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Mental health conditionsOH employment lawOccupational Health

Citizens Advice Bureau: an occupational health resource

by Jane Fairburn 18 Apr 2016
by Jane Fairburn 18 Apr 2016 Employment problems are a chief cause of attendance at the Citizens Advice Bureau PHOTO: Geoff Moore/REX Shutterstock
Employment problems are a chief cause of attendance at the Citizens Advice Bureau PHOTO: Geoff Moore/REX Shutterstock

The Citizens Advice Bureau (CAB) should be on the “signposting resource list” of all OH practitioners. OH adviser Jane Fairburn, trustee of St Helens CAB and managing director of People Asset Management, looks at how the service can be used to support workers with problems.

“One person at a time, helping people to solve their individual problems” – this is how John Gladwin, chair of trustees of the Citizens Advice Bureau (CAB), described the organisation in its most recent business plan.

My involvement as a trustee in the bureau has led me to consider the benefits of having a greater understanding of the CAB, both as an OH adviser and a citizen of the local community. This improved awareness brings an advantage to me as a practitioner in supporting OH service users.

The CAB in my area has been part of the local community since 1933. It provides free, independent, confidential and impartial advice to everyone in relation to their rights and responsibilities, while valuing diversity, promoting equality and challenging all forms of discrimination.

“Help which is at the heart of the community,” is how Karl Pearce, chief executive of the St Helens Bureau describes the service that he is responsible for.

Pearce believes that the bureau needs to be properly and effectively integrated within its local geographical area in order to have the greatest impact for its residents in dealing with prevailing local issues. In essence, the CAB is about solving problems, changing lives and making society fairer.

Chuka Umunna MP, former shadow business secretary said, “few services could boast of that level of impact” and he stated that he considered the CAB to be this country’s “fourth emergency service”. Umunna went further in saying that “advice is a critical ingredient of any healthy democracy and often vital to the successful implementation of government policy”. But, without appropriate signposting, many citizens are not informed appropriately and this can lead to reduction in wellbeing due to real, or perceived, lack of control.

OH referrals

It is likely that the CAB is already on many OH adviser’s “signposting resource list” and so they will, at some time, have recommended that employees seek its help. However, how many advisers fully appreciate the range of services available and how the CAB impacts on the local communities in which they deliver OH services? Karen Coomer, OH specialist at KC Business Health, values this free resource when supporting employees. She says: “I generally signpost to the CAB for debt/benefits advice and the feedback has been excellent.

Coomer says she is currently dealing with a case where the CAB is assisting an employee with a financial plan and liaising with his bank to support him. She has also been involved in a case where an employee with learning difficulties obtained advice to help with a complex legal issue. These are excellent examples of how the CAB can support OH with employees, which, in turn, assists both the employee and the employer.

Help locations

There are just over 300 CAB services delivering support and advice from 3,300 locations across the country and each operates as an individual charity requiring funding sources to sustain their continued services. Funding is obtained from a variety of sources, with local authorities being one of the key backers, with other money available for specific projects. These include clinical commissioning groups, the Big Lottery Fund and British Gas Energy Trust.

Locations where advice can be sought are varied and are not limited to the traditional visit to a local CAB office. In order to become even more integrated, there are now many “outreach” centres being set up to ensure that the services are accessible. These include: schools; GP surgeries; supermarkets; and call centres, where telephone-based advice is increasingly being provided due to its instant availability.

The staffing of the CAB is made up of both paid employees and volunteers (including its trustees, who are also volunteers), all of whom provide time and expertise to support the bureau. CAB is highly reliant on its league of volunteers who bring a wealth of life skills, experiential learning and academic rigour to the role.

Resolving issues

In 2014, the CAB conducted a large-scale national survey (the Citizens Advice 2014 National Outcomes and Impact Research Report) to measure outcome. It revealed that two in every three clients said their problem was partly sorted (15%) or completely sorted (51%). A further 19% needed more time to resolve it and the remainder (15%) were left unresolved.

