Mental Health and Benefits Handbook 1st edition - with new materialPart 1: Mental health Chapter 3: Giving advice
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Chapter 3: Giving advice
This chapter is mainly aimed at professionals who give advice about benefits. You may find this chapter useful whether you are a benefits specialist or benefits advice is only a small part of your work. It should be read together with the information in Chapter 20 about being a ‘third-party representative’.
Key facts
    •Giving good advice is not just about supporting someone with something they have difficulty doing. It is also about identifying what their strengths are and empowering them to use those as much as possible.
    •Using the correct and preferred language and agreed communication methods of the person you are supporting is important.
    •Not everyone needs the same type of support for the same things. It is important to allow each individual as much agency as possible when they are making a benefit claim.
    •You can set boundaries with the person you are supporting, such as agreeing on times when you will not be available and being clear about what you can and cannot support with.
1. Supporting people with mental health problems
If you are not a benefits professional, the benefit system can be very difficult to understand, whether you have a mental health problem or not. The additional barriers and stigma that people with a mental health problem may face can make dealing with the benefit system distressing.1Mind, People, Not Tick-Boxes: a call to rebuild the disability benefits system, October 2020, available at mind.org.uk/media/6483/people-not-tick-boxes-october2020.pdf Having someone who supports and understands our needs, and who advocates for us can make claiming benefits possible.
Good advice and support needs to come from a place of understanding. This is not just an understanding of the benefit system, but an understanding of how someone’s mental health and personal circumstances impact how they move through that system. People tend to respond better to someone who can relate to their experiences. You do not necessarily need to have had a mental health problem yourself to support someone. Putting in the time and effort to know more about someone’s individual issues can be just as valuable.
Giving good advice is not just about supporting someone with something they cannot do or have difficulty doing. It is also identifying what their strengths are and empowering them to use those as much as possible. Remember you are acting as a guide through the benefit system. Do not gatekeep information or create a situation where someone would be defenceless if you were not around.
What advisers say: giving advice
‘Mental health is incredibly complex and everyone has their own story. The only person who fully understands what they are going through is them. It’s important to have empathy and treat everyone you meet with dignity, respect and patience. Benefits are often the only financial support some people have and it’s sometimes the only thing stopping someone from becoming homeless or going hungry. Knowing that you are able to support them to receive help is incredibly rewarding.’
‘Don’t give false information and don’t give information you think will make someone happy in this one moment. You have to be honest.’
 
1     Mind, People, Not Tick-Boxes: a call to rebuild the disability benefits system, October 2020, available at mind.org.uk/media/6483/people-not-tick-boxes-october2020.pdf  »
Terminology
Mental health and the benefit system can involve jargon. Both you and the person you are supporting might need to explain terms to each other.
Mental health terminology
Using the correct and preferred language of the person you are supporting is essential in showing that you understand and care about them. You should ask the person you support what terms they prefer and consider them an expert on their own experience.
There may be times when you need to use terms that the person you are supporting does not feel describes them. These could be terms like ‘disability’ or certain diagnostic labels. These terms may need to be used for applications. If you have to use terminology that someone is uncomfortable with, explain why and only use those terms when absolutely necessary. Apart from in the claim itself, you should use the terms the person prefers.
It is also important to correct others when they use the incorrect terminology. This could happen during benefit appointments or assessments. This should be done whether the person you are supporting is with you at that time or not.
There is more information about mental health terminology on here and more information about symptoms and treatments in Chapter 2.
Benefits terminology
There can be a lot of jargon involved in the benefit system. Part of your role as an adviser is to help people understand this jargon. Explain, in plain English, what certain terms mean.
You may also have to explain why certain terms apply to the person you are supporting. These might be terms that they know but do not identify with in their own experience. For example, not everyone knows that mental health problems can also be a disability, just like physical health problems. Someone could be missing out on essential financial assistance because of this misunderstanding.
Communication preferences
Knowing how someone prefers to receive and give information can be key to supporting them. It is also important to identify when these preferences may need to be communicated to the people working in the benefit system as requests for reasonable adjustments (see here). Remember that no one communication method is superior to another, and just because you prefer one form of communication it does not mean other forms are not valid or effective.
Be as flexible as possible in how you communicate and accept how the person you are supporting needs to communicate. Some people might prefer to send voice notes rather than type a text or email. Others may need things explained in diagrams rather than written words.
