by Fred and Peter Done. One of their other companies is Betfred. 

Yup, you heard that right. 

Health Assured also provides an EAP for parliamentary staff. Fred and Peter are also major funders of the Tory Party.

Health Assured is not a cowboy company – they are accredited by the largest professional body the BACP – but they are now quite openly offering jobs to counsellors and psychotherapists at half the rate before the crisis. Half. The. Rate. For the many self-employed therapists working for Health Assured, at a rate of £20 an hour they are in a text book dilemma of the gig economy. Work for less, or not at all.

Even if you’ve been seduced by claims of professional heroics, some companies are about to make a lot of money out of our despair.

The situation in mental health is at best fluid and at worst rapidly declining into the clinical wild West. That is to say, because so many people working in mental health are essentially zero hours workers in insecure and precarious conditions, we don’t know what state the carers will be in when the real human loss kicks in. 

So, as part of PCP’s lobbying and campaigning work over the next few months we will be carrying out a series of surveys in mental health services – looking at money, working conditions, the movement to digital working and the issues around working therapeutically in the current climate. 

The aims of this dedicated body of research are to establish an up to date picture of what is happening to build a platform for negotiating protections for workers during and after the crisis ends.

It is worth pointing out that by ‘mental health workers’ we mean anyone working in mental health – whether you are a counsellor, psychotherapist, psychoanalyst, IAPT worker, wellbeing practitioner, mental health professional, mental health nurse, private practice, NHS, community care. If you work therapeutically whatever your job title or training (and often the two things don’t match) we want to hear from you. 

The surveys will each last one month and will be carried out by Dr Elizabeth Cotton, who runs Surviving Work. Full anonymity will be guaranteed and to ensure data protection and ethics Elizabeth will have the sole access to the data and responsibility for ensuring safety and anonymity of participants.  At the end of each month we will prepare summaries of the data and key quotes for open access distribution in the form of infographics. These may be useful to you and your institutions in understanding and protecting services. 

Our first survey is focussing on self-employment, something that is of the moment in the UK with over 5 million people working under this category. 

The Future of Therapy research indicated that 30% of mental health workers are self-employed, mainly in counselling and psychotherapy. The average monthly income across the sector is relatively low at £400-500 per month with 91% of self-employed working in multiple workplaces. The picture that emerged is far from the couch-in-North-London image. Over fifty percent of self-employed interviewees were worried they could not earn enough to live, particularly if they were below 55 years and didn’t have a life of service to the NHS and pensions behind them. 

There is a lot more research to do about what is happening in the light of the new financial package for self-employed workers. How are you surviving? Are you managing to earn money working online during the crisis? What will happen after the crisis in relation to opportunities for paid work? Are you having to access Universal Credit?

Our first survey on Self-Employment in Mental Health is now live. You can access the survey here and please forward this link to anyone who you think can help us build up a picture. Click here to do the survey.

If you would prefer to make confidential contact with Elizabeth at Surviving Work please send an email to [email protected].

To read about PCP and its 12 member organisations and to access The Therapist Hub set up to support counsellors and psychotherapists in the crisis please go here.

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