Unresolved issues are often due to systemic barriers that prevent clients from resolving their problems – drawing a parallel to OH practice. In OH, a residual number of employees continue to endure unresolved problems, whether or not this is due to the impact of chronic health on capability or performance, or some other real or perceived barrier to a satisfactory outcome.

The CAB aims to deliver a specific level of support and advice, albeit this does vary across the country due to the levels of funding available. It is worth exploring local availability and a visit to a local bureau would be of benefit to any OH practitioner seeking to effectively signpost employees.

The top five “issues” presenting at the CAB would no doubt be predictable to OH practitioners who see the impact of similar issues affecting people at work, not least as they commonly result in reduced mental wellbeing. They include:

  • the impact of changes to welfare benefits and tax credits;
  • debt-related concerns;
  • employment issues;
  • relationships; and
  • housing

A further place where the CAB has an impact on the population is the work that it does in relation to improving mental wellbeing. In 2012/13, it piloted a scale used by the NHS to measure clients’ mental wellbeing before and after receiving advice on different topics, using the Shortened Warwick-Edinburgh Mental Well-being scale, which was developed to enable the monitoring of mental wellbeing in the general population.

The outcome was that, before advice, the average mental wellbeing score was six points below the UK population mean and, four to six weeks later, there was a measurable improvement, with the average score being just short of the UK population mean. Mental health tools are now used routinely at the CAB and the service is continuing to determine the impact on its clients’ health and wellbeing, including which interventions are most effective, and in what circumstances.

With regard to mental wellbeing, and its impact on individuals in employment and seeking employment, it is of interest that a review of evidence (Almark et al, 2013) suggested that positive financial outcomes can have secondary impacts on mental health in particular. In this context, therefore, the evidence that debt advice reduces stress and anxiety is especially clear. It is therefore important that OH advisers consider signposting this important free source, in order to give employees the opportunity to take advantage of this outcome.

Another development for the CAB that ratifies the value attached to the reliability and performance of the services is that, on 1 April 2015, CAB took over responsibility for the Witness Service from Victim Support, to continue a vital service providing free support for witnesses in more than 300 criminal courts across England and Wales.

Volunteers were trained to offer emotional support and practical help to witnesses before, during and after a trial. This service included: greeting witnesses; providing court tours; explaining court procedures; giving updates on the progress of the case; and providing emotional and practical support linked to giving evidence. CAB Witness Services also provides the same free, confidential support service offered to their communities to anyone called to give evidence for either the prosecution or defence.

Employment issues

Directly related to employment matters and of interest to OH advisers is research from the Legal Services Commission (Balmer, 2013) that showed about one in 20 people experiences an employment related concern over an 18-month period. Examples presented included: disputes and grievances over pay; contracts and dismissals; problems related to redundancy or retirement; and discrimination or failure to comply with the Equality Act 2010.

In order to deal with these problems effectively, it is important that people have access to employment advice and that cost is not a barrier to this. But the introduction of employment tribunal fees in July 2013 has raised concerns and the CAB is reviewing the impact of fees on decisions by individuals to enforce their employment rights.

In addition to its traditional face-to-face services, the CAB offers extensive self-help information on a wide range of topics through its website and this can also be used as a signposting tool by OH advisers.

Many volunteers work to support the services delivered by the CAB and other charities around the country, and OH practitioners who opt to volunteer for a period of time will help to raise awareness of the advantages and opportunities available within this community resource.

OH practitioners have the appropriate transferable skills in abundance and, by supporting their local CAB, they will gain

OH practitioners have the appropriate transferrable skills in abundance and by supporting their local CAB they will gain valuable insight into what CAB has to offer. To find out more about some of the opportunities available for Trustees, Witness care or Bureau volunteers, log onto the CAB website.

References

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Almark P, Baxter S, Goyder E, Crofton-Martin G (2013). “Assessing the health benefits of advice services: using research evidence and logic model methods to explore complex pathways”, Health and Social Care in the Community; 21(1), pp.59-68.

Balmer N (2013). English and Welsh Civil and Social Justice Panel Survey: Wave 2, Legal Services Commission.

Jane Fairburn

Jane Fairburn is trustee of St Helens CAB and managing director of People Asset Management.

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