Universal credit trajectories among individuals who access secondary mental health services: analysis of linked data

TL;DR

This study explores how people using mental health services in the UK experience Universal Credit, identifying different patterns of benefit receipt and work requirements over time.

Contribution

The study introduces a novel analysis of Universal Credit trajectories among mental health service users, linking health and benefits data to explore patterns and sociodemographic associations.

Findings

Six distinct Universal Credit trajectories were identified, including clusters for short-term, medium-term, and long-term work searches.

Women were more likely to be in the medium-term work search cluster, while older individuals were more likely in the long-term work search and no work requirements clusters.

Those with severe mental illness were overrepresented in the no work requirements cluster.

Abstract

To examine Universal Credit (UC) trajectories, and transitions between UC conditionality regimes among secondary care mental health service users. Sociodemographic and diagnostic characteristics associated with UC trajectories were explored.

Mental health record data from 4876 individuals who attended mental health services were linked with administrative benefits data. An entry cohort was created including mental health service users who had received UC in 2016 and followed up for 4.5 years. Sequence analysis was used, followed by cluster analysis to identify typical UC trajectories. Sociodemographic and diagnostic characteristics associated with UC clusters were explored using multinominal logistic regression; results were presented as average marginal effects.

Six distinct UC clusters were identified. These clusters indicated: short-term UC searching for work (18.7%), medium-term UC searching for work (19.1%), long-term UC searching for work (21.4%), no work requirements (11.9%), UC working cluster (6.1%), and no work searching and caring responsibilities cluster (22.8%). Women were overrepresented in the medium-term UC searching for work cluster whereas older people were more likely to be in the long-term UC searching for work and no work requirements clusters. Those diagnosed with severe mental illness were overrepresented in the no work requirements group.

Most trajectories were dominated by those required to search for work albeit for different time periods before exiting UC. One in ten people were assessed as unable to work for an extended period. Findings can be used to inform support for people with mental health problems vulnerable to conditionality or longer-term UC receipt.

The online version contains supplementary material available at 10.1007/s00127-025-02930-3.

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