Thursday, 3 January 2013

Work Capability Assessments cause suffering for the mentally ill

People suffering from mental health problems are often the most vulnerable when seeking help. Mental health can have a major impact on work, housing, relationships and finances. The Work Capability Assessments (WCA) thus present a particular challenge to those suffering mental illness.  The mentally ill also are often the least able to present their case. Staff involved in assessments lack sufficient expertise or training to understand mental health issues and how they affect capability.

Because of  concerns that Work Capability Assessments will have a particularly detrimental effect on the mentally ill,  an e-petition on the government web site calls on the Department of Work and Pensions to exclude people with complex mental health problems such as paranoid schizophrenia and personality disorders.

Problems with the WCA  have been highlighted in general by the fact that up to 78% of 'fit to work' decisions are  being overturned on appeal. It is all to the good that they are overturned,  but the stress caused is considerable and many claimants receive no help in the process. A flawed process is causing harm. The mental health organisation Mind are concerned that people with mental health issues may be asked to undertake unsuitable activities as a result of these flaws in the assessment criteria,  leading to stress and breakdown. It may also be difficult for many to get appropriate advice on dealing with the process.

The British Medical Association has already warned that its members are overwhelmed by patients seeking help with appeals and that no extra funding has been provided to support this. The BMA have also expressed their concern that the assessment system is flawed and takes insufficient account of individual circumstances.  To date these concerns have been ignored by the government.

In the early part of the 1970s I was a member of Wandsworth Council in London. I was concerned then with the impact of the closure of mental hospitals and the move to the 'care' of the mentally ill in the community. It wasn't because I was against the idea of moving people from institutions so they could have enriched lives in the community. That was all to the good. It was because I believed that too little was being done to ensure appropriate support. I was not alone.

The BMA had also looked at the issues and they sent me their report expressing their concerns.  It was a question of looking ahead. I prepared a policy document outlining the likely impact on the borough and what might be needed in planning for the change. With all-party support and wonderful help from local organisations the document was incorporated into the council's 10 year plan. I was always pleased that the issues were understood across the political parties.

Much has changed since then. We have a much better understanding of how mental illness can affect us all in some way and at some stage in our lives. We may even suffer without realising or receiving appropriate help or advice.

It is a sobering statistic that 1 in 4 of us will experience a mental health problem in any given year.  It is often quoted, but it is not a cliché; it is based on sound evidence obtained from several studies.  The impact of mental health problems are often exacerbated by the social and economic environment. Periodic hospitalisation may have impact on housing and jobs and on maintaining contacts in the community. All these problems can create instability. It is a time when help within the community can be of greatest benefit to maintain that stability. Financial problems can be acute because of periodic or long term inability to work. Financial help is a vital part of care in the community, enabling people with mental health problems to lead as stable life as possible.

The government should think again about the way in which WCA has been set up and is operating and in particular on those most vulnerable such as the mentally ill and also those supporting them.

Link to the petition: e-petition.
Link to general petition on WCA: WOWpetition

Postscript


In a survey of 1000 GPs published in September 2012,  21%  said they had patients who have had suicidal thoughts as a result of undergoing, or fear of undergoing, the Work Capability Assessment. 14% had patients who self-harmed as a result of undergoing, or fear of undergoing, the Work Capability Assessment.


4 comments:

  1. The ongoing stress induced by recurring assessments has, I believe, added to the existing pressures of living with Chronic Pain/Disability; it exasperates the pre-existing link between Physical & Mental illness

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    1. I am sure you are right Jayne. Tragedy is that until someone publishes the results of a good study of this, we are unlikely to be listened to.

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    1. Thank you Mohammad, your comment is much appreciated.

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