Today’s blog is given over to the letter in The Guardian from leading mental health experts and charities, on the impact of some of the government’s welfare reforms. It is self-explanatory.
Reform of the welfare system is steaming ahead, and already we’re hearing about the devastating effects this is having on the mental health of hundreds of thousands of people across Great Britain. While much is made of the impact that changes to benefits will have on people with physical disabilities, it is vital that those with “invisible” issues such as mental health problems are not forgotten. Reassessments of people on incapacity benefit (IB) via the deeply flawed work capability assessment are due to start next month, and the new personal independence payment test is being trialled over the summer – just some of the changes already alarming many people affected by mental distress.
We’ve found that the prospect of IB reassessment is causing huge amounts of distress, and tragically there have already been cases where people have taken their own life following problems with changes to their benefits. We are hugely worried that the benefits system is heading in a direction which will put people with mental health problems under even more pressure and scrutiny, at a time when they are already being hit in other areas such as cuts to services.
There needs to be a shift towards a more sympathetic and supportive system that genuinely takes into account the additional challenges people with mental health problems face and can make a real objective assessment of their needs rather than placing them into a situation where their wellbeing is put at risk.
Paul Farmer Chief executive, Mind, Paul Jenkins Chief executive, Rethink Mental Illness, Professor Bob Grove Joint chief executive, Centre for Mental Health, Dr Jed Boardman Consultant and senior lecturer in social psychiatry, Royal College of Psychiatrists, Bill Walden-Jones Chief executive, Hafal, Billy Watson Chief executive, Scottish Association for Mental Health
Credit to The Guardian for also making this their lead front page story and credit to you for posting it on your blog.
But as I’ve said here before, the assessment has never been fit for purpose in respect of mental health. You cannot assess a mental health condition by ticking boxes on a form. The last Government was told this repeatedly by mental health professionals and welfare organisations but refused to do anything about it.
The difference today is the context of £18 billion cuts to the welfare budget and the stream of propaganda demonising claimants that the Government is feeding to the media (Polly Toynbee was interesting on this last point yesterday).
It’s often a cheap piece of rhetoric to accuse politicians of having blood on their hands. But if politicians just shrug when told that their policies are tipping some ill and vulnerable people over the edge to suicide or attempted suicide, I don’t think that’s putting it too strongly.
Thank you for bringing this to our attention, Alastair.
If ever there were mounting evidence that this Government is unfit to lead the country, this type of letter from eminent professionals has to be it.
Yes, we do read more about people with physical difficulties (I am one of them) and the new tougher benefit system that assumes all are guilty (of fraud) until proven innocent (and worthy beneficiaries just trying to have a life).
Hidden symptoms are not easy to assess and need to be addressed by clinical psychologists rather than general physicians. ‘Lucky’ claimants will be assessed by more aware testers; others will be castigated by those with tunnel vision.
NEVER think you know what an illness is like until you have lived alongside a person for at least a day – and night. Not that I am advocating such a costly and stressful assessment scenario but I DO know that the relatives and friends of many people with many disorders that have hidden elements will be much more qualified to assess what we need.
My prayer, daily, is that sense will prevail within the ruling parties, in the rank and file of those with sound minds and firm hearts. Surely it is an easy concept – if you are ill, it doesn’t always show. So look deeper please.
I really don’t think that most of the Govt understands real life. It must be hard for them to do so.
I heard on R4 at the weekend that despite the ‘Big Listen’, changes are going ahead.
Cable ‘explained’ that it would cost more to stop things than to let them carry on; he’s turning in to a typical disingenuous dislikeable self-interested powerholic.
We ALL know that during this Big Listen things will move to stages where they cannot be turned back.
If this Govt had managed just half as much constructivity in one year as it has managed of its opposite, who’d not be impressed?
What’s also terrifying is that in a few months there will be no legal aid to challenge decisions if they are wrong. Vulnerable people will have to fill in their own forms and prepare their own appeals. It’s not difficult to see that this will not actually save money – for example, a person with learning difficulties who doesn’t get their housing benefit is at risk of losing their home…
Perhaps we need a team of people with a new, holistic role.
Surely those that deem a person fit for work could prove their expertise by finding them that suitable job, an employer willing to take them on. Things have to match – while one person might be fit enough to clean public WCs they might live in a borough where they have all been closed due to a 4 letter word !
Is ‘examining’ yet another role that is passed out to private agencies working from limited choices, more box ticking?
