King's College London

The project aims are:

• To deepen understanding of the experience of psychological distress among people engaging with the UK welfare system, in order to improve the health-related benefits assessment process and enhance effectiveness of welfare-to-work support for people experiencing mental health problems.
• To engage in deliberative dialogue with DWP civil servants, benefit assessment providers, third sector support organisations and experts by experience, to contextualise and identify the policy and practice implications of the research findings, including how the benefit assessment process might be adapted to better identify, acknowledge and support the work-related limitations of claimants experiencing mental distress.
• To evolve conceptual understandings of claimant distress among key policy stakeholders, helping to ‘shift the narrative’ on mental health within the welfare system by centring lived experience and social context
• To generate substantive and methodological insights to inform the development of further primary research, building towards future empirical projects that directly explore claimant narratives of mental distress and its interplay with welfare system experiences and outcomes

Our detailed research questions are as follows:

1. How did claimants in the Welfare Conditionality study narrate or ‘story’ their lived experience of mental health problems/mental distress?
2. What language did claimants use in describing the symptoms of their distress (e.g. biomedical, diagnostic, social, ecosocial)?
3. What accounts did claimants give of the origins or causes of their distress? How did they ‘make sense of’ the emergence/unfolding of these experiences in recounting their experiences to researchers?
4. What perceptions did claimants hold about the duration or chronicity of their mental health problems?
5. How did claimants describe the impacts of mental health problems on their journeys between benefits and employment?
6. How did claimants’ illness representations influence or interact with their experience of the benefit assessment process and of welfare-to-work obligations and supports?
7. What tentative policy and practice implications can be drawn from the QSA findings regarding how benefits assessment processes might be adapted/improved for claimants with mental health problems?

Research questions 1-5 will be addressed through Qualitative Secondary Analysis conducted by the research team. Research questions 6-7 will be addressed through deliberative dialogue with a diverse group of stakeholders bringing expertise and insights from policy, practice and lived experience. 

The study is a qualitative secondary analysis of a large archived qualitative data set. We will use the method of thematic narrative analysis applying the theoretical lens of the Illness Representational Model, to identify differing ways in which benefit claimants describe, make sense of, and act upon their experiences of mental distress, particularly in the social realms of welfare and employment. 

Our impact goal is to evolve conceptual understandings of claimant distress among key policy stakeholders, helping to ‘shift the narrative’ on mental health within the welfare system by centring lived experience and social context. In turn, this will contribute to improving the health-related benefits assessment process and enhance effectiveness of welfare-to-work support for people experiencing mental health problems.

We will convene an advisory group bringing a diverse range of insights and expertise to the project, from perspectives including use of the welfare system, provision of employment support, mental health services, DWP policymaking, frontline Jobcentre delivery, and provision of health assessment.

Advisory group members will be invited and encouraged to provide feedback and reflections on emerging findings at regular intervals throughout the project, offering alternative interpretations of the data, suggesting further avenues of inquiry, and connecting the research team to relevant activity and evidence from policy, practice and activism/advocacy.

Towards the end of the analysis phase (early Summer 2024), we will hold an in-person deliberative dialogue workshop with all members of the advisory group, to contextualise and identify the policy and practice implications of the research findings, including how the benefit assessment process might be adapted to better identify, acknowledge and support the work-related limitations of claimants experiencing mental health problems.