Mental health and PIP

I am concerned. I am really concerned.

In my PIP medical report it stated that I receive no mental health support so therefore don't qualify for having any recognisable mental health problem. What the ATOS assessor actually meant by that is that I don't qualify for any NHS mental health support.

I am a frequent reader of many forums and this theme seems to be appearing again and again. The ATOS assessors are justifying their reasoning using the fact that people are not accessing NHS mental health services, even if they have done previously and are now under the care of the GP.

I only need to do a quick google search to find  these articles and headlines:

There can be little doubt that the mental health sector is under pressure, however understanding the nature of those pressures has been difficult.
http://www.kingsfund.org.uk/publications/mental-health-under-pressure

More than one in ten (12%) people with mental health problems are stuck on waiting lists for over a year before receiving talking treatments and over half (54%) wait over three months, reveals a new report launched by the We Need to Talk coalition of which the mental health charity Mind is part of.
http://www.mind.org.uk/news-campaigns/news/people-with-mental-health-problems-still-waiting-over-a-year-for-talking-treatments/#.Vz7TjRMrLnA

The mental health service in England is in crisis and unsafe, says one of the country's leading psychiatrists.
http://www.bbc.co.uk/news/health-24537304

This leads me to the conclusion that in order to be able to access NHS mental health services you need to be considered seriously unwell  before they will even consider you for treatment, and even then that treatment will be severely limited by funding. All of this is well known to "service users" like myself. It is damn near impossible to get NHS help, which is why for me personally I used my Disability Living Allowance to pay for private treatment.

I now want to highlight the sort of treatment that is available on the NHS, usually for people whose mental health is deemed "mild" or moderate" (but considering how stretched the service is, the definitions are also stretching to include some people who would traditionally be classed as severe).
Cognitive Behaviour Therapy (CBT) is the NHS talking therapy of choice. It is relatively cheap and relatively effective. It can be delivered in a variety of different ways, depending on the client group (and sometimes geographic location).
http://www.nhs.uk/conditions/Cognitive-behavioural-therapy/Pages/Introduction.aspx
I want to highlight a  few sentences from this page here:

"The course of treatment will usually last for between 5 and 20 sessions, with each session lasting 30-60 minutes."

"CBT cannot remove your problems, but it can help you deal with them in a more positive way."

It is not a cure, and it is a short term therapy. It relies on the person being in a position to be able to engage with the suggestions and to practice them daily and apply them daily. It doesn't (unfortunately) mean a nice quick fix and the person is sorted, it is trying to teach people how to live differently. There are problems with CBT, there is a good post here to read about its limitations here: 
https://everydayproblemsolving.wordpress.com/2010/04/12/cbt-from-an-everyday-perspective-part-ii/

but I am not going to into details, everything has its limitations. That, in this post is a side issue.

The main issue coming from these two points is this: NHS mental health services are limited, and any therapy you can usually get from the NHS is CBT based, which is short term therapy, around 6-20 sessions.

Going back to the ATOS assessment, why are they assuming that anyone who doesn't access NHS mental health services is not mentally ill, when the NHS is so stretched that if and when people can get treatment it is only short term therapy, not designed to cure a persons mental ill health?

People with mental health problems are increasingly looked after by their GP, even those with severe problems. People are looking to private treatment because there is very little on the NHS. People are not lying or saying their condition is worse than it "appears on paper". It is the very simple fact that the help is not there for them to access.

I feel like people with mental health problems are being punished twice over. The NHS for failing to care for them and from ATOS and the DWP for failing to take this into consideration for benefits assessments. 

down the rabbit hole (the week that was)

i dont really know where to start with this blog. Mainly because so much has happened and its all floating around in my head, feeling like it is crushing me down. So I guess I will start at the beginning.

After 6 weeks of waiting ATOS replied to us regarding our complaint. They admitted they did wrong, the assessment should have never taken place in the room with no soundproofing and it was only a temporary measure used for that day.

I got angry, I got very angry, I felt like ATOS were saying that they did it and they don't care, after all I am just a disabled person, why does it matter?

So, I wrote a letter to the DWP adding this evidence to my original reconsideration statement, which is still in progress, nearly 8 weeks after submission.

I also contacted the guardian. I am of the opinion that the personal is very much political. I didnt go to them with my story for my own personal gain, I went for everyone who didn't have a voice, or a letter from ATOS admiting their mistakes. I went to expose the systemic abuse that is happening to disabled people right now in the benefits system. Quite simply, it was bigger than myself. I felt willing to forgo my privacy to expose yet another failing in the system.

