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Mental Health and the Benefits System

Andrea sits down in front of her careers adviser, John, clearly very agitated.  She rushes to get her words out.  “I’ve just come from the Job Centre, and they say I’ve got to have a CV.  Can we get it done today?”

“Yes, we could work on a CV,” the adviser replies.  “But it sounds like it’s the Job Centre that wants this CV.  What do you want?”

Andrea insists that she must have the CV today, otherwise her benefit will be cut. It’s clear that this is the only reason for the CV, and the threat of having her money cut is uppermost on her mind.  She’s typical of many clients referred by the Job Centre.

John has met Andrea before, and when they met a month ago, Andrea had told him that she was on medication for depression and anxiety and had been on Incapacity Benefit for a few years, but had recently been switched back to Job Seekers Allowance, as a result of a medical assessment. Her GP, however, doesn’t think she is ready to work yet.

When they last met, they talked about Andrea’s ideas for the future.  She was once a Care Assistant, but she said “I can’t go back to that work.  Because I just don’t care and it’s not fair on the older people for me to be in that job.  I need to do something else.  Something practical with my hands, so I don’t have to talk to people all the time.”

John offers to ring up the Job Centre and negotiate a more sensible deadline for the CV, and Andrea immediately relaxes.  After some haggling on the phone, it is agreed that the Job Centre will give Andrea more time to create the CV, provided she spends time with the Careers Adviser on “preparation”.

With the immediate threat of being left without money tackled, Andrea is now able to tell John what has happened since they last met.  Her sister-in-law told her that there were jobs going in a local meat-packing factory.  “I really thought about it, ” says Andrea, “but then I got so worried, I had to take more medication, and just go off for a walk.  I was gone all day. My husband knows me, he knew I was getting worse and he wanted me to go back to the GP.  I don’t know why thinking about that job set me off, but it did.  I didn’t feel right for a couple of weeks.  I think my sister-in-law thinks I’m just lazy.”

They talk about the reasons she wants to work – to be busy, to have more money, to get back to a normal life, to be out of the house.  They also talk about the reasons that she doesn’t feel ready.  She can’t face crowds of people.  Some days, she can’t get out of bed in the morning.  She lacks energy.  She has panic attacks when things feel out of control.  “It seemed like a good job for me, just what I wanted, but it just felt like too big a step.”

Andrea and John spend some time thinking about “small steps”.  Andrea comes up with the idea of an exercise class, a craft class at the adult education centre and ringing her friend to go to a nearly town for a shopping trip on the bus.  John suggests voluntary work – maybe in a charity shop to get used to being around people and having a regularly place to be each week.  Eventually Andrea creates an action plan that includes calling into the adult education centre and a local charity shop.   They agree to meet again in a few weeks to review progress and do the dreaded CV.

Andrea looks anxious as soon as the CV is mentioned.  “A CV isn’t just for getting a job,” John reassures her.  “We can use it as a way to think about all your experiences and what you can do.”

This is real career guidance.  Professional careers advisers work from a Code of Ethics, and putting the client’s needs first is at the heart of this.  A professionally qualified careers adviser will explore the deeper issues that prevent people from achieving their goals, rather than focus immediately on job applications.

Professional career guidance, however, is being cut back all over the UK, and replaced by “job search advice” or “employment support”, offered by staff who are often trained only to a very basic level, and who often work in a very target-driven environment – if they don’t get clients into jobs quickly, their organisations won’t fulfil  the targets in their contract and they will be out of a job.  Some of them are on temporary contracts or have performance-related pay, so the can’t afford not to get their clients into work quickly.

You can’t really blame these advisers for pushing their clients to get back into work quickly, but it’s often a very inappropriate approach for clients with mental health problems, who may need to take many small steps towards being “job-ready”.  The process of getting back to work has to proceed at a pace appropriate to the client – it can’t be rushed. Many clients with mental health problems do want to get back to work, but they recognise that they need support (perhaps part-time or flexible hours, a reduced workload or social support), and many employers would rather just employ someone else.  A paid job is often a very the long-term goal.