Timing is also important in effective communication. Some people may be more comfortable speaking at certain times of day and be able to understand information better at these times. This could be for different reasons, such as the impacts of medication or certain symptoms.
There may be certain periods when someone finds it difficult to communicate. This could be around the time of a big event, such as a holiday, or on the anniversary of a trauma. It may be harder to meet deadlines or attend appointments around these times.
It may also take some time to establish good communication. Mental health can be a very personal experience, and while some people might be comfortable opening up to you, it may take others a while. You may not get the full picture from one conversation.
Finding a suitable place to talk is also important. Some people may prefer a confidential room where they feel safe to open up without being overheard, others may prefer to meet in a less formal setting such as a cafe or in a familiar place.
Support needs
Not everyone needs the same type of support for the same things. It is important to allow each individual as much agency as possible when they are making a benefit claim. It is better to support someone to understand what to do and do it themselves than to take over the process and do everything for them, unless they have explicitly asked you to do that. Even if you are taking on a substantial supportive role, record what you are doing in a form that is easy for the other person to understand if you are not there or if they need to do something themselves.
Remember that support needs can change with time and with variation in someone’s mental health problem. It is good to check regularly whether these needs have changed.
The person you are supporting may need your help to request appropriate support within the benefit system – eg, from the job centre or the tribunal. Chapter 20 has more information.
Suicidal feelings and self-harm
Some advisers are uncomfortable talking about suicidal feelings and self-harm and worry that mentioning them will cause the person they are supporting to harm themselves. If you ask these questions respectfully and in a safe way, this is very unlikely. Suicidal feelings and self-harm can be difficult for people to talk about, and they might not bring it up themselves if they do not feel they can trust the person they are talking to. Mind has information on how to talk to someone about their suicidal feelings and about self-harm, which might help you have these conversations.1mind.org.uk/information-support/helping-someone-else/supporting-someone-who-feels-suicidal
Even though having these conversations can be beneficial, take care about the questions you ask and only explore what is relevant. If you are having these conversations, make sure you have plans in place to support someone afterwards if they feel vulnerable.
Do not overreact or assume that all suicidal feelings and self-harm need urgent medical attention. While these experiences and feelings are serious and indicate that the person having them is in a vulnerable place, they may have their own support and safety measures in place to manage them. Make sure you listen to what they have to say before taking any next steps.
There is information about answering questions about suicidal feelings and self-harm during an assessment on here. There are also tips on here for advisers and supporters who have a safeguarding concern.
 
1     mind.org.uk/information-support/helping-someone-else/supporting-someone-who-feels-suicidal  »
Getting needs recognised in the benefit system
As the person with knowledge of the benefit system, you should use this knowledge to make sure the person you are supporting has their needs heard.
Discussing another person’s benefits
The DWP 1The Department for Work and Pensions. A central government department that pays many benefits in Great Britain., Social Security Scotland 2A Scottish government department that pays many devolved benefits in Scotland., local authorities and other bodies have rules about discussing benefit claims with people who are not the claimant. These policies uphold confidentiality and data protection rules, but they can make it more difficult for you to help the person you are supporting to navigate the benefits system. Chapter 20 has more information and tips about speaking to public bodies on someone else’s behalf.
Reasonable adjustments
Some support and communication needs may be considered reasonable adjustments under the Equality Act 2010. As an adviser, you should accommodate these reasonable adjustments yourself, as well as making sure the person you are supporting knows they can request them within the benefit system – eg, from job centres and assessment providers. See here for more information about reasonable adjustments.
Alternative payment arrangements
A mental health problem might affect how someone is able to manage their benefit income. Alternative payment arrangements are available for some benefits. These can include:
    •splitting a monthly payment into more regular payments;
    •having housing elements paid directly to a landlord, housing association or local authority;
    •splitting payments for joint claims between bank accounts.
If the person you are supporting identifies that one or all of these would be helpful for them, you can help them advocate for this change. For more information about alternative payment arrangements for a particular benefit, see the ‘Getting paid’ section of the chapter on that benefit in this Handbook.
Deadline extensions
Deadlines for benefit forms, mandatory reconsiderations 1The requirement to have a decision looked at again by the DWP before you can make an appeal. and appeals can be a source of stress, but there are some rules to protect people unable to meet these deadlines. For more information about deadlines and extensions for a particular benefit, see the chapter on that benefit in this Handbook.
