DDB 50 British Psychological Society
The British
Psychological Society
St
Andrews House, 48 Princess Road East, Leicester LE1 7DR
Tel: 0116 254 9568
Fax: 0116 247 0787 mail@bps.org.uk
33 John Street
London WC1N 2AT 020 7 692 3411 Fax: 020 7 419 6922
Summary
1. This submission is concerned
with the meaning of disability.
2. We support the inclusion of cancer,
HIV and MS in the definition of disability.
3. In our view the provisions of
the draft Bill do not provide equitable access to legal protection
from discrimination for people with a broader range of cognitive
and mental health problems.
4. Psychologists are particularly
concerned with the impact of physical, cognitive and mental health
problems on a person's capacity to reason and communicate their
thoughts and feelings. At present, the definition of "normal
day-to-day activities" does not adequately address these
areas. Thus, cognitive disabilities such as psychosis, autism
spectrum disorders, acquired brain damage, are not properly recognised.
5. We believe the requirement that
cognitive disorder and mental illness needs to be clinically well
recognised is not easy to clarify, as, for example, there is considerable
controversy about areas such as attention deficit disorder and
autism spectrum disorders. The differential requirement for physical
disability and for cognitive and mental disorders is, in our view,
essentially inequitable.
6. We are not as concerned as Mind
about the question of the duration of the illness as part of the
definition. We are aware of the necessary balance between securing
rights and the costs of maintaining these. Also, the proposal
would produce inequity if a particular group were made an exception.
However, we agree that the negative impact of a disability is
not necessarily related to the duration of illness.
Consultation to the Joint
Scrutiny Committee on the
Draft Disability Discrimination
Bill
Submission from the British Psychological
Society February 2004
With 40,000 members, the British
Psychological Society is the representative body for psychologists
and psychology in the UK. Its Royal Charter charges the Society
with national responsibility for the development, promotion and
application of psychology for the common good.
The BPS welcomes the opportunity to
contribute written evidence to the committee and would be happy
to submit further oral evidence, if appropriate.
The Society has expertise in the scientific
understanding and practical implementation of psychology. Chartered
psychologists with specialist expertise of working with clinical
populations are aware of many of the issues for people living
with a disability, and are particularly concerned about the psychological
impact of discrimination and stigma.
Our comments are intended to advance
two broad aims: to assist in the effective implementation of the
Bill, a bill whose policy intentions we support, and to encourage
a coherent and psychologically informed approach to this legislation.
1. Introduction
The BPS welcomes the inclusion of
the medical conditions, cancer, HIV and multiple sclerosis, into
the Bill but notes that there are other physically and neurologically
disabling conditions which are not included.
We support the position of MIND, the
Disability Rights Commission, The Disability Task Force and the
Royal College of Psychiatry, that there still remain disabling
conditions not covered by the legislation. People with mental
illness are not afforded the same legal protection as other disabled
groups.
2. Definition of day-to-day activities
The Act defines a disabled person
as someone with "a physical or mental impairment which has
a substantial and long-term adverse effect on his ability to carry
out normal day-to-day activities".
The areas identified as day-to-day
activities do not presently include the activity of reasoning,
and communicating thoughts and feelings. At present, a person
who has an illness which affects their ability to judge reality,
for example due to psychosis or depression or head injury, is
not protected if all the other criteria are met. This means that
a group of people who have problems with judgement, whether this
be as a result of severe mental illness or of brain damage, even
to the extent that they may require compulsory treatment, are
not able to have their rights preserved. An example of this issue
is being considered at present through an appeal against an Employment
Tribunal that a person with Asperger's Syndrome and Autism does
not satisfy the statutory definition of disability (DRC/02/5289).
This group is most likely to attract stigma, and accordingly
experience discrimination.
As psychologists we are aware of
the importance of effective communication in combating discrimination
for any client group. If a person does not have problems with
speech or hearing, but they cannot express themselves or be understood
due to the effects of their illness or injury, whether it be the
"pressure of speech" that can accompany psychosis, the
mutism that sufferers of depression can experience, or the difficulties
with speech and language that people with stroke or brain injury
can struggle with, the lack of understanding of these conditions
by ordinary people can lead to them being ignored or, worse, shunned,
and again can mean that people who are recovering are not able
to regain their right to work and participate in society.
Accordingly, we support the recommendations
for amendments made by Mind,
"add to the list of day-to-day
activities (i) thought processes, perception of reality, emotions
or judgement.
Or
To (h) add "or ability to care
for oneself", AND (i) perception of reality; (j) ability
to communicate.
3. Process - assessment and determination
of disability
The tribunal evidence required to
assess a person's case for discrimination includes reports on
a person's activities and capacity to understand. However, the
WHO in its 2001 ICD classification includes impairment in participation
as well as activity in its definition of disability. At present,
although the question of transport is addressed, the day-to-day
activity of interacting with other people is not fully reflected
in the assessment.
The inclusion of cognitive and communication
problems as outlined above would acknowledge the limits to participation
in everyday life that some sufferers of serious mental illness,
learning disability and brain injury experience.
Chartered clinical psychologists have
expertise in the assessment of cognitive functioning for people
with mental health problems, learning difficulties and acquired
brain damage, and may be able to usefully contribute to the evidence
considered in tribunals.
4. "Clinically well recognised"
requirement
The BPS acknowledges the need to
ensure the Act operates for people with conditions that are well
understood. The government and employers may be concerned with
bearing the cost of ensuring non-discriminatory practice, and
are not in a position to accept too wide a range of problems,
where the primary issues may be socially rather than clinically
defined. However, the same argument applies to physical illness
as well as mental illness. At present, a person with non specific
back pain may be able to access this legislation, whereas a person
with manic depression, potentially subject to compulsion, may
not.
It is difficult to measure the cost
implications of discontinuing the requirement for mental health
problems, but since the Regulatory Impact Assessment has estimated
the recurrent costs to employers and the government of £100,000
to include three diseases without this restriction, we would suggest
that the impact is not likely to be as substantial.
We support the recommendation of the
Disability Rights Task Force, that the advantages and disadvantages
of removing the limitation be properly reviewed.
5. Substantial and long-term adverse
effect
The impact of a disability is not
necessarily linked to the duration of the dysfunction. A person
who has asthma may be asymptomatic for much of the time, but may
experience life-threatening symptoms in specific conditions.
We acknowledge the need to set a cut off point that recognises
the balance between the rights of the disabled person and the
cost to the government and employers to uphold these rights.
This decision is essentially a political question, not within
the remit of one professional body. We would argue that any definitions
of duration should be equitable across all types of disability.
|