Clients who are pushed back into work before they are ready, without appropriate support, may find that they can’t actually perform the job at the speed and standard expected, they may feel socially isolated and often find that their condition is exacerbated by the pressure to “keep up”.  Their attendance at work may be poor, especially if they don’t get appropriate support from their employer.  They are unlikely to hold down the job, so the cycle begins again – they are back in the benefit system with even lower levels of confidence.

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The Value Of Career Guidance

I was out and about with another Careers Adviser recently, sitting in on some of her Year 11 interviews to see how they were going, as part of our quality assurance process.

The first client of the day was a smart young girl, who sat down confidently and greeted us both.  She was well spoken, and immediately said that she wanted to be a dentist, and she would be doing A-Levels in Biology, Chemistry, Maths and Physics in the school sixth form.

Although she was quite happy to see the adviser, it was clear that she didn’t really think she needed a careers interview.  However, she agreed to the adviser’s suggestion that we “check out her plans, just to make sure she hasn’t missed anything”. She agreed, although she said really wanted to stay focused on dentistry and not be distracted.

The adviser did indeed check out her plans, and they seemed pretty watertight.  She was expecting mainly A and A* grades.  She had done work experience in a dentist’s surgery and loved it.  This was her own idea – “the first idea I’ve had that’s been really mine” – but her parents were supportive.  She had been to a careers fair and picked up some careers information which she had read carefully.  She liked the idea of running her own practice, working with her hands, solving problems and of helping to make the world a better place.  She loved Maths and Physics but was equally good at Biology and Chemistry and knew these subjects were the most important.  She had even looked at the UCAS website and identified some universities she was interested in.

So far, so good.  This is what most people expect a Careers Adviser to check out, and many teachers and non-professionals, if supplied with the right information and enough time, could also check these things out.  Our adviser, however, knew from the research that many young people who are very focused at this age go on to be unhappy with their career choice, but feel it is too late to get off the treadmill and end up feeling stuck in the wrong career.  Over half of university graduates feel they did the wrong degree.

The Adviser congratulated her on her thorough research and agreed that she was a strong candidate for dentistry.  She gave a few figures about the level of competition, and offered to discuss a few ideas that could be a “back-up plan”.  Optometry and pharmacy were suggested as offering the same opportunity to run a practice and use science to help people.  The client was happy to consider these ideas and could see the importance of the back-up plan.

The adviser then went on to query whether she had ever thought of any jobs related to Maths, her favourite subject.  The client said only accountancy, which sounded boring: too repetitive, just making figures add up.

The adviser asked her to picture an engineer in her head.  What did she see?  A man in overalls, working with machines, she replied.  The adviser chatted about some other examples of engineering – using nanotechnology to design face creams, working on coastal defences in areas threatened by climate change and designing mobile phones.  The client pricked up her ears – “wow, that sounds really interesting.  I never would have thought of that.  Maybe I need to look into those ideas a bit more.  I mean, dentistry does sound good, but I guess I haven’t found out enough about the other things I could do.”

They went on to discuss websites that she could use to do further research into these new career ideas.  She seemed really keen, asking lots of questions, and saying at the end that she would start her research tonight.

This client was lucky to live in Wales, and be seen by a Careers Adviser, as every pupil in her school was.  But the practice is giving every year 11 pupil a careers interview with a professional adviser is being phased out.  Only those “most in need” will get career guidance.  This client, who, on the face of it, was academic, well focused and planning to stay in her own school sixth form, would not be a high priority.  The situation in England is even worse, with many schools having no access to a Careers Adviser.  Able Year 11 pupils are supposed to make do with using websites.

Websites are very useful – they contain occupational information, information about courses and entry requirements, helpful advice about jobsearch, applying to university and a  range of other issues relevant to young people.  But without this careers interview, today’s client would never have been motivated to research engineering careers on the website.  Providing websites isn’t enough, if the young people don’t see the point of using them and don’t know what to research.