It’s awful that there really are scroungers and cheats but it’s even worse that people that are already sad and depressed are made to feel looked down on.
I started travelling for my work in the late 70s and what I saw in Asia made me so grateful to live in a more humane society; a few years later we had our own cardboard cities.
Am replying to myself to correct an impression I’ve given.
……Things have to match – while one person might be fit enough to clean
public WCs ……
…………… it was in the context of my …..
……private agencies working from limited choices …..
and should have included …..
……. where ‘fit for work’ means any work at all.
Last night’s devastating Panorama programme, coupled with the IB & other proposed welfare reforms, demonstrates the problems of privatising our welfare state and imposing swingeing cutbacks without proper asessments and diligence. The treatment at this one centre was appalling and I hope those arrested today get charged with GBH at the very least. However the finances involved also seemed like a major assault on the public purse. I can’t remember the figures exactly but Castlebeck is earning something like £90m a year to care for approx 500 people….do the sums – I’m sure several of the families involved would like approx £180k a year to manage their own programme. They could employ their own nursing staff to provide 24 hour care for far less. This is crazy and is repeated across the board in care homes, nursing units etc around the country. It explains why investment funds have got invovled as substantial profits can be made.
As for IB I had a young woman client in her mid 20’s who was Aspergers and extremely paranoiac. Her psychiatric team were unsure if she was also schizophrenic. She was very bright with a degree in Philosophy but when I last saw her she really needed major help as she was sinking fast and left wandering most of the day around the town centre. She had worked on and off since leaving university but was finding it increasingly difficult to hold down a job because of her worstening condition. She was filled with anxiety (worst thing for paranoia!) after being told that she was going to lose her IB at her assessment. She was being recommended for a job in retail customer service – obviously by someone who has no idea what her condition means. In view of her extreme paranoia a shop would be the worst place to put her. I can see the newspaper headlines when this poor girl loses it and possibly attacks a customer through stress over having to handle the public.
The big picture when it comes to cuts is this.
There is no economic need to cut £81bn. Even Nick Clegg has admitted to that.
Bond markets are NOT demanding cuts on this scale. It is a question of political choice!
Mr Osborne is once again misleading when he says that Labour would cut almost as much as the Tory-led government.
Ed Miliband would cut only £34bn. His split between cuts and tax rises would have been 60:40.
In 2010 Finland´s public spending was 56.3% of GDP. Yet Finland is one the most prosperous countries in the world. The reason for this is public investment! Plus commitment to equality.
It is OK to argue over specific cuts. But please keep in mind that banks caused the mess. And the cuts are IDEOLOGICAL aiming at smaller state.
And benefit fraud amounts only to a fraction of tax avoidance, tax evasion and uncollected tax.
Once again people are looking down when they should be looking to the very top of society.
The overwhelming majority of people with an mental illness do not want to be on benefits.From the times when I have been an in-patient in hospital my fellow patients are afraid that there employers will find out the real reason my they are ill.The message has to be driven home that mental illness is classless,it can effect anyone.I also have to say that I love the’Time To Change’ ads which are currently being shown,the express a lot of what I feel i.e trying to explain my illness.What should be addressed is people with an mental health problem do want to work but there are many barriers in peoples way.
What intrigues me about this whole shabby, spiteful business is the suggestion that so many people currently on some form of benefit, either for physical or mental reasons, are perfectly capable of working, if only they are give a little “support”.
Support like a superficial assessment of their capabilities by a private company that makes millions out of the state, an assessment that is un-reliant on any medical evidence from specialists who have often known them and their problems for years.Support like the withdrawal of DLA, instead putting people onto time limited Jobseekers’ Allowance.Support like the publishing of lists of excuses used by the relatively small number of fraudulent claimants released to a couple of Murdoch’s papers by the Department run by Ian Duncan Smith, just in time for the Bank Holiday.Support like the venom and hatred encouraged by the Daily Mail with its regular articles on “scroungers” encouraging reams of vile comments from readers.Sounds like an awful lot of big sticks to me, not what I would call support.However, if it is true that “support” is all that is needed, presumably there must be queues of potential employers just waiting for the opportunity to take on new staff. I’m sure that anyone who is capable of working would love a good, secure,well paid job. I bet loads of people who can’t currently work for medical reasons would also love to be able to, if a suitable job could be found, in suitable surroundings, with a sympathetic employer who would make allowances for absences due to appointments, recurring symptoms, etc.Maybe the firms, led by Marks and Spencer, who were so keen to support the Tories publicly before the election with regard to “Labour’s job tax”, will be leading the way when it comes to providing such posts. After all, many people with a disability paid “Labour’s job tax”, otherwise known as National Insurance, for years before they became ill, or had an accident and had to put in a claim. And didn’t we all pay NI thinking that was what it was for? That it could just as easily have been us who needed support?I’ll not be holding my breath, by the way, waiting for M and S and co. to step up to the mark.