Rescheduling benefit appointments
There may be reasons why someone cannot keep an appointment (eg, a job centre appointment, an appointment for an assessment, or a tribunal hearing date) due to their mental health. You should inform the person you are supporting about the rules around rescheduling and help them to explain their circumstances. See Chapter 17 about job centre appointments, Chapter 16 about assessments, and Chapter 19 about appeal hearings.
Work-related requirements and sanctions
Some benefits, like universal credit, have requirements about looking for, or preparing for, work. These requirements do not apply to everyone and should be adjusted to reflect your capabilities. People with mental health problems can be placed in the wrong work-related activity group because the person deciding their claim does not recognise how their mental health problem affects them. If the person you are supporting is put in the wrong group, explain their options.
If the person you support has been sanctioned (or threatened with a sanction 1A reduction in a person’s benefit for failing to meet their work-related requirements without a good reason or because they have committed a benefit offence.) for failing to comply with a work-related requirement, advise them about their options and the financial support that might be available.
Chapter 17 has information about work-related requirements and sanctions.
Mandatory reconsiderations and appeals
Benefit decisions can usually be challenged. Make sure the person you are supporting knows their options if they disagree with a decision. Chapter 19 has more information about challenging decisions. Offer to support them through this process if they are comfortable with this. If you are unable to provide this support, make sure they know who can and support them as much as possible in transferring the relevant information over to this new individual or agency.
Complaining about discrimination
It is unlawful to discriminate against someone because of their mental health problem if it is considered a disability under the Equality Act 2010.1ss6 and 15 EA 2010 This can include failing to put reasonable adjustments in place. The person you are supporting might not always realise they are experiencing discrimination. The Equality and Human Rights Commission has more information on disability discrimination and how to challenge it.2equalityhumanrights.com/en/advice-and-guidance/disability-discrimination See here for more information about making a complaint.
 
1     ss6 and 15 EA 2010 »
2     equalityhumanrights.com/en/advice-and-guidance/disability-discrimination  »
Not passing judgement
We can feel uneasy about seeking support and talking about our mental health. As an adviser, it is important to be non-judgemental about the person you are working with. Take time to understand their experience and do further research if necessary. How someone behaves might not always make sense to you, but trying to understand the need behind this behaviour will help you approach these situations non-judgementally.
Keep in mind that many mental health symptoms are hard or impossible to control and can make everyday tasks difficult. It is very unlikely that someone is intentionally doing something to impact their benefit claim, like missing a deadline or appointment, even if these things seem simple to you.
Encouragement and realism
Applying for benefits can be a long process, particularly if you need to go through mandatory reconsiderations or appeals. Receiving benefits is also an ongoing process, with claims that need to be managed in the long term, and which may involve reassessments or reviews. Try to be as encouraging as possible when someone finds this process difficult, but also be realistic. Do not promise things you cannot deliver, as this may result in someone losing trust in you. For example, you cannot guarantee that someone will be awarded the same benefits after a review, but you can encourage them and support them in presenting their best case and challenging decisions they are unhappy with.
When supporting somebody is challenging
Advisers have a finite number of appointments to offer and a finite amount of time in each appointment and for follow-up work. It can be difficult to know how to respond if the person you support repeatedly misses appointments, does not respond to calls or emails, or does not do things that you ask them to – eg, provide a copy of a letter, or return a signed form. Your organisation might have a policy about managing ‘dropped contact’ or missed appointments. This must be flexible and recognise people’s different needs and the many good reasons why they might struggle to get to appointments or make a phone call. You should consider reasonable adjustments if somebody’s challenges are the result of their mental health condition. If somebody stops engaging with you and this means they are not getting help to address a serious benefit issue, this could be a safeguarding concern.
Sometimes distress prompted by a decision or situation is expressed as anger or aggression towards you as the adviser. This is always challenging. Again, your organisation might have a policy on how to respond in these situations, which must be flexible, recognise the different reasons why somebody might act in this way, and consider reasonable adjustments.
What advisers say: appointments
‘I try to see it from their point of view and remain patient. I reassure them that we can always make another appointment and adjust it so that they feel more comfortable. For example, if they prefer face-to-face appointments, make that change so that they are more likely to come to the appointment.’
‘We don’t book back-to-back appointments. We always have a break between appointments because if something happens or if someone is upset we need time to just be able to sit with them rather than say “I’ve got another person to see”.’