So, the article was written:
http://www.theguardian.com/commentisfree/2016/may/12/benefits-assessment-ptsd-benefit
and it was well written.

But then I felt like Alice as I tumbled down the rabbit hole unable to stop the chain of events, either as a result of the article or my letter to the DWP highlighting the ATOS complaint letter.

I received a letter on friday informing me of another assessment, this time conducted in my home, next week. I am currently in panic mode. I can't describe what im currently going through, as it is really hard to put down into words what the thought of another assessment is doing to my head. I am also very clear that this will not be happening in my home. I need it to take place in a grey, anonymous office away from my life and certainly away from my place of safety in my home. Having ATOS there will feel like a home invasion. Just NO.

I have rung both ATOS and the DWP and neither know why I have been issued with this appointment. I have spoken to both the CAB and  another independent advice service who are both unsure as to what is happening. We are awaiting a call back from the DWP tomorrow to see if a manager can tell us what is going on.

In the mean time my husband has written a letter explaining why another medical is inappropriate at this stage. Its just too late for them to be gathering evidence.

I have also taken a step that I didn't think I would have to, I have contacted my MP. I didn't want to because it feels like I am being selfish, but as I am currently travelling down the rabbit hole I need all the help I can get to land safely and move on from this experience.

Answers on a postcard as to whats going on, and whats going to happen next.

Monday update: Im not really sure whats going on anymore. The DWP and ATOS are denying all knowledge of ever speaking to each other and I feel like Im in the middle of some sort of lovers tryst, or fight between them. I just want them to throw out the mandatory reconsideration so I can take it to appeal for them to laugh at it all. ATOS or the DWP say theres not enough medical evidence to make a paper based medical happen, but then say that its too personal information, but then say they are the only ones able to tell me what my life is like on a day to day basis.

and they wonder why the suicide rate is going up...

transcript

transcript for this voicemail: http://justiceforlb.org/a-culture-of-candour-justiceforlb/

Good morning, hello, hi, I believe this is a message for Dr Sara Ryan, um obviously on the media (not sure on this any help?) into the care of southern health. I work for southern health and I feel awful that you lost him I’m so sorry that you have done, it’s tragic, and, I hope you find some closure after the report, the issue of the cqc today, but I do think you are being very vindictive. I think you are a vindictive cow

On tv all the time um slating NHS southern health, with your intelligent background, ya know as much as much as anyone else knows, that southern health only took over those units in Oxfordshire recent you know the recent months before , before your son died.

You know, with your background, it takes a while to make changes in anywhere, and I think now your (on a mission) (again I think that’s right sorry on this word), you want some attention, but you are vindictive and you are unpleasant, and you are a nasty cow.

933am Friday april 29th

Rage

I am angry. I am really angry.

I was awarded zero points for my transfer from DLA to PIP on the 18th March. Thanks to the lack of staff at the DWP my mandatory reconsideration, part one of my appeal can take up to eight weeks to complete. I sent it on the first april, and so have been told it could be up until 30th May before I hear anything. But that isn't why I am angry (although its leaving feeling pretty helpless).

My husband complained about my medical assessment just after it happened. I have written previously about how distressing it was, we could hear everything that was said from next door and when we asked to move was told there were no rooms available.

We got the reply today, and this is what I am angry about. Some quotes from the response

"I have contacted the assessment centre in question and the confirmed room the was a temporary measure used for one day only due to a lack of computers available. The room is not normally used and will not be used again in the future."

"The health professional (HP) followed correct procedure as the only option open to them was to cancel the assessment, which would have caused even more distress to you."

I got zero points for this distress. I got zero points because none of this distress was even mentioned on my medical report, despite the fact they clearly mention it here.

They used a room that they admit was not suitable and will never be suitable to conduct a medical assessment. They should NEVER have even let me be in that room in the first place. It wasn't a case of cancelling the assessment if it was going to cause distress, (ie if they could get away with it then why bother re arranging).

It is horrible to think I have been treated so poorly. I have written a strongly worded letter to the DWP. I am hoping they can see how disgusting this is.

I have asked them to completely dismiss the medical as ATOS themselves have admitted it wasn't up to their usual standard. I have provided plently of other good evidence from medical professionals to not need another (I hope).

O, and ATOS mentioned the DDA, perhaps I need to write to them and let them know the equality act came in at the same time of the welfare reform act, and suggest they take a read of both? And the english really is as bad as my quoting.

