Transport CommitteeWritten evidence from The Mental Health Action Group (DAT 28)

Introduction

1. The Mental Health Action Group is an independent service receiver-led organisation whose purpose is to campaign for improvements which will benefit the lives of people living with a mental health condition. Although based in Derbyshire and working extensively on local issues we have regularly campaigned over the years on a national level as well.

2. Our campaigning on public transport began back in 2008 when the Concessionary Bus Travel Act came into force. We noticed immediately a level of discrepancy and discrimination which alarmed us and, as we peeled back the layers, we discovered that the treatment of people with a mental health condition in that piece of legislation is simply the tip of the iceberg when it comes to public transport. Underneath it lays a level of ignorance and misunderstanding of mental health which at times has been quite shocking. In most cases this is not deliberate but rather the result of genuine ignorance about how a mental health condition impacts on people’s mobility. However it is unacceptable in this age of the Equality Act and the Disability Discrimination Act for this lack of awareness and therefore discriminatory behaviour to be allowed to continue.

3. Our campaign work was extended in 2011 when we carried out a national survey of people living with an enduring mental health condition about their experience of public transport. We suspected that our experience in Derbyshire would be echoed around the country but even we were surprised by the strength of feeling expressed by our respondents. (We have included as additional evidence a copy of our Mental Health & Public Transport report published in Sept 2011 and presented to Norman Baker). Following a presentation of our report to DPTAC we were invited to attend future DPTAC meetings as observers providing the Committee with much needed knowledge and understanding of mental health.

4. We would like to present evidence to the committee under three main headings:

(A)The scope and effectiveness of legislation in relation to mental health sufferers.

(B)The awareness of transport staff of the needs of passengers with mental health problems and the availability of appropriate assistance.

(C)Accessibility of information and its importance to mental health sufferers.

5. We feel it is in these areas above that we can offer most useful evidence and observations. All quotations are taken from our national survey undertaken from April to June 2011. We would strongly urge the Committee to make use of the extensive additional evidence contained within our report from over 200 respondents.

A. Legislation

Concessionary Bus Travel Act 2007

6. Back in 2008 when the Concessionary Bus Travel Act came into effect we had our first indication that the Government’s understanding of the relationship between mental health problems and mobility was not all that it should be. In that particular piece of legislation and previously in the Transport Act 2000 mental health (despite being the largest single area of disability) was not included within the 6 specific disability criteria for a concessionary pass. It was only included in category (g) which is effectively a catch-all category for anything that hasn’t been included in its own right. Secondly we discovered that if your disability happens to be psychological rather than physical you cannot access a concessionary pass on the same grounds as most other disabled people. You can only have access to a pass at times when you are deemed medically unfit to drive. This means that when you are at your most unwell and most in need of accessing support you are faced with the process of surrendering your driving licence and applying for a concessionary pass. By the time that process has been undertaken your health could have deteriorated to a point where you don’t want to go out or even worse you are in hospital!

7. When someone with a mental health condition looks down the list of disabled categories they feel that they are somehow being treated as a second class of disability, not quite worthy of a qualifying category of its own and made subject to additional qualifying criteria. For example if you have a physical disability you can choose to drive an adapted car or to travel on the bus. You are allowed to choose according to your wellbeing on that particular day and according to the type of journey you need to make. The same flexibility is not accorded to you if your disability is a mental health condition and yet there are journeys which are less stressful by car and some that are less stressful by bus or train. Many people who live with a mental health condition already suffer from low self-esteem and any legislation which implies a double standard against them only convinces them that they are less deserving and less important to society!

8. Many people who force themselves to drive a car, even at times when they’re not well enough, do so not because they wouldn’t prefer to use public transport but because they don’t feel safe on it or can’t afford it! If a concessionary pass was granted to them purely on the grounds of their condition (as it is for many other disabilities) then they could choose the best option for them on any particular day. Similarly there are many sufferers who cannot afford to drive a car and are not qualifying for a pass but who desperately need one to access the support and recovery programmes that will help them to recover:

“Everybody has to budget for transport, of course. But I’m often forced to make choices about how I spend my money, which CAN and HAS been: food or transport? In the past I’ve missed appointments, cancelled visits, and slowly shrunk back into my flat becoming increasingly reclusive and, then, increasingly ill. Wellness and recovery are fragile. It only takes one journey missed to ruin a day, which can ruin a week, then a month, and before you know it you’re ill all over again”.

