PIP system traps people experiencing mental illness in “vicious cycle” of recovery and relapse, new report warns

New evidence from Rethink Mental Illness highlights how the current design of the PIP system is causing harm 

The system around Personal Independence Payment (PIP) traps people living with mental illness in a “vicious cycle” of recovery and relapse, according to a new report published as the government weighs up changes to the disability benefit. 

Drawing on in-depth interviews and group discussions with people experiencing mental illness, the report highlights a “recovery trap” in the PIP system. The charity found that PIP helps people to access therapy and other support to manage mental ill-health, with increased stability then used as a reason to withdraw PIP, putting people at risk of financial difficulty and relapse. 

Participants described being unable to move forward in their lives, as recovery could lead to losing PIP and a return to feeling severely unwell. Some told the charity they had not engaged in volunteering opportunities and support groups which could help them due to fears their PIP award would be stopped. 

People living with mental illness said they experienced feelings of guilt and unworthiness despite being unwell and requiring support, reinforced by public narratives suggesting PIP is claimed for “mild” mental health issues. 

Unfair assessments 

The report found that, when it works well, PIP can be life-changing, helping people to manage mental illness, avoid crisis, maintain relationships with others and engage in meaningful activity such as work or volunteering. 

Some examples of how PIP was used included funding therapy not available on the NHS; paying for taxis to appointments, work or social activity where neither driving nor public transport were possible due to mental illness; and enabling a gym membership or participation in exercise classes to manage medication-related weight gain. 

However, the charity also heard that the current PIP system causes harm and isn’t designed to support people experiencing mental illness. 

Participants described a confusing and burdensome administrative process, with many giving up on their claim even when they desperately needed support. Long delays, administrative errors and lost documentation were also common, exacerbating financial insecurity and mental distress.  

People also reported being met with suspicion and scepticism, and said assessment reports often distorted or contradicted what they had told assessors. For example, one person living with anorexia said she had not eaten for three days due to assessment-related anxiety but was recorded as having a “good day”. 

People told the charity that assessors often lack understanding of mental illness, and that the scoring system does not reflect how fluctuating conditions typically present. The system was described as a “lottery”, with similar cases leading to vastly different outcomes. 

Participants said the assessment was intrusive, distressing and re-traumatising, and reported worsening mental health as a result. One respondent said that their interactions with the DWP had contributed to complex-PTSD.  

A vital opportunity to reform PIP 

The government’s interim report on PIP, led by the Minister for Social Security and Disability Sir Stephen Timms MP, is due to be published imminently. Rethink Mental Illness is calling for urgent reform to ensure the system works for people living with mental illness. The charity’s report warns against tightening eligibility, introducing voucher-based schemes, or tying financial support to work, which could make PIP less flexible and even harder to access. 

The report recommends re-designing assessments to better reflect how mental illness presents; ensuring assessors have mental health expertise and are trained to take a trauma-informed approach; and introducing clear safeguards so that stability is never used as a reason to remove support. 

Mark Winstanley, Chief Executive of Rethink Mental Illness said: 

“PIP can be a stabilising factor in people’s lives, helping them to access support, maintain relationships, and even hold down jobs or engage in volunteering. But as our report makes clear, the system is frustrating, inconsistent and distressing for people living with mental illness, causing harm when it should be keeping them safe.  

“What’s most concerning is that the system is penalising recovery. No one should feel they have to stay unwell to keep the support that helps them survive. With major decisions about PIP on the horizon, this is a crucial moment to get reform right.” 

Tessa, 38, said: 

“Unfortunately, the process of applying for PIP severely affects my quality of life to the point I’ve been told I have complex PTSD from the way I have been treated by the DWP over the last decade.  

“I explained how I struggle to do food for myself and when I got the report back, they wrote ‘We have decided this is not true as [she] appears well nourished and overweight.’ 

“Every time I’ve been through the process claiming for PIP, apart from the last review I’ve had, I’ve had to go to tribunal.  

“I am trying to live the best life I can but I feel like I can’t be proud of my achievements when they can be used against me, to take away this safety net that enables me. It’s a constant cycle of uncertainty and instability.” 

Nina, 31, said:   

“I’ve had three assessments which were traumatic. I live with PTSD and [the assessor] touched on my trauma without warning. I was really taken aback and had a panic attack. I had an in-person assessment in 2024 and went into a full-blown mental health crisis. My mum had to come from London to keep me safe from the process... I genuinely don’t know what I would have done if she couldn’t come.  

“You’re so often made to feel that you’re asking for too much when you’re just saying what life is like and answering their questions. It’s like you’re a failure or burden. It’s as if the questions are designed to trip you up. They’re geared more towards physical health than mental health, not how they both affect you.   

“I feel like PIP could get taken away any minute because of government reforms and I’m never living with security.”  

Daniel, 38, said: 

“I was diagnosed at a young age and have lived with bipolar now for many years, which has resulted in me being detained in hospital under the Mental Health Act on a dozen different occasions.  

“PIP massively helps with my quality of life, but the stress that comes with applying for PIP or any benefit is overwhelming, often leading to sleepless nights and depression. 

“If on the day of your assessment you happen to be having an okay day, the assessor may take that at face value, not considering that on any other day you’re just about managing to cope and get through your day. 

“Applying for benefits such as PIP can become a nightmare unless you happen to get an assessor who is empathic.” 

Notes to editor 

For further information or interview requests, please contact Jamie Morrell, Media Manager, at media@rethink.org or 0207 840 3138. 

About Rethink Mental Illness 

Rethink Mental Illness is the charity for people severely affected by mental illness. No matter who a person is or how bad their situation has got, we are here to help them get the information and support they need to live a better life. 

We work tirelessly to ensure people living with mental illness and their carers are listened to, treated fairly and have easy access to services that meet their mental health needs and wider physical health, financial, housing, work and volunteering needs. 

We do this by providing our own services, campaigning on a local and national level, and working with a wide range of other organisations to create communities that care.