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Category: Depression

Fitness to Work test Ruled as Discriminating Against those with Mental Health Conditions

Posted in Depression, Journalism, Mental Health, Personal Narratives, and Welfare Benefits

Charlotte Walker has Bipolar Disorder. She was declared unfit to work by her psychiatrist, GP and occupational health. After a Work Capability Assessment for Employment Support Allowance, she was found fit for work.

The Fitness for work ESA assessment has been confirmed as discriminatory to those with mental health illnesses.

Today, the Work Capability Assessment was upheld at the Court of Appeal as discriminatory to those with mental health problems. Mental health claimants on Employment Support Allowance benefit, a sickness benefit for those out of work, are expected to provide evidence of their condition which can be complicated by the nature of their illness. The ruling stands from May this year that the fitness for work test may hinder these claimants as they could have problems asking for and finding evidence, providing it or understanding the assessment process itself.

Due to mental health difficulties which hamper the process from filling out the form for the benefit, through to problems with people being unable to describe their condition because of shame, stigma or lack of insight, the assessor may not get a full picture of the disability or their ability to work and claims could be rejected on this limited view according to the court ruling.  The process of completing the questionnaire and undergoing the interviews were mentioned as causing those with mental health problems disproportionate stress when compared with claimants suffering from other disabilities.

Across the UK, mental health sufferers and campaigners are celebrating this success. Those who have gone through the Work Capability Assessment under Employment Support Allowance, testing their fitness for work have had their feelings of the unfair process confirmed in law.

Charlotte Walker, 39 was diagnosed with bipolar affective disorder twenty years ago, where moods swing from extremes of mania to severe depression. She had eight symptom free years but in July 2010, her mental health worsened because of a pressurised managerial role. Describing the mania, Charlotte said: “I was seeing pseudo hallucinations with centipedes, worms, ladders, brightly coloured beads and kaleidoscopic fragments, I wasn’t sleeping. There were snatches of music in my head and the same phrase looping over and over. I couldn’t think of ways to stop it and felt that I would probably have to kill myself.”

Charlotte went to seven back-to-work meetings before accepting her employer’s decision in April 2012 that she was unable to return, so she left her post. Within three months of her psychiatrist, GP and occupational health concluding she was too ill for work, Charlotte attended a Work Capability Assessment accompanied by her partner, after applying for Employment Support Allowance and was found fit for work, scoring no points.

The face to face Work Capability Assessment carried out by Atos, the company employed by the Department for Work and Pensions, measures physical and mental health conditions affecting a person’s ability to complete daily tasks, such as dressing themselves and cooking.  Atos log criteria on a computer during assessment and the Department for Work and Pensions makes decisions with this information. The process was designed to look at an individual’s functional ability, looking at what he or she can do rather than what he or she cannot do. The higher the points scored, the more limited the person was in capability for work. The intention was this should provide a focussed assessment looking at the unique needs of the individual. Fifteen points are needed to remain on Employment Support Allowance and people scoring fewer points are deemed fit to work and cannot claim the benefit, which is where Charlotte found herself.

She said: “During the assessment, they didn’t understand my health and kept asking me about a typical day when I don’t have a typical day. I took a lot documents but they didn’t want to see them. They wouldn’t let us take notes and accused us of being aggressive for wanting to know the full name and qualification of the person assessing me. I was crying all the time.” Charlotte felt “there was no way she could win” as her condition varied on a daily basis.

A DWP spokesperson wasn’t able to comment on individual cases but said: “Employment and Support Allowance assesses someone’s capacity for work and looks at what a person can do because we know conditions affect people in different ways.

“Since 2010 we have improved the Work Capability Assessment. As a result the percentage of people getting long term unconditional support has more than doubled in two years, everyone has the right to appeal if they disagree with the outcome.”

Charlotte appealed and after a year, a tribunal ruled in her favour. She then stopped her Employment Support Allowance as she couldn’t go through more assessments.

Jenny Townsend, 37, suffered post-natal depression after the birth of her second child. She is also diagnosed with back pain, sciatica, anxiety and endometriosis. In August 2010, she felt suicidal, lacked motivation and didn’t bathe much. During maternity leave, she was made redundant. Meanwhile, Jenny and her husband were worried that her son had brain damage. Her GP prescribed antidepressants and she started to claim Employment Support Allowance. After her Work Capability Assessment, she was deemed fit for work and she appealed with assistance from a charity.

She said: “I was shocked when I had my assessment, it was like an interrogation. They never looked at me when they asked questions and were serious and cold. They asked how I’d got there and asked if I had walked from the bus stop, that information was used against me. I was astounded at the report that I got when I appealed. It said I was able to communicate, was clean, dressed well, tidy and clear speaking.

