Written evidence submitted by Mental Health
Resistance Network and Mad Pride UK
1. ABOUT
THE
MENTAL
HEALTH
RESISTANCE
NETWORK
This is a new organisation which was founded this
year 2011set up by and for mental health service users
to discuss the Coalition's Welfare to Work strategy and changes
to mental health and other health services. It is not yet formally
constituted but reaches a membership (including members of local
groups of mental health system survivors) of about a few hundred.
It is supported by Mad Pride UK which has a membership of about
800 people in Britain and branches in the US, Ireland, Ghana and
many other countries.
2. SUMMARY
We deplore the lack of communication about the changes
to benefits brought about through the migration of IB claimants
to ESA. We are very worried that the process is going ahead without
adequate attention given to mental health related impairmentsthrough
the descriptors and that the Harrington review recommendations
have not been implemented, as promised, before the migration is
rolled out. Some are so worried they are discussing suicide. The
Work Capability Assessments do not address the impairments which
fluctuate, nor do they take into account support structures (such
as day care) already in place. Mental health service users are
consistently saying they want to work, but the support they need
is very often lacking. And most of all we are horrified by the
prospect that huge numbers of peoplelabelled up to nowwith
"severe and enduring" mental health problems will just
be cast adrift and lose benefits and services, to languish on
the lowest possible benefitJobseeker's Allowance.
3. LACK OF
COMMUNICATION
We have been told nothing, hearing only through the
grapevine, without knowing what information is correct and what
is notrumours and Chinese whispers. We have been living
with this worry and financial insecurity for three years without
any communication from the DWP.
We should be informed that there has been a change
in criteria for what constitutes "being unfit for work",
what these changes are, ie "focusing on what we can do and
not what we can't do", what this means (if anyone can explain
that!) and why these changes have been made.
4. FLUCTUATING
IMPAIRMENTS NOT
RECOGNISED BY
THE TEST
Fluctuation in mental health conditions should be
specifically assessed according to the manner and the extent to
which they fluctuate; how frequently would we be able or unable
to function and what are the levels of severity of the more difficult
periods.
5. PROCESS IS
STRESSFUL, WORRYING
AND MAY
CAUSE SUICIDES
The WCA makes no assessment of the cumulative effects
of stress which could result in mental health breakdowns at great
cost to the individual, the NHS and the employer.
We have seen this before, with cuts to services after
WW1, the Great Depression, etc with distressed individuals wandering
the streets.
We are finding that current cuts in services are
unable to cope with the distress this process is causing including
high levels of suicidal thinking and ideology. (51% reported it
had made them have suicidal thoughts (MIND ESA Survey April 2011)
Mental health is a hidden disability whereas the
Atos assessment is based on superficial observation that places
significance on appearances.
Mental Health Champions do not know us on an ongoing
basis and our disabilities need to be viewed over a longer-term;
this ties in with their awareness of how our condition fluctuates
and how we respond to different situations. We do not believe
that they are sufficiently qualified to assess the specific idiosyncrasies
of such variable conditions as mental health problems.
6. NO ACCOUNT
TAKEN OF
PEOPLE WHO
ARE SOMETIMES
SECTIONED
People who have a history of being sectioned as an
inpatient, on a section 117 or on a CTO may be subject to additional
discrimination by employers.
We have concerns that services are being designed
around government policy rather than directed by clinical needs.
7. BACK TO
WORKBUT
WITH WHAT
SUPPORT?
The Recovery Model was conceived of by mental health
service users but is now being misrepresented by the Government
in order to get us off disability benefits. The Recovery Model
speaks of meaningful work and activities as defined by the individual,
not paid work at all costs. Also, one of the original prerequisites
of recovery under this model is that we start from a position
of financial security, precisely what we have not had since these
changes were mooted.
Previous administrations have abolished sheltered
factories and other projects. Assistance for service users to
set up collective businesses and other projects would be good.
We don't believe that all mental health claimants
can reliably present or give an adequate account of their condition
and the problems these cause them at an interview with a stranger
who is not medically qualified.
The stress for someone with a mental health problem
that involves anxiety or mood disorder having to attend these
interviews cannot be overstated.
If someone has to go to work, all of the support
systems that have been put in place to maintain them at their
current level of functioning will be lost, such as day care services.
People will disengage with services which will result
in loss of continuity.
8. SIDE EFFECTS
OF MEDICATION
NOT TAKEN
INTO ACCOUNT
Side effects from anti-psychotic medication require
further drugs treatment which adds yet more side effects. These
side effects can be debilitating.
Claimants in the WRAG will be subject to harassment
when it is already established that they are not yet fit for work.
The speed with which you are recalled for subsequent
assessments, in some cases just a few months, means that people
will be in a constant state of anxiety and insecurity.
The whole process involves attrition and is adversarial,
designed to trip you up rather than help you back to work. 95%
expect not to be believed. ((i) MIND ESA Survey April
2011)
9. BENEFIT FRAUD
IS NOT
AN ISSUE
WITH PEOPLE
WITH "SEVERE
AND ENDURING"
MENTAL HEALTH
PROBLEMS
Nobody with extended contact with community mental
health teams and with severe mental health problems are doing
so fraudulently.
We want the vast majority of cases to get back to
work but we need sensible and realistic support structures in
place and we don't want to languish on JSA with minimal help in
the competitive job market place. This would be a move to poverty.
10. WE WANT
TO WORK,
BUT WITH
THE RIGHT
SUPPORT, SO
IT IS
SUSTAINABLE
This is happening when there is no likelihood of
jobs and when mental health services are being slashed.
11. LACK OF
ACCURATE MENTAL
HEALTH DESCRIPTORS
SHOULD MEAN
THE PROCESS
SHOULD BE
PAUSED
Harrington's review of mental health descriptors
won't be happening till this year and published around November,
after many people have been assessed.
The Harrington review was based on a version of the
WCA which contained ten descriptors that related to mental health.
This number has been reduced to just seven which means that the
actual test that we will be subject to is not quite the same test
Professor Harrington reviewed.
The high number of appeals that are launched tells
us that huge numbers of claimants feel they have been misunderstood.
We are concerned by the length of time people have
to wait for appeal tribunals which causes undue stress.
The high number of successful appeals reflects the
inaccuracy of the tests.
Despite Harrington's recommendation that tribunal
judges be given evidence supporting the idea that work is always
beneficial, a recent Australian study published in Online First
found that poor psychosocial work causes deterioration in mental
health.
12. PEOPLE WITH
COMMUNICATION DIFFICULTIES
WHO MAY
ALSO LACK
CAPACITY MAY
NOT UNDERSTAND
THE PROCESS.
The descriptors are worded in a way that is almost
cryptic so that it is difficult to recognise what kind of experience
that they might refer to, ie hearing voices may affect concentration
or make someone feel suspicious or pressurised to do something
they would not choose to do. The questions are so open that many
people with mental health problems may be unable to make the connection
between what they are experiencing and the fact that it is this
that affects their functioning in a particular area.
REFERENCES
(i) The MIND Survey
April 2011 (not yet published) summary is appended as a web document
4811_welfare_reform_anxiety_making_people_ill.htm.
April 2011
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