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Mental Health Issues Don't Come With a Blank Cheque

 

Split image on a blue background. Left side shows a white woman with long
red hair, wearing a pinstripe suit, sitting at a desk with her head
in her hands. Right side shows a man slumped forward with his head
in his hands, setting across a table from an older woman.

Tony Blair's centre-left think tank wants people with conditions like ADHD, depression, and anxiety to be actively prevented from claiming welfare assistance for unemployment.

These conditions, the think-tank believes, are "not work-limiting."  

As someone with lived experience of severe depression with suicidal ideation, generalised anxiety disorder and social anxiety, who has never claimed any of these conditions mean I "can't work", and who generally takes the view that you "may as well go to work depressed and anxious - at least you get paid for it", I'd like to agree.  I've been into work the morning after a failed suicide attempt. I've had a full on psychotic episode while at work.  I regularly show up for my freelance work feeling depressed. I have panic attacks about opening my email, and after sending cold outreach emails.  But I open the inbox. I send the emails. 
(The idea of a cold phone call literally paralyses me with anxiety. I also have mild hearing loss and Auditory Processing Disorder, which make phone calls very difficult as a form of effective communication for me.)

But, as someone who got sacked with immediate effect and blacklisted from working in the financial services sector because of that psychotic episode I had at work, as someone who was subjected to extreme workplace bullying, including physical and sexual violence, because my anxiety means I show up as "quiet and mild-mannered", which, in a man, upsets a surprising amount of people, both men and women,  as someone who was repeatedly yelled at for "not having a positive attitude" before being sacked "because no one here likes you, because you're so negative", by a manager in a Disability Confident employer (who already had me in their sights because I'm legally blind, and they changed the nature of my job to a "mandatory" way of working that I physically couldn't do, because of being blind...that ramped up my anxiety and depression, which likely led to the "no one here likes you" experience), I can't agree with the statement that ADHD, depression, and anxiety "aren't work-limiting", and therefore those experiencing them "shouldn't be entitled to welfare assistance."

It may not be the case that you can't work with "mental health" conditions and neurodiversities, but it is the case that:
. Employers really don't want to hire you
. Application and interview processes are the very first barrier you'll encounter
. The stress of the Universal Credit "fit for work jobseeker" claimant commitment and process is overwhelming
(it's overwhelming if you don't have depression, anxiety, etc...if you do? You'll want to kill yourself on a regular basis, but you're not allowed to talk about that, because it upsets the Jobcentre Plus staff.)
. There are fewer working environments which don't exacerbate your condition/s
. It is harder to establish and maintain the "social networks" that project opportunities, stretch opportunities, promotions, and access to leadership facilitate

It's easy for mentally well people to imagine that depression or anxiety claims are "people saying they're too sad or scared to go to work, and getting thousands of pounds a month to lay in bed and cry to social media."

In my case, it looks like anger. Which in a six foot, stocky guy whose face will definitely tell you exactly what I'm thinking, in a world where work is increasingly centring women's feelings and fears, is not conducive to avoiding "conversations" with HR, however well you do your work.   

It looks like me showing up and focusing on my work - which is taken as me being "aloof and antisocial", which "upsets" people, and "makes me a bad fit for the team."  There's a reason I work freelance, after all.

But remote work is also in the crosshairs of the government and their various allied think tanks, as well as the media.  Remote workers are skiving off, they're working in their pyjamas, they're declining meetings to go to the gym. (I wish!)  Increasingly, companies are snatching away the right to work remotely - the job just can't be done remotely! Employers are genuinely sorry, but it's just not possible. People here have to be on site.

Mental health issues don't come with a blank cheque.

It doesn't matter how sound, data-driven, or evidence-backed your arguments that "people with depression, anxiety, and ADHD can work! These are not work-limiting conditions!" are - the experience of applying for, getting, and keeping jobs is far more challenging when you have mental illness and/or neurodiversity than it is for people who don't experience these conditions, and people have to be able to afford to live.

We're not all twenty-somethings with loving parents who let us live with them rent free.
We're not all winsome, stereotypically-attractive cisgender AFAB people with partners who can support us financially.

