Evaluation of the mental health impacts of Universal Credit: protocol for a mixed methods study

Introduction
The UK social security system is being transformed by the implementation of Universal Credit, which combines six existing benefits and tax credits into a single payment for low-income households. Despite extensive reports of hardship associated with the introduction of Universal Credit, no previous studies have comprehensively evaluated its impact on mental health. Because payments
are targeted at low-income households, impacts on mental health will have important consequences for health inequalities.

Methods and analysis
We will conduct a mixed methods study. Work package 1 will compare health outcomes for new recipients of UC with outcomes for legacy benefit recipients in two large population surveys, using the phased rollout of UC as a natural experiment. We will also analyse the relationship between the proportion of UC claimants in small areas and a composite measure of mental health. WP2 will use
data collected by Citizen’s Advice to explore the socio-demographic and health characteristics of people who seek advice when claiming UC and identify features of the claim process that prompt advice-seeking. WP3 will conduct longitudinal in-depth interviews with up to 80 UC claimants in England and Scotland to explore reasons for claiming and experiences of the claim process. Up to 30
staff supporting claimants will also be interviewed. WP4 will use a dynamic microsimulation model to simulate the longer-term health impacts of different implementation scenarios. WP5 will undertake cost-consequence analysis of the potential costs and outcomes of introducing UC and
cost-benefit analyses of mitigating actions.