A progressive government: Schizophrenic man who has just spent 6 months in mental institute told to find work

I heard of this story yesterday via Twitter (yes I am a convert) and I thought it worth sharing - mainly because it only happened this week and it shows that the much-derided medical test for ESA is affecting real, vulnerable people now - it's not just a dry political argument with which to bandy insults at Prime Minister's Question Time.

A man with Schizophrenia has just been taken off Employment Support Allowance (ESA) and put onto Job Seeker's Allowance. Earlier this year he was discharged from a mental institution where he had spent the previous six months. He is now living in residential accommodation, which in itself shows he is not yet healthy enough to live a fully independent lifestyle. He has also not worked for 10 years.

The real shock behind this story is the way in which this change has happened. He was asked to attend a medical test which is administered by a company called ATOS, who have the contract from the Government's Work and Pension department. A person has to score over 15 points to be deemed eligible for some form of ESA. This man scored 0. Yes, you read that correctly, ZERO. As he has a clear diagnosis of a severe mental illness this score tells me either that ATOS doesn't recognise the debilitating nature of a mental illness or its test criteria are entirely inadequate for unearthing the effects of mental illness on a person's capacity to work.

Either way the man has been moved from ESA straight onto JSA - he has not even been moved to the lower rate of ESA which would mean he would have been given greater support on how to go about preparing himself for work and identifying which employers are accepting of a long history of mental ill-health and unemployment. How is a job centre employee with basic training on how to get the average Joe back into work going to know how to deal with a schizophrenic not yet capable of fully independent living?

I'm beginning to warm to the Work and Pensions minister Ian Duncan Smith, he seems to be intriguingly genuine in his desire to reform our benefits system so that, in his words, people don't get left behind. And clearly the man of our story has been left to languish for ten years on incapacity benefit. But it's obvious the current welfare reduction drive is more focused on reducing the cost of welfare than exercising any common sense or, dare I say it, empathy towards those with long-term ill health.

Rumours are going round Twitter that Ian Duncan Smith has threatened to resign 12 times since taking office due to consistent, unyielding clashes with the Treasury. With stories such as this schizophrenic man surfacing, it seems clear that the battle is far from over between government members who just wish to reduce the cost of welfare and those who wish to reform welfare to help those who are on it achieve a better life.

I can only hope that the schizophrenic man in question appeals the decision so that at the very least he is awarded lower rate ESA and given proper support in finding work. If not, he clearly has very little chance of ever gaining employment and will be left to live in even greater poverty than before. That's a 'progressive' government for you.

Will toddlers on anti-psychotic drugs be the future for the new NHS?

Great article I read last week in the New York Times about the increasingly prevalent use of psychotic drugs to treat toddlers. Yes you read that right. An 18 month old was put on an anti-psychotic drug for throwing temper tantrums. And this isn't an isolated case.

Admittedly, this is America, where the use of mental health drugs on children is much more widely practicised, and it's easy to read this piece and say 'Thank God that's not our country'. BUT what really struck me in this piece, and which should act as a harbinger for the UK, is that those who are poorer in the US are more likely to be put straight onto a mental health drug rather than time be taken to provide talking therapies or more in-depth diagnoses.

And as our country's politicians are considering changes to the NHS that could see the creation of a two-tier health system - one level of service for those who can pay and another level for those who cannot - such stories as this should act as both a case study and a warning.

Last December a US research team found that those kids on Medicaid, the health cover provided by the US state for families on low incomes, were four times more likely to be given antipsychotic medication than children who were privately insured. The reasons given by the researchers for this disparity were partly because Medicaid often pays less for counselling than private insurers do and because the waiting time to see a psychiatrist who accepted Medicaid patients was so long that medication felt like a better option.

Turning back to the UK and the great charity Rethink found that only 1 in 6 mental health patients received all the treatments recommended by NICE, with over half of people with schizophrenia or bipolar disorder NOT receiving psychological therapies (such as talking to someone) as recommended.

It seems the UK already has a problem providing access to non-medication treatment for mental health issues, and I'd hate to see this worsen due to cost implications and waiting lists. But for a government that wishes to hand over funds to GPs and effectively privatise hospitals allowing them to seek income from the NHS or from private patients at a ratio they chose (creating long waiting lists for NHS patients and budget-conscious GPs who may feel compelled to prescribe the cheapest option) I just can't see how those who are poorer in society will have a chance to choose their mental health treatments.

In the future, I'd hate to read about UK toddlers heavily medicated on anti-psychotic drugs but I wouldn't be surprised at all.

How belief in good luck brings us good luck

So if August was measured in terms of bad luck than I think I'd be up there for some kind of award (a few giant buckets of gin and tonic would be a suitable prize if anyone wants to send it my way). I don't need to tell you what's been going wrong, mainly because its September 1st and I've decided that August is the month of bad luck and September the month of good luck.