Look after your own needs
Make sure you take time for yourself. You can set boundaries with the person you are supporting, such as agreeing on certain times when you will not be available and being clear about what you can and cannot support with. It will not help either of you in the long term if you are overextending yourself or taking on more than you can manage.
What advisers say: looking after yourself
‘I make sure that I maintain a healthy work-life balance and that I create enough time in the day to take care of myself especially on the days when clients disclose difficult information to me. Having a good support network is important. That could be a friend, colleague, manager or relative that you can speak to. I make sure that I exercise regularly, do yoga, practise meditation and mindfulness and make time for hobbies. The days can be long and overwhelming so I make sure that I do take adequate breaks during the day and try not to skip meals.’
2. The advice journey
If you are an advice worker, it is likely that you will spend a lot of your time supporting people with the following steps in their benefit claims.
Helping people understand what they might be entitled to
This can be described as a ‘benefit check’. Some advice agencies use benefit calculators as a starting point.
    •For a brief explanation of the different types of benefits, see here.
    •To understand the basics about the benefits covered in this Handbook, see the ‘Key facts’ list at the start of each chapter.
Starting a claim
Different benefits are claimed in different ways. Whether or not your advice service helps people start claims, you often need to explain the different claims processes and what to do if something goes wrong.
    •For information on how to claim universal credit (UC), see here.
    •For information about moving to UC from other benefits, see here.
    •For information on how to claim employment and support allowance (ESA), see here.
    •For information on how to claim personal independence payment (PIP), see here.
    •Information about claiming other benefits can be found in the ‘Making a claim’ section of the chapter about the relevant benefit.
Completing forms
This can be a particularly crucial area of advice work. The person you are supporting may have a symptom that makes completing forms difficult, or the forms themselves might not allow someone to explain properly how their mental health problem affects them.
    •If you are helping somebody to complete a UC50 or ESA50 form, see here.
    •If you are helping somebody to complete a PIP form, see here.
    •Information about completing other forms can be found in the ‘How you are assessed’ section of the chapter about the relevant benefit.
Collecting evidence
Supporting evidence about a mental health problem and the impact it has on somebody’s life can help them to get the right decision about their entitlement to benefits.
For information about different types of evidence that might support your client’s claim, and how to get hold of it, see here.
Assessments
Sometimes, claiming benefits involves having an assessment with a healthcare professional 1A doctor, nurse, paramedic, physiotherapist or occupational therapist who carries out assessments.. This is most common for UC, PIP and ESA.
    •If somebody is going to a PIP or UC/ESA assessment and wants advice, see here.
    •If somebody has missed or cannot go to a PIP assessment, see here.
    •If somebody has missed or cannot go to a UC/ESA assessment, see here.
Challenging a decision
Most benefit decisions can be challenged. As an adviser, it is often your role to support somebody through this process.
    •If you are writing a mandatory reconsideration 1The requirement to have a decision looked at again by the DWP before you can make an appeal.request, see here.
    •If you are helping somebody complete an appeal form, see here.
    •If somebody has appeal papers and you are helping them prepare submissions, see here.
    •If you are attending a tribunal hearing with somebody, see here.
Communicating on somebody’s behalf
It is often important for you to be able to contact other agencies on somebody’s behalf.
    •If you are struggling to get the DWP 1The Department for Work and Pensions. A central government department that pays many benefits in Great Britain., Social Security Scotland 2A Scottish government department that pays many devolved benefits in Scotland. or a local authority to speak to you as a third-party adviser, see here.
    •If you think that somebody may need an appointee 3Someone authorised to claim and receive your benefit on your behalf, when you are unable to manage it yourself., see here.
Advice appointments
Knowing the benefit system is an important part of giving good advice, but listening and communicating clearly are also crucial.
Advice skills for appointments
– Consider how to make the person you are supporting most comfortable. Would they prefer an appointment in-person or by video or telephone? What time is best for them? Have you given them the opportunity to bring somebody to support them in your appointment? Can you put them at their ease by changing the layout of an appointment room or offering a drink of water?
– Remove distractions or stressors as much as possible – eg, external noise, interruptions from colleagues, or phone alerts.
– In longer appointments, plan breaks.
– Consider your body language and tone of voice throughout the appointment.
– Consider a ‘script’ for the start of the appointment – eg, introducing yourself, explaining your role, and asking the person you are supporting to tell you at any point if they need a break.