I've been rejected from McDonalds and OnlyFans in the course of my life.  I can't even apply for a job as a litter picker with my local council, because "you need to have a full UK driving licence and access to a vehicle to be eligible for this job." (I'm legally blind. Driving licences and cars are not going to be part of my life.)  I've previously been refused work as a cleaner, because the female manager insisted that "men don't know how to clean."  Never mind the fact that I'd been responsible for handling housework since I was eight, and had been living on my own, and keeping my own place clean, for over half a decade at that point, as well as having previously worked at a breeding and boarding kennels. (If you can clean a kennel, you can clean anything...)

My current freelance contract ends in December. I've already started cold-pitching for new contracts, something which feels completely pointless, if I'm honest, and which sends me into a deep spiral of depression and anxiety; not being able to drive means I can't trot around building up "contacts."  Not being able to drive means I'm mostly shut out from even applying for senior roles, because apparently the existence of taxis and public transport is a myth, and it would be completely impossible for a person on a decent salary to utilise such services - almost all of those jobs insist that "a full UK driving licence is a mandatory requirement."  And in the era of ChatGPT et al...what's the point? No one wants a human any more, but they won't tolerate those humans claiming welfare support, either.

Anxiety and depression isn't just "all in your head."

My anxiety is a major trigger for my IBS.  I will literally be soaked in sweat, snarling in agony, shaking and close to vomiting.  I regularly soil myself without realising, despite taking charcoal pills (which help a bit), and following an IBS-sensitive diet (which helps slightly less than the charcoal pills, mostly because those are very fibre-dense, and fibre is also a trigger for my IBS...but also necessary for wider health.)

I have panic attacks which feel like heart attacks at least twice a month, sometimes more frequently, despite taking medication for anxiety, meditating, journalling, and following somatic processing, EMDR (Eye Movement Desensitisation and Reprocessing), CBT and DBT (Cognitive Behavioural Therapy and Dialectical Behavioural Therapy) practises.  My GP has recommended hypnotherapy; the NHS doesn't offer it in my area, and I can't afford private sessions, especially when my anxiety is sky high at the idea of not being fully conscious and in control whilst alone with a stranger, which means I may hand over a significant amount of money, just to find out I can't actually engage with hypnosis. 

The panic attacks cause my remaining vision to black out entirely, and the spike in intercranial pressure that results from the panic attacks risks my unstable retina detaching - which would mean the 40% vision I currently have (centre field left side only - the rest is totally gone already) would be lost. Which would make working, even self-employed, almost impossible. (My hearing loss and APD makes using a screen reader very frustrating, even when, as now, I can still see to an extent, once I've sorted out adjustments to settings and displays, etc.  If I was fully reliant on a screen reader? I can't realistically imagine being able to function.)

And, as I've already mentioned, my anxiety often manifests as anger. Not just frustration, but sheer, terrifying rage.  The other option is overwhelm and shut down. Neither of which are particularly seen as "appropriate in the workplace."

I've lost count of the number of hours of actual work I've been forced to lose when I've been in PAYE roles to attend mandatory "resilience training" courses - as though showing up when my intention had been to be fucking dead isn't peak resilience.

I've been in full time PAYE work. 45hr week, with a 15hr per week commute by two separate buses and a 25minute walk each way.  I was completely unable to do anything but work.  I had a mental breakdown in that job; I got signed off for two weeks. Five working days later, colleagues were calling me on my private phone, sending emails to my private gmail - I went back to work on day seven.  I didn't have time to go to the follow up appointment I was supposed to have with my GP. I didn't have time to engage with the mental health service I'd been referred to.

That was almost a decade ago.

Now? My sight loss is causing extreme fatigue, because it takes so much more effort for me to manage visual tasks than a sighted person uses.  And my anxiety and depression are worse; they also take an energy toll.  I have kinship care responsibilities.  I have to be an equal participant in the domestic work of running my house, because my wife has high-impact physical disabilities which mean she is not always able to manage housework.

I can't sustain full time work any more, even in a freelance capacity.  
My wife can't work at all.

We don't have family who can "help us out" financially.
We don't have friends who can afford to "have our backs."
We can't access credit.