“They didn’t address my illness as they were looking for someone who could walk and talk, therefore they could work.”

Jenny came off Employment Support Allowance despite still suffering from depression. She had a second assessment but her contributory ESA had ended so she completely cancelled the claim as she didn’t want to go through the assessment again.

Services have seen an impact on people going through assessments. Vocation Matters in Lambeth provides vocational support for people with mental health problems. They have had to turn people away because of demand. Shaun Williams, the manager, said they had to attend work capability assessments, which is outside their normal casework. Mr Williams foresees further problems when people will be affected in 2015 as benefit changes are rolled out across the country. He said: “It makes people feel bad and they question, do I really feel these things? It screws people’s belief in themselves and people are railroaded through the system.”

The original May ruling said the Department for Work and Pensions must do more to ensure evidence about a person’s illness is collected and taken into account and adjustments must be made to the process, as the current Work Capability Assessment puts some groups at a substantial disadvantage.

Jayne Linney, 51, has long-term diagnoses of fibromyalgia, Sjorgens syndrome, cervical spondyltitus, spinal cord damage, nerve related incontinence, depression and migraines. She built a thirty-year career in community work, adult education and counselling but said: “My health took it away from me.” Her claim for Employment Support Allowance began in May 2011 after severe work stress nearly led to her being sectioned. Jayne described her experiences of Atos assessing her three times for Employment Support Allowance, saying: “It’s unwelcoming, it’s an inhuman process, like a sheep or cow going to cattle market, you’re not a person. “You’re guilty and have to prove you’re ill. The assessment takes no notice of your consultants or GP. You know the person knows nothing about your condition, they could be a physio.”

An Atos spokesperson said: “We do not make decisions on individuals’ entitlement to benefit: we carry out Work Capability Assessments in line with policy and guidelines laid down by the government.

“All our doctors, nurses and physiotherapists are registered with their professional body and have at least three years post registration experience.”

Jayne fought an online campaign to record her assessment but finds repeated assessments draining. With new legislation affecting her housing benefit alongside the assessments she said: “It’s never ending. You’re never free from it, that’s the worst part. “I don’t know how or if I will cope. I’ve got a cupboard full of drugs and Oramorph. I’m aware that suicide is an option that is always around the corner. Sometimes you look at what’s going to happen, it might be the best way out.

“When you can’t participate in the world, what is the point?”

In a joint statement Mind, the National Autistic Society and Rethink Mental Illness said:

“The judges in the original ruling independently confirmed what our members and supporters have been saying for years – the system is unfair for some of the most vulnerable people in our society and is failing the very people it is meant to be supporting.

“In light of today’s ruling it would be irresponsible for the DWP to carry on using these flawed assessments as they are.”

The final judgement is expected next year unless the Department for Work and Pensions wishes to appeal the decision through the Supreme Court.

Disabling Walls Cracking Through to Daylight

Posted in Depression, Identity, Mental Health, and Writing

“If you can’t keep yourself alive and safe then I’ll have to send a psychiatrist around and bring you into hospital.”

I never thought I would hear those words and I cried and cried down the phone to the duty doctor at my GP practice feeling a rising sense of desperation.  I wanted and needed help but this wasn’t it.

The duel impulses of wanting to take my own life, as I couldn’t cope with managing my own mental ill health with thoughts running alongside of all I had achieved that hadn’t quite unfurled yet was breaking me into pieces. I wanted to live and I wanted to die and I felt the weight of both pressing on me to cast the deciding vote on my life. Life is standing uneven footed on this edge, facing down the nameless void and being overcome with unshakeable opaque blackness or tilting my weary head up to look at the blue, expansive sky with the possibilities to come. Sometimes gravity is stronger than freeing myself to fly up to the warmth of the sun.

Hospital was not an option and I made sure it didn’t happen but when a GP uses that as a threat when you’re getting help, it makes you cynical and hardens you up a bit.

I have thought long and hard about whether to write this post on my professional website.

This blog came about as I wanted to bring thought and personality into my work, as that’s part of the reason to commission me for photography and writing. However, I always considered the tone of voice I use and the personal information that I put out in a professional context. Fundamentally, I’ve always been an honest person and I truly believe that if you strip away the layers, you are left with the essence of who you are so it’s important to speak with an authentic voice about my truths and my reality.

