Health & Worklessness

Improving individual health and wellbeing across Wirral

Tackling entrenched problems in service delivery related to worklessness to improve outcomes for residents (Full content) (December 2015)

Health inequalities across Wirral, particularly between the east and west side of the borough, persist regardless of the cross sector work to alleviate and minimise their negative impact.

This research was jointly commissioned between Public Health and Regeneration in order to gain a greater understanding of  the barriers people are facing when existing on Employment Support Allowance with subsequent outcomes for their mental health and wellbeing. Public Health wanted to understand what motivated people to change their behaviour and how the place where they live impacts on their motivation to change.

Alongside developing our collective understanding as to these issues facing people in the borough there is an absolute recognition of the need to build the capacity of communities to take responsibility for their own health; using asset based community development techniques.

This research approach was an ethnographic method that focused on observing and interviewing real people to gain vital insight

Now the work is complete the research is being shared with local professionals and leaders and there has been agreement about the need for the need for transformation of services and investment strategy.

Headlines from reports 

(Also see Overview and Full content)

• Overly Basic Support
  Setting activities and programmes at the lowest common denominator means that some individuals aren’t challenged, with ability and/or health only maintained rather than improved. Content may even patronise and deskill individuals. It could also deter people from accessing further support.

• Unrealistic Goals
  In regards to health and wellbeing, many individuals couldn’t see themselves engaging in fitness or sport, or could not see how they could fit in it to their life. With little idea of how and/or motivation to take first steps, goals felt unachievable.

• Confusing service provision & messaging
  From the perspective of service users it is very difficult for them to understand what is available to them. Navigating the landscape of different brands and offers, and understanding what they may be eligible to can feel impossible. This can lead to individuals missing out on services and support that could be helpful.

• Perverse Incentives
  Claimants were so worried about being judged ‘work-ready’ in the Work Capability Assessment that they had stopped enjoying any aspect of their life (or hid enjoyment) in order to fully embody what they understood as expected of an ‘ESA claimant’. This had negative implications for individuals’ sense of self worth and confidence, and interaction with others.

• Social Isolation
  The absence of connection and increased isolation can have a significant impact on mental health, reducing confidence and self-belief. ESA claimants suffered from focussing on how they might be perceived by others- as a benefits scrounger, without interesting experiences to talk about- and this led them to retreat from social situations further. Some health conditions left individuals housebound.

• Mental Health
  Problems were often going ‘untreated’ or treated only with medication. Few people had contact with mental health services. Some individuals had experienced their mental health problems worsen before reaching a point of crisis, and only then received treatment.

• Demotivation
  Research found that some individuals were very quick to blame outside factors for their lack of success, and had a lack of awareness of more internal barriers. By focussing on external barriers, individuals can reason their self-limiting behaviour, and divert their attention away from their low self-confidence.

From the work there has been a number of key aspects that need addressing to improve this situation faced by many - View the 'opportunities for progression'. 

Further to these key areas for consideration there are a number of suggested actions that can be taken to mitigate impacts and improve outcomes for Wirral residents facing these situations.

View '9 ideas to investigate further' or the Full content. 

Access the full slide set or select the overview for more information.

Also consider other JSNA content such as:

• JSNA Mental Health

• JSNA Employment

• Economic Profiles

• JSNA Older People

• JSNA Social Isolation & Loneliness

• JSNA Social Prescribing

• MECC .. Make Every Contact Count