I need to get a minimum of two further freelance contracts, ideally four to five; I have no idea how I'm going to do that.  I can't easily travel for on-site commitments. I don't have "contacts." I can't easily travel to find "contacts."  I can't make outreach phone calls, because of my hearing impairment. Sending outreach emails causes me overwhelming anxiety, and they probably don't even get read anyway - or at least they don't get read by a human.

I don't have anything left I can sell.

I don't know how to work social media to the point that that generates revenue.  I can't see well enough to edit videos. Social media sites are hell for my anxiety.  I can't afford to pay people to help me.

I could very easily produce a written course - but no one would buy it, because "everyone knows courses are just a scam."   I don't have the money to rent a venue, or promote tickets for, an in-person course.

The NHS doesn't have the capacity to provide decent, relevant mental health support.
I self-identitified everything the NHS would suggest (yes, I work out - I do strength, resistance, and kickboxing training 5 days out of 7.  I used to go swimming - then I lost my PAYE job, because my "negativity" meant my colleagues "didn't like me", and couldn't afford to keep my gym membership. I go outside every day - I have dogs. They need walks.)   It doesn't really make any actual difference.

Medication doesn't really make any actual difference.

My anxiety is also actively preventing me from engaging with NHS healthcare, because of the NHS' current fixation with "make everyone who shows up, especially for "mental health problems", go on GLP-1s.  I do not trust what is a genuinely unproven "medication", which is showing significant adverse health impacts, and has strong correlations with causing sight loss; since I already have four formally diagnosed sight loss conditions, I'm not taking those kinds of chances, whatever the NHS believes about GLP-1s.  I recently just...didn't attend a routine condition management appointment for my sight loss conditions - because the thought of engaging with a "healthcare" system which is aggressively defaulting to overreliance and insistence on what is proving to be a potentially dangerous, if very popular, medication caused a major, hours-long panic attack.

If the government, or Tony Blair's think tank, would like to extend a fully remote freelance contract, which offers ongoing financial certainty? I'd gladly take it.

In the meantime, there are some urgent - and zero-cost - changes to the "business as usual" of the DWP and Jobcentre Plus, as well as UK recruitment, that need to happen:

. The adversarial "claimants are lying scum, and it's our job to catch them out" nature of Jobcentre Plus and the DWP needs to stop. Completely, immediately. You're supposed to be professionals. You're engaging with adults. Act like it.

. The complexities and over-reliance on forms, unclear timeframes, and confrontational interviews which often feel like set-ups to fail for job applicants needs to be changed.  There is absolutely no reason why a CV and cover letter isn't sufficient for a job application.  There is no need for more than two interview rounds.  It is completely possible for the application-to-response process to take no more than a week, which allows applicants to move on promptly, and also more effectively manage Universal Credit claimant commitments when they are out of work and reliant on welfare.

. Remote work needs to be centred, and demanding driving licences and access to private vehicles prohibited unless a job actually involves driving.

. There needs to be a far more compassionate attitude from the government towards trans people.
 The recent Supreme Court rigmarole, the resulting EHRC "interim guidance", the fixated insistance on people like Baroness Falkner and JK Rowling on preventing trans and gender-non-conforming people (including intersex cisgender people) from having any kind of safety or certainty outside their own homes is a major contributor to people citing mental health issues as a barrier to pursuing employment - who the hell is going to willingly go into a workplace where they risk harassment for going to pee?  Who is going to choose to deal with people who feel they're supported by the government when they harass, intimidate, and threaten people whose gender they have opinions about?

. Likewise, the government and media rhetoric against "immigrants" needs to stop - just as is the case for trans, intersex, and gender non-conforming people, those who are, or could be assumed to be, "immigrants", or even just "not British enough", are facing genuine reasons to be extremely anxious about engaging with employment.  Prejudice and bigotry only ever results in people turning away from PAYE employment, because it becomes too much of a very real risk to their safety.

Five changes.
None of them costly.

Surely it's worth it if it addresses the least costly element of the DWP spend - welfare support for those unable to work owing to disability. (The highest element is the State pension and its associated benefits, closely followed by support for children and families, including those in work, and the programmes around that.)

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