I have suffered from severe clinical depression and anxiety for a long time so that it’s classed as a disability. Many times it has cut into my life and stopped me in my tracks, interfering with my ability to do normal daily things like cooking, reading, getting dressed or halting achievements and plans of mine. For an intensely driven high achiever with the work ethic of several small countries, frustration does not even cover it, I know when it descends, I am weighted down by the part of me I try to keep from blotting me entirely with black inkiness.

There are many eye rolling stories about the colleague that overshares to the point of discomfort and that is not my aim here. This is who I am and a part of my make up but right now I am fighting for it to not consume me and it will never run me. I spend so much time thinking and photographing around identity and the hidden and with that trust my sitters give me to see into their lives, I would like to give something back and knock down those suffocating barriers that don’t end up protecting us but create a wall of silence. This is me and I hope to conquer it and get stronger again.

Mental health conditions aren’t rare, 1 in 4 of the general population will experience a mental health problem in any year. Whenever I have talked about my condition it has led to others opening up,  stigma is something that stopped me writing on here but it should be out there. This condition influences the jobs I’m able to take, the decisions I make for myself and the ways that I am able to work. Mental health can be damaging and negative but it can be a positive story where people survive to fight another day to achieve all these big and wonderful things. I feel that by writing this, I am reminding myself not to effervesce myself into glittering blackness because it feels good at the time of productivity and I can tell myself to just keep putting one foot in-front of the other until it feels natural to walk again.

As I sit here typing, medication which I got put on and now taken off is buffering me with waves of sedation mulling my braincells into dizzying heights, spaced out and suffocating where my head swims back and forth. I want my sharp, quick witted brain back. It’s not like the past few days, with a trip to hospital and sleeping all day as medicine was knocking me out. Today, I draw the line under it and am trying to continue the battle without chemicals. I’ve been drafting this post for weeks but have just been too unwell but it either gets said or sits there silently gathering weight. I’ll take the odd sleep patterns, crying in a heap not knowing why, squaring up with suicide, unsure how to respond to people asking “how are you?”, the unshakeable grip of feeling just a bit too raw and the rest, if I can keep myself going.

In the middle of healthcare bureaucracy, I’m trying to set up professional support and relying on friends becomes difficult as I feel like a dead weight burden. Trying to put anchors down amongst all the wavering uncertainty. Who I become when I get ill is the opposite of who I am when I am well but these sides of me need to co-exist in a healthy way and not jostle for space in an all or nothing bid for war. Internally, keeping myself alive and well sometimes feels like the most impossible task when I hit the lows with no end point in sight and ping back up in anxiety driven jitters of activity where my perception starts to distort and I can’t trust what’s in-front of me.

This recent bout of illness has been a case of quite a lot happening in my personal life and juggling that with the responsibilities of a very intensive and demanding course. Since the end of January, I started an industry recognised NCTJ diploma in written journalism on a eighteen week fast track. It’s not been easy due to an enormous workload and I know it’s challenging and not me when my peers wander around looking like drained perma-zombies with glassy, blinking eyes. My ability to do well on this course may well be jettisoned by ill health and this feels like the biggest defeat of all.

Amongst all of this my management strategies have either not been possible due to lack of time or have really failed to work. After a mental health assessment, I decided to go to Green Park to enjoy the sun and try and get some normality back in my life but this proved to be one of the worst things possible. I lay on the grass and the merging of hundreds of conversations, traffic noise and general city buzz which I usually thrive off started to sound like a million telephones ringing, the people talking took on a metallic quality like sheets of metal rumbling and grating at the same time. The sky loomed over me and I felt like it was going to cave in on me as it was getting oppressively closer. It scares me to not be able to trust my own perceptions as every sense of mine has been turned up to maximum volume so everything is in overdrive. I usually buzz off lots of information and multi-tasking but I’m inundated with sounds, sights and touches that feel overwhelming now. I can’t even cycle at the moment either due to intense fatigue or the reverse and feeling wired and risky on the bike.

I’ve worked in enough big companies where they put you through psychometric tests to figure out your personality type to slot you in to the grand masterplan. An important theme that came out was that I was happiest in my work when I demonstrated courage and empathy.

What does courage mean? For me it means not giving up, not letting go, asking those questions others are afraid to ask, tackling tough issues and dealing with conflict.

What does empathy mean? One of my biggest strengths is being able to sit down with a complete stranger and get their life story in minutes and to not to be afraid to share mine, fractures and mistakes included and to be able to bring people out of themselves.

These are strengths that make me a strong journalist and photographer.

But for me right now when I shrink it down to the waves of dizziness circling my head, courage is facing up to being ill, being vulnerable and being able to stick my hand up and still be counted and not give up and I ask for your empathy and to remember it for when you see someone you love or know suffering with their demons.