But as my boyfriend points out this concept of good luck and bad luck makes no sense to someone, who like me, purports to be rational. So it got me thinking whether our concepts of fate, luck and the belief that life can't always stay bad is an inbuilt coping mechanism we deploy in bad times to create our own light at the end of the tunnel?

A recent psychological survey found that superstition improved performance across four key areas: memory, sporting tasks, intelligence test and motor dexterity. For example 41 students were told to bring a lucky charm with them and performed a memory task either with the lucky charm to hand or when it had been removed from the room.  Those with their lucky charm performed better at the memory task than those without it.

So I suppose it shows that if we believe we can do something than we are more likely to be able to achieve it. And 'luck' seems to be our way of externalising our own self-belief, allowing those with less confidence to still achieve their dreams. Perhaps, conversely, it also means that bad luck does not 'belong' to us either, and therefore is something we can 'shake off' and move on from.

So lets see if September does bring me better luck. I suppose the belief that something has to change for me, that such bad luck can't continue, is actually my own way of not giving up, of not falling into a mire of doubt and inactivity.

Anyhow, I might write more on this at another date and tie it back into health issues and the NHS. But for now I'll sign off as I'm off to hospital (hopefully just as a day patient) to start some intravenous antibiotics tomorrow (ivs) and fancy getting an early night. 

Have you been consulted over the proposed changes to YOUR NHS?

I promised to write regular updates on the planned changes to the NHS so here we are.

Unison announced this week that it's planning legal action against the Government's plans to give a vast chunk of the NHS budget to GPs (abolishing PCTs) and effectively privatise hospitals by turning them into businesses that compete for money from GPs and can treat an unlimited number of private patients.

The coverage unions get from the media is undoubtedly overwhelmingly negative, as the age in which they were championed has been replaced by a society modelled on individual rather than community spirit. But it's this very shift in how our society thinks about itself that makes unions so vital as their strikes and legal actions, act as a worthy balance against Government plans that are often focused on profits over community.

Unison believes that the Government's consultation about its NHS white paper, which it is legally obliged to undertake, is unlawful. This is because Department of Health has already indicated that its plans are non-negotiable making its consultation irrelevant and unable to effect change. The Guardian reports that the day after the white paper was released in July: "Sir David Nicholson, the NHS chief executive, wrote to NHS executives telling them to start work on the reforms "immediately".

What I didn't realise is that the NHS has a constitution of which the State's own website says: "No Government will be able to change the Constitution, without the full involvement of staff, patients and the public,"

Having read through the constitution, it does seem unbelievable that such sweeping changes can just be unilaterally imposed, especially as the more radical suggestions were not even mentioned in either the Tory or the Lib Dem election manifestos.

As an example, one of it's patient rights it outlined is: "The right to expect your local NHS to assess the health requirements of the local community and to commission and put in place the services to meet those needs". It goes on to say that this is the "responsibility of your local PCT". However as the Government plans to abolish PCTs it is clear that this right will be altered, at least in terms of who will be responsible for implementing it.

Moreover as of April 1st 2010, there was a new patient right which outlined that each NHS patient must be able to see a consultant within 18 weeks from referral by his or her GP. This right has already been abolished when Health Secretary Andrew Lansley announced in July that waiting times were being axed as they were too bureaucratic.

So bravo to Unison for highlighting our right to question these NHS changes. If this radical white paper is the best way forward for our national NHS then why not explain the changes and the benefits and let doctors, nurses and the public have proper involvement in whether they should be implemented?

Has anyone yet been consulted over these changes? Have you seen a single poster, email, or TV appeal asking for your opinions? Fingers crossed this legal challenge slows down the implementation process so that we all have a chance to think about and campaign for an NHS that we all want, not just one that works the best for the Treasury coffers.

How to make your voice heard about benefits

Just found a great disability charity (www.lcdisability.org) that also campaigns for disabled people and found out some great info - the government is inviting individual responses and experiences to: the Work Capability Assessment used to determine if someone is eligible for ESA; amendments to ESA in general and ideas for overall changes to the benefits system.

I've posted more info and links below. It might take a bit of time but we live in a democracy and should take every available opportunity to make our opinions heard, especially in such austere times.

Please pass on to anyone currently in receipt of ESA or any disabled benefits at all - and anyone, disabled or not, can provide ideas about the benefits system.

I'll post my response on my blog once I've sent my ideas and opinions.

WCA
For the first five years of ESA the Government has to hold an independent review of the test used (the Work Capability Assessment). They have appointed Professor Malcolm Harrington to carry out this year’s review. He is asking for people to share their experiences of the current test for ESA. You can find out more and respond by visiting www.dwp.gov.uk/docs/work-cap-ass-call-for-evidence.pdf . The deadline for responding is 10th September 2010.

ESA in general
To introduce proposed changes to the test for ESA (the Work Capability Assessment) the Government needs to introduce a new Statutory Instrument (this is a type of legislation). The Social Security Advisory Committee looks at any new Statutