Migration to ESA

ESA 51

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 2011 - set 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 impairments - through 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 people - labelled up to now - with "severe and enduring" mental health problems will just be cast adrift and lose benefits and services, to languish on the lowest possible benefit – jobseekers’ allowance.

3. Lack of Communication

We have been told nothing, hearing only through the grapevine, without knowing what information is correct and what is not – rumours 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, i.e., ‘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 (i) 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 Work – but 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. ( (ii) 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, i.e. 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

(ii) 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