‘It’s like the Sword of Damocles’ – A trauma-informed framework analysis of individuals’ experiences of assessment for the Personal Independence Payment benefit in the UK

Abstract

While a growing body of evidence has highlighted the psychological distress experienced by individuals dealing with the UK benefits system, there has been little research into that system from the perspective of Trauma Informed Care (TIC). This study explored to what extent people’s experiences of benefits assessment fitted with TIC principles, using a framework produced by NHS Education for Scotland. Secondary aims were to understand experiences that were not captured by the framework, and to explore the limitations of the framework in context. Participants were 12 people receiving NHS therapy for trauma-related difficulties, who had attended an assessment for the Personal Independence Payment (PIP), a UK financial benefit designed to help with long-term illness or disability. Semi-structured interviews were carried out, and a framework analysis conducted. Results suggested that PIP assessments were severely re-traumatising, with a prolonged adverse effect on mental health. Participants’ experiences contrasted so greatly with the principles of TIC that an alternative framework was constructed, comprising five key themes: harm, distrust, rigidity, intimidation, and powerlessness. Recommendations are made for further research, including an understanding of assessors’ perspectives, and how TIC principles might be introduced into the assessment process.