As from a family with inherited immune disorders, those in power need to broaden their mind on this. To watch my mother disolve through my life with crippling rheumatoid arthritis was not a good experience, to say the least. Remarkably, she more or less kept working at her trade as a nurse until sixty, but had only nine years of retirement until it got to her heart, destroying it with her fibrosised lungs. Life is shit at times.
Just a few brief points regarding yesterday’s Panorama programme. At the risk of stating the obvious, whoever it was that saw fit to hire the likes of Wayne and Co. to “care” for these vulnerable people should also be fired themselves!
It takes very special highly trained staff to be entrusted with the care of these vulnerable souls. Let’s not kid ourselves here either, trying to care for them properly must be a difficult and largely unrewarding task in terms of job satisfaction. I wouldn’t do that job for £100,000 p.a.
It was inevitable that the cuts would lead to loss of life; and also to the loss of quality of life.
I took my rather two year old boy for his development check at the Children’s Centre today. As I am now the Disctrict Councillor for the area where the centre is based, I was keen to get a first hand account of how the cuts were impacting on the quality of provision being offered, so I took the opportunity to ask what was going on. There were the obvious things like some of the groups and clinics being cut back on, but what horrified me most was the changes to the WAY the health visiting team is being expected to work.
Two practical examples might serve best than a blow by blow account of what turned out to be a very impassioned outburst by a young health visitor. Up until very recently she ran a baby weaning information class. This has now been scrapped. They were not able to measure “outcomes” sufficiently to justify keeping the class going. How would you measure “outcomes” for that? So because it can’t be measured or ticked it has been scrapped. And guess what….first time parents are now turning up at doctors surgeries for vaccinations etc and guess what? Yep. They are asking about weaning. SO, rather than give the information and answer questions to 20-30 mums per month in one go, the health visitors are now dealing with them individually. Which is exactly what the health visitors warned would happen.
One of the other cuts has been to the baby massage class. Before anybody smirks about the middle classiness of it, the beauty of this class was not in the baby massage, but that it was a very non-threatening way for new mums to be around their babies, other parents and health visitors. Much of this work was preventative as it gave the mums a support group; and the health visitors a chance to watch the interactions of the mums with their new babies. Thus, they were able to pick up those women who might be struggling, and those who might be tipping into depression. But how the bloody hell do you measure those outcomes? How would you know if just being there had made enough of a difference to someone who could otherwise end up in difficulty? What box would you tick, or pie chart wold you colour? But if you can’t measure it, it clearly must be crap and not worth carrying on with. So that class is gone.
I was also horrified to hear her speak about the “efficiency” obsession. If there is one thing I do not think a health visitor should be thinking about as a paramount concern is whether they are “efficient” enough. In the drive for “efficiency” home visits are being scaled back to virtually nothing to save on travel time. It was also felt that the home visits took too long, apparently. New parents are now given a red, amber or green classification during an initial visit. The green families are those left to their own devices, only then accessing support from health visitors when they “need” it, and then only from the Children’s Centre. Anyone who has ever had a baby will know that half the time you don’t know your own name. You certainly have no bloody clue if you need “help”. And anyone with any experience of safeguarding will know that you cannot assess the complexities of home life and relationships on the basis of one visit, and that you cannot rely on people who do need help to be brave enough to admit it.
Human beings and their needs are not “efficient”. I am sorry we are so awkward, especially at emotionally significant times such as producing babies. If these examples are being replicated on a national basis, I fear for the mental health and well being of many women, and their children.
I seem to remember a time working in the public sector that we talked constantly of “best practice”. The new speak is of efficiency, and that is nowhere near what is going to be best for those depending on those services.
The brilliant Ronnie Lane, who mother and son himself came down with multiple sclerosis, a horrible affliction to come on one,
That’s the trouble though isn’t it Gillie? I don’t think I have the capacity to be a carer either, not for LD and not for the elderly.
My little DiL has just finished a nursing degree and has specialised in psychiatric care, I hope she never has colleagues like Wayne (not that I’d even like to pass him in the street).
Very interesting interview on R4/pm just now – workloads for inspectors were increased in October..