9. Transport costs are a seriously de-motivating factor for anyone who suffers from debilitating anxiety, depression etc. We believe that anyone living with a severe and enduring mental health condition should automatically qualify for a concessionary bus pass and not be subject to a driving licence test. Not only does it alleviate cost barriers it actually alleviates some of sufferer’s symptoms which prevent travel in the first place!

“It is better for me (being agoraphobic) to be able to suddenly say “I would be able to go out today” and go and visit my mother. To be able to just hop on a bus and not have to worry about the fare is so “freeing”. It enables my mind to relax and not panic, I can go where I want, when I want and it gives me much more confidence and keeps me going out thus helping my debilitating condition.”

Chronically Sick and Disabled Persons Act 1970—Blue Badge Parking Scheme

10. We are aware that the Department for Transport has recently carried out a consultation to review this particular provision. We believe this is a timely review and, whilst we appreciate the need to restrict this concession to those with the greatest need, we believe it should now be extended to other non-physical disabilities where the disability affects the person’s mobility to a serious extent. This should include people suffering from non-visible disabilities such as mental illness and autism where the person is otherwise unable to access community facilities. Our experience at DPTAC tells us that there is still some way to go before the Department for Transport fully grasps the fact that psychological barriers can be as powerful as physical ones. There is still a strong tendency in some quarters to think of mobility issues as being related only to physical disabilities. This needs to be addressed once and for all so that future policies and legislation reflects the mobility needs of all disabled people:

“If we were in a wheelchair they can see we have trouble with our mobility but you cannot see the crutches we use for our minds and how easy they are knocked from under ourselves.”

Equalities Act 2010

11. We are concerned that mental health seems so often to slip under the radar when it comes to applying the requirements and the spirit of the Act. In relation to public transport we have found many instances where mental health has simply not been considered, for example:

12. Over the last couple of years we have approached many transport providers most of whom do not include mental health in their staff disability training and are therefore, inadvertently, affecting accessibility for those customers. This includes for example Transport for London where there will be such a high percentage of passengers with a mental health problem. It includes Abta training for travel agents/tour operators where mental health does not appear at all even in the non-visible disability section! But it also includes most of the large train and bus operators and yet mental health is one of those disabilities where the stress of travel will usually increase symptoms.

13. Mental health is not included as a category for advanced travel assistance bookings on trains. When one of our members phoned to book assistance she was told that he would have to put her down as “mobility impaired—no ramp”! and indeed when the member of staff came to meet her he turned up with a wheelchair which was very embarrassing for her. When he discovered she did not need a wheelchair he then assumed she was ok and left her.

14. Disability signage is in general based on physical disabilities (wheelchair sign) so that if a person who is clearly able-bodied sits in a disabled seat on a bus or train they are likely to get short shrift from other passengers. This is understandable but could be addressed by signage which reminds passengers (and drivers) that not all disabilities are visible! Many people suffering from severe anxiety or paranoia would need to sit near the front of a crowded bus to feel safe and would like to access a disabled seat if that is all that is available.

15. Brochures and leaflets advertising travel assistance such as those produced by Passenger Focus always include examples of people who are physically disabled and elderly. We have never seen any examples of someone with autism or mental illness receiving travelling assistance.

16. Mental health is also not specifically identified within the annual passenger surveys carried out by Passenger Focus or the Department for Transport. This means that the needs and experiences of this category of disabled people are being missed; their unmet needs are not showing up on Government statistics and reports and therefore remain unaddressed.

B. Awareness by Transport Staff of Passenger Needs and Availability of Assistance

17. All of the above of course means that so many people living with a mental health condition experience a lack of understanding and support when travelling and therefore withdraw from using it or use it only when unavoidable. A good example of this ignorance and lack of training is that many people with a non–visible disability such as mental illness are questioned by bus drivers about their concessionary pass. This is a common occurrence reported to us, drivers challenging passes or even worse asking the person in front of other passengers what their disability is because it’s not visible to them:

“On a number of occasions they have even questioned why I have got a disabled bus pass because I “don’t look disabled”. Obviously this causes me to feel very self-conscious, panicky and annoyed. All bus drivers should be reminded that “disability” can mean different things and especially in relation to bus passes is not always a physical impairment”.

18. In our national survey carried out from April to June 2011 respondents placed awareness training for staff as their second highest priority just behind improved eligibility for concessionary fares. They shared with us some of the lack of understanding and, at times, downright abuse that they suffer both from transport staff and the travelling public. We know from the recent “Hidden in Plain Sight” report that public transport is a domain that still attracts hate crime towards disabled people.

19. The plea of our respondents was that whilst it is difficult to control the behaviour of other passengers it should be reasonable to expect understanding and support from transport staff.

