Background Research focusing on the impact of current welfare reform in England has identified that people with mental illnesses experience pronounced difficulties when accessing social security compared to those with other health conditions. This includes a disproportionate risk of being sanctioned, problematic assessments resulting from a system designed to focus on physical capabilities and a greater likelihood of being viewed as a fraudulent claimant. The impact of individual policies is useful evidence, however the existence of disadvantage across several aspects of this system may imply the presence of underlying mechanisms which need to be understood if further marginalisation is to be prevented. The perspective of individuals with mental illness has been largely omitted from this discussion and may provide useful insights into these topics. The current study therefore aimed to explore the lived experiences of people with mental illness accessing housing and income benefits in England.

Methods Participants were recruited through five organisations offering support with social circumstances to people with mental illness in Leeds, England. Semi-structured interviews were completed with adults (n=11) accessing housing and income benefits, living independently in the community. Convenience sampling in conjunction with organisation staff was employed to recruit participants. The sample was comprised of participants with the following mental health issues: depression (n=8), anxiety (n=5), post-traumatic stress disorder (n=1), bi-polar affective disorder (n=1), psychosis (n=2), borderline personality disorder (n=1) and substance misuse (n=2) with several instances of co-morbidity. Data was interrogated using a six stage thematic analysis approach.

Results Accessing housing and income benefits can be problematic for people with mental illness due to the ‘unseen’ nature of these conditions. Barriers included being unable to provide evidence of illness to obtain financial support and the level of system flexibility in recognising the impact of mental health needs. Alongside this, participants encountered stigma from family, friends and the wider community rooted in the perceived validity of mental illness as a reason for claiming benefits. These themes were present across different types of mental health condition.

Conclusion These findings suggest that to create a social security system designed to be effective for people with a mental illness; changes are needed to the way in which mental illness is understood, assessed and monitored in this context. This study used a diverse but small sample in a localised setting and further research is needed to confirm these findings.