I am sorry about the loss your mother.My own mother has it as a result of a car accident nearly thirty years ago.The pain that she does be in sometimes is quite unbearably to watch, she has great difficulty walking sometimes and now is having trouble with movement in her hands.She is still working.Again very sorry,to watch someone close to you in constant pain is hard to watch.
Thanks all, she was a hell of a woman, total excellent spirit about life, which, ahem!, I might have inherited.
…….Very interesting interview on R4/pm just now – workloads for inspectors were increased in October……Also sounds like they use Control Risk Self Assessment or some such similar bright idea where you audit yourself then, depending on your own audit report on yourself, they might come out from head office and audit you. So if you can talk the talk you can get away with anything.
My old employer introduced that for its branches to let it make two travelling auditors redundant (and me).
Company’s long since gone down the plughole, of course.
To see my mother totally gasping, in the last days, I would not put on anyone. I am still traumatised, even after ten years. My mother.
I’m a Jobcentre Manager. We piloted IB / IS reassessment in our area. By far & away the biggest issue has been IB customers with mental health issues finding themselves in the jobseeker’s allowance regime. That regime itself has been hardened since the change of government, though we have no targets on suspending & stopping benefit. Mental health issues affect people’s ability to complete forms or attend medical assessments even before they’ve tuned up for the test itself. It makes my team’s job much harder as I’m asking them to test ‘jobseeker’s’ against our conditionaility & entitlement, but this group of customers is in no position to do so. The Jobseeker regime is much tougher than anything they’ll have experienced on IB & it’s down to Jpbcentre staff to understand the issues & offer appropriate, tailored support packages. There’s much more to us than you might think.
My Dad died when I was 13 ,losing a parent is hard.Its great that you can think of the good times and not the illness.
Yes, you’ve summed it up. Overview isn’t about inspection any more, it’s lower level.
I was impressed with the woman interviewed, long-term head of the organisation that used to be a real inspectorate but whose job (and that of the teams) has now been narrowed.
She’s not taking the coward’s way out and resigning / blaming the situation on the limitations recently placed on her.
She’s worked her whole career in care situations and feels best-qualified to describe what’s wrong.
Programmes like this do give such people a head of steam they just didn’t have before.
I was encouraged, pained and perturbed reading this. I am glad that the plight of those crushed by this system has been highlighted – a little light cast over a very dark situation on the margins of society yet afflicting so many individuals and families. The pain of living so perilous a meagre existance is crushing and I am also deeply distressed that the most vulnerable are victimised so readily by those who have most and are most secure.
This grinding and crushing beaurocracy is a stain on the values of decency and humanity that should underpin good governance.
I am still awaiting the morning post bringing my manilla envelope entitiling me to a review, to have my benefits focussed and my meagre amount of money slashed. I need every penny of it. Harsh and arid times.
Good article and well
put, but I feel the need to take the issue with the phrase
“customers” I am guessing that this is everyday terminology that
is used across Job Center departments – rather like how the MH
Service identify us as “service users or clients” I further
assume that this is because they are afraid of comebacks if they use
the label “The Mentally ill”. (I was once deemed to be a
“visiting guest”, which was rather novel, while being admitted at
an ex forces residential mental health treatment centre).
Perhaps the ideology of
descriptive labelling needs to change as well, I mean I am not a
customer buying a tin of beans am I, We are real people suffering
real mental difficulties in need of understanding and well informed
support both medically, and financially. Thanks again for your
article and perhaps you could offer further snapshots of how the
benefit system is viewed from your side of things, certainly helps me
to get a better perspective! Cheers and kindest regards.
I would very much have liked to be in a position where I might have been able to offer you some words of sensible advice. Sadly this is not the case. But I know that I and many others that visit AC’s site are wishing you well in your current predicament. I assume that you as an ex-teacher have the support and advice of a union of some sort?
Another commenter on this site sometimes writes of this very unequal society and he is right. I’ve said before and I’ll say it again democracy in this country is an illusion. Therefore, I think it may soon become a justifiable reason to “bring on the revolution” (I could make the tea!)
dear alastiar, one of my friends as bi-polar grade 1. she as had her benefits cut by £30 aweek. the pyschiaist wrote a letter.the nurse was with her for the acessment. there do not want her to work. any stress and she in hosptial for months. the acessment did not fit her, it was all silly questions about weather she could made a cup of tea. she is very worried about her bills. not enough money to eat. i hope she does not do anything to harm her self. regards selkie field.