I'm fat

Last night on dispatches the assessor was caught on camera talking about claimants in a derogatory fashion. Its just made me think. They called me fat to my face. Here is a copy of my PA4, my medical assessment.
I have mental health problems, tell me what relevance this "observation" is?

I quit. I had no choice

I wanted to write something smart or inspirational tonight, but when it comes to it, I can't.

Today I have had to give up my teaching qualification. Why?

Because the DWP took my Personal Independence payment away. Even though I am appealing, appealing takes time and in the meanwhile I can't live on nothing. The money I could get from student finance isn't enough to cover every day bills, and you cant get extra unless you claim PIP.

At least this way we can hopefully get housing benefit. Which will keep a roof over our heads.

It was also the medical that made me too ill to continue as it came at a crucial time of the year for me. Due to the trauma it caused me I was too ill to work for two weeks, and thats' a long time for teaching.

Perhaps there will be time for equolent words tomorrow. Tonight, there is just this.

How I wrote my mandatory reconsideration

couple of disclaimers, I am not legally trained (its more a student/academic approach) and I am yet to receive word on how my MR has been taken, but thought it might be helpful to some people.

Its not easy . I wrote a 10 page report on why I qualified and how for mandatory reconsideration, but its not entirely necessary as MR is usually just a rubber stamp by the DWP and the majority go to appeal. (That being said as you can use your MR for appeal why not both, it was my logic).

Once you have your statement of reasons from the DWP as to why they didn't award PIP 

have a good rant about. Shout, scream, write or talk about all the things that are so stupid about it all. Now put that aside, and onto the serious bit of getting what you are entitled to. 

I didnt use any of that in my MR statement. Not worth it, emotions are going to be distractions to the facts. Become a robot. Put yourself in the place of a decision maker. They are sitting down with your claim and your evidence in front of them and the assessment report. Put the assessment report aside for the first part.

Go through each descriptor as a decision maker. Write that you disagree with the decision made because of this piece of evidence. Quote it, reference it in the text with an indication of where it is in which piece of evidence. All facts, no emotions. If you don't have evidence for a descriptor, then you might need to get your evidence provider to write something additionally (but you may not have time for it as you only have 30 days, but still request it for the possibility of appealing as you still will only have 30 days if you need to appeal after MR is over). Just add you don't have evidence at this time but are requesting additional information from X with contact details.

You need to prove that you hit the points descriptor for the majority of days and to do so means that you need to be able to do the activity reliably. That is safely, to an acceptable standard and repeatedly. There is a definition of what the "reliably test" is in the PIP dwp assessment guide here: https://www.gov.uk/government/public...ment-providers

Ok, to reverse it. You need to demonstrate that it is dangerous, you can not complete it to an acceptable standard or would not be able to repeat it again at the same speed as would be expected, and take over twice as long as a non disabled person (I think thats right but the definition is in the booklet linked above). Remember that it has to affect you for the majority of days as well.

Bullet point it if you need to. Use your evidence, your original form, any additional evidence, stuff about your condition, and include it all in the final submission for them to look at.

For example: I disagree with the decision you made regarding descriptor X because, according to the evidence I submitted with my original claim My Consultant states

"My patient cannot do this"

Which means that I am unable to do this safely, to an acceptable standard and reliably. I can not do this for the majority of days because in addition to the above evidence I have also stated on my original form this:

" I can not do this on any days"

and my friend who wrote a supporting statement wrote this

"This person can not do this and I have to do this because of this."

(Im being intentionally vague because i'm really bad with examples and dont want to influence what you write, its just to demonstrate the format I used)

OK, next bit, discrediting the report. Well, not discrediting it as such. Remember, your the decision maker here. You need to justify why you didn't use it.

Any inconsistencies with the evidence from medical professionals compared with the report?

Is your condition complex to understand?

Does your anxiety manifest itself clearly and standardised so that anyone could pick up on it?

Don't lie, and don't accuse them of lying. Just state that the evidence you have provided is going to be enough to support your claim without needing to take into account the medical. Would it be possible for the people who went with you to the medical to record their own observations of you at the medical and send it in as a letter? Was there anything with the medical that meant you may not have been able to engage properly etc.

If you want to complain about the medical, send a complaint to the medical providers. Ask them to improve their standards.

As I said this is just my method, and it means I have done it for the appeal as well as the mandatory reconsideration so it saves some work.