“The understanding and support of staff is vital as we cannot expect the general public to understand all of the time. But good well trained staff can then help and advise the public of what is happening and waylay any fears that they may have.”

20. As already mentioned the Assisted Travel schemes available for train journeys is not well publicised towards mental health sufferers. Most respondents seemed unaware of any assistance or support and those few who reported having tried to use it were often disappointed:-

“Tried to use disabled assistance at train station, I booked explaining that I needed help in getting to the right platform and on the right train. The man looked at me, said you’re not disabled and walked off and left me—not at all good for my mental health!”

C. Accessibility of Information

21. Respondents to our survey stressed how vitally important accurate and timely information is to their experience of public transport. In some areas of the country where real time information is available at bus stops this was much appreciated. It helps to allay mounting anxiety while waiting for the bus, offering as it does constant reassurance that a bus is on its way. Many sufferers feel a great sense of anxiety when attempting anything except very familiar journeys. The availability and reliability of advance information is key here.

22. Concerns regarding information seemed to fall into the following main categories:

(i)Lack of joined up information across boundaries between one transport operator and another particularly on bus routes. There was a call for a less territorial behaviour for the benefit of the customer. For many sufferers it is vital that all journey information is available in advance in order to allay fears. If it is not available the journey, in most cases, won’t be made or at best will be very stressful:

“Having a mental health issue can be like an army moving base. They would plan every part of that trip making sure that there was support from land, sea and air to make it to their destination. This is the same for us”.

(ii)For the same reason as above, information at bus stops and on transport websites needs to be up to date and reliable. This was variable from one operator to another and a significant number of people complained about timetables at bus stops not being up to date. Audio information on buses is also a great comfort but not always available.

(iii)There needs to be a concerted effort to improve awareness of assistance schemes and concessions to mental health sufferers in particular. As previously mentioned it needs to be made absolutely clear that mental health is included and that must be demonstrated by operators both in their publicity and at every customer interface point along the journey.

(iv)Great anxiety is caused by unexpected delays, amendments to schedules and cancellations. Operators need to be mindful of giving out timely information, explaining clearly what alternative arrangements are being made for passengers and offering assistance to all disabled passengers who ask for help and reassurance. It may have taken huge courage and effort to attempt the journey in the first place so if help is unreliable in this situation it will have an effect well beyond that particular journey:

“Delays, cancellations and poor service can increase my anxiety and lead to panic attacks and if i have a bad experience it makes it harder for me to repeat the journey in the future”.

(v)Our survey indicated that only a very low percentage of our respondents were aware of the Disabled Railcard and that they might be eligible for one. This is very disappointing and concerning since so many of them state that the cost of train travel is totally prohibitive for them. Again there needs to be a concerted effort by ATOC to improve awareness for this sector of disabled people.

Additional Concerns

Future of DPTAC

23. Before finishing our submission we would like to express our grave concerns to the Transport Select Committee at the Government’s proposed abolition of the statutory voice of disabled people in relation to transport issues. We believe it is vital that the statutory obligation for the Department for Transport to consult disabled people remains enshrined in law. That is not to say that DPTAC cannot be improved further but it would be dangerous and in the end costly for the Government to resort to consulting with disabled people as and when it sees fit. We ourselves have experience both as an outside stakeholder and now currently as a voice on DPTAC. There is no comparison between the two options in terms of being able to voice our concerns and influence transport policy. We have fought hard for change on a couple of transport policy issues and this has only been possible because of the recognition we have been accorded via DPTAC.

24. It is clear to us that there is much educating to be done and the danger of leaving decisions about consultation to transport officials and Ministers is that they may not realise when they have missed something vitally important. Part of DPTAC’s role is to be pro-active in pointing out to Ministers potential pitfalls and areas where improvements need to be made. For all of these reasons we would urge the Committee to do what it can to ensure that this statutory voice is protected for the benefit of future generations of disabled travellers.

Changes at Department for Transport

25. Finally we are alarmed at the reduction in numbers of Department for Transport staff who hold responsibility for disability and inclusion issues. This again seems counter to the Government’s pledge to disabled people and indeed to the Department for Transport’s own recently published “Accessibility Action Plan”. It is hard to have any faith in fine sounding aspirations when all other indicators suggest that there is less and less priority being placed on pursuing the travelling needs of disabled people. It is certainly even more reason why DPTAC must be protected and supported in its independent role of advising the Department for Transport and advocating necessary improvements.

January 2013

Prepared 13th September 2013