The fabric of Britain as we know it is being ripped apart. So much is changing, almost behind our backs, we haven't got time to notice what is happening to us. And it is happening fast.

Wednesday, 4 January 2012

On The Tenth Day of Xmas, My True Love Gave To Me... Ten Layabouts a-Leaping

"There are thousands of people who have a mobility car and are perfectly well. I know lots of people who are off sick on disability and manage to dance at parties and do the gardening".

How often have you heard that? Is it really that easy to get Incapacity Benefit or its replacement Employment Support Allowance (ESA) or Disability Living Allowance (DLA)? Alicia Duffy has a different experience.

I was recently required to attend a work capability assessment (WCA), administered by the controversial ATOS healthcare. The assessment is meant to decide if somebody is eligible for employment and support allowance - the main benefit for people unable to work due to illness or disability - and, if so, whether they should have to undertake “work related activity” such as training and careers advice.

WCAs have been causing worry to many people, especially as stories spread of unfair decisions, inexpert assessments and simple bad treatment from ATOS employees. Disability message boards and support groups are full of people terrified of losing their benefits due to what is literally a box-ticking exercise - the medical professional simply selects the option on a computer screen that best meets the answer given, with no room for flexibility. Some of the most worried are people with severe mental illness.

Mental illness is hard to see, and especially hard to judge in a meeting of less than an hour. Most sufferers from severe illness - usually defined as including schizophrenia, bipolar disorder and other conditions where psychosis can be present - have spent years in the system, taking strong medication, being treated by specialist teams and often with periods of inpatient care. Despite this, they are still being called in for the WCA, often itself leading to deterioration in their conditions. When I had my assessment, I was only a few weeks out of hospital after a relapse.

My case highlights many of the contradictions in the WCA system. My husband works, so our income is too high for me to receive ESA payments; the only benefit I get from claiming is that basic national insurance contributions are made on my behalf. The total value of these contributions are around £13 a year. Even if I had managed to fool all the doctors, nurses and other professionals all these years, and the WCA exposed me as that modern folk-devil, the benefit fraudster, it would save the taxpayer very little. ATOS and the DWP have repeatedly refused to reveal how much each assessment costs, but it seems unlikely that it is less than £13.

The nurse who performed my assessment was not trained in mental health - ATOS does not employ any mental health nurses, despite “mental and behavioral disorders” being far and away the most claimed for group of illnesses, at around 35% of all claims. This has implications both for the amount of people wrongly deemed able to work, and the amount of people able to fool an untrained assessor into declaring them incapable.

As I also claim other benefits, I have faced many long and often irrelevant questions about my condition, repeatedly provided the same evidence and contact details for my specialist team who confirm details of my illness, and spent many hours researching the correct forms, claims and procedures. Not only is this upsetting and bad for my mental state, I am also constantly worried that I have made a mistake and that my income will be taken away or reclaimed, or that I could face criminal proceedings through an administrative mistake. I am lucky enough to be relatively educated, and to have a variable condition, meaning some days I am able to coherently put my case across. Many sufferers of severe mental illness are not so lucky.

Benefit claimants are routinely portrayed as “scroungers” and those of us reliant on the state for much of our income find ourselves stigmatised and afraid. Often these are some of the most vulnerable in society, and unable to stand up for themselves when faced with discrimination. Sufferers of severe mental illness often have to deal with the double jeopardy of being told on one side that they are malingering and should snap out of it and get back to work, and on the other that they are dangerous and need locking up. If they try to object to negative treatment, they can find their opinions and testimony discounted on the grounds of their mental illness, especially if they suffer from psychosis or other such severe symptoms.

Sufferers of severe mental illness are much more likely to be vulnerable and need extra support, and although there are many excellent services and charities working with and for them, the benefits system is not currently set up for their needs. It sometimes feels as if the government are working towards the ultimate Catch-22; if you can qualify for benefits by handling the hundreds of pages of form-filling, negotiating the maze of departments, offices and units, and convincing the GPs, psychiatrists, psychiatric nurses, civil servants and ATOS box-tickers, you’re not just fit for work. You’re good enough to be Minister for Social Security.

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  1. Top article, well said.

  2. Thank you for posting your story, Alicia. It resonates with me - I didn't claim at all for two years, as the process itself made me so ill. If CMHS hadn't given me a social worker to sort it out, I'd be a gibbering vegetable by now. Or dead.

    Last year's ATOS assessor replied to my statement that I have severe clinical depression with "My friends knew I was depressed when they came round and saw I hadn't done the washing up." Although my thoughts were "You had friends, missus, so you hadn't been depressed for long," "I wish the washing up was the worst of my problems," and "Are we discussing your health or mine?" But I didn't say any of that, I made sympathetic noises ... because I'm mentally ill. She 'failed' me, of course. Sigh.

  3. I remain convinced that the only reason I managed to convince the ATOS assessor I was ill (he'd never heard of the variety of epilepsy I have been diagnosed with) was because I actually had a seizure there in the assessment room; I was that stressed out.

    He then proceeded to ignore all that I had been telling him about my seizures for the last half an hour - I think he panicked slightly and called for help, summoned an ambulance, didn't put me in the recovery position, forgot I retain a degree of consciousness, and was generally pretty damn unhelpful when the paramedics arrived.

    I live in terror of being summoned to another one now that I know my health is more complicated than epilepsy alone.

  4. What a shocking experience, J.Hill! "Health Professional" indeed ... no medical knowledge required? It sounds as if he hadn't even done a first-aid course.

    To be fair, my first ever assessment was done by an actual doctor, whose notes were perceptive. The next two, however, were so inept it would have been funny if it weren't so serious.

    My social worker told me a harrowing tale of a claimant she'd accompanied - in an ambulance, with drips attached - to his interview. He died in the same week he received notice that he was fit to work.


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