– You will probably be asking a lot of questions about what somebody cannot do or finds difficult, rather than focusing on the positives of what they can do. This could be disheartening for the person you are supporting. Consider addressing this at the start of the appointment and explaining why this is necessary.
– Only ask one question at a time.
– Listen carefully. There is the risk of ‘tuning out’ information that does not answer your question (eg, which relates to a different part of the form you are going through) but it might be critical information and the person you are supporting might not repeat it. Use scrap paper to record these comments if necessary.
– Consider using open questions (eg, ‘how’ or ‘when’ questions) if the person you are supporting is finding it difficult to open up. Consider asking closed questions (ie, ‘yes’ or ‘no’ questions) if you find it difficult to get the precise information you need.
– Think about what you are asking and whether it is strictly necessary. Some people might be happy to open up about the details of their life, but many people can be retraumatised by going into too much detail. If you have to ask something that may be upsetting, explain why and offer the person you are supporting a break if they need it.
– When you give advice, try to do this concisely and without using jargon.
– If the information you need to share is complicated, consider the best way to share it – eg, verbally with a follow-up letter that sets it out in writing.
 
3. Difficult times and bad news
Even with good preparation, a benefit claim may not have the outcome that the person wants. In cases involving mental health problems, decisions are often made which lead to very difficult situations. These can include:
    •sanctions 1A reduction in a person’s benefit for failing to meet their work-related requirements without a good reason or because they have committed a benefit offence., which may leave someone unable to pay for essentials;
    •a benefit application being turned down, or a lower award than expected, leading to a mandatory reconsideration 2The requirement to have a decision looked at again by the DWP before you can make an appeal. or appeal;
    •an appeal not being successful;
    •a review or reassessment resulting in a lower award or in benefits stopping altogether;
    •moving from one benefit to another (eg, because of a change in circumstances), which may make it more difficult to manage or leave somebody worse off.
These issues can have a significant impact on someone’s mental health.1Rethink Mental Illness, Tip of the Iceberg? Deaths and serious harm in the benefits system, July 2021, available at rethink.org/media/4758/tip-of-the-iceberg.pdf When you are first supporting someone with a benefits claim, it might be beneficial to talk about what support or self-care plans they have in place to manage bad news if it comes. This could involve speaking to someone they are close to, or going through a calming routine to help them process the news. Letting someone know what support they can get or where they can find out more about their rights in these situations can also help.
When going through these situations and delivering this news, be sure to follow the tips on here, including following agreed communication methods and reviewing what the person’s support needs may be.
If the person you are supporting is at risk of harm, you may need to take certain actions to safeguard them (see here).
 
1     Rethink Mental Illness, Tip of the Iceberg? Deaths and serious harm in the benefits system, July 2021, available at rethink.org/media/4758/tip-of-the-iceberg.pdf »
Challenging decisions
Many of the issues above are the result of decisions that can be challenged. Chapter 19 has more information about challenging a benefit decision.
The processes involved in these challenges and appeals vary depending on the circumstance and the benefit. These processes can take a long time. The person you are supporting might be unsure about challenging a benefit decision because of this. While you must respect their wishes, make sure they are making an informed decision about whether or not to pursue a challenge. Let them know what support is available and be realistic about what will be involved so they can make the right decision for them.
When nothing can be done
There are rare occasions when nothing can be done about a benefit decision. Not all decisions are made on challengeable grounds and sometimes changes to the benefits system leave people worse off. Once an appeal has been heard by a tribunal, it cannot always be taken further.
Do take great care before writing off a situation as one in which ‘nothing can be done’. Measures like judicial review 1A way of challenging the decisions of government departments, local authorities and some tribunals against which there is no right of appeal., complaints and involving an MP (see Chapter 19) might help where an appeal is not an option. Just because a decision is discretionary does not mean that it cannot be challenged (see, for example, here about challenging someone’s work-related requirements 2Activities connected with finding or preparing for work that some people must undertake to receive universal credit or employment and support allowance. for universal credit, or here about asking for a different format/venue for a benefit assessment).
While the decisions themselves might be justified based on the rules, they can still have serious effects on individual lives. A reduction in benefits can have a serious financial impact, as well as making someone’s mental health worse.
While there may be no steps you can take to challenge the decision, that does not mean there is nothing at all that can be done to improve the situation. You can signpost to the financial support that might be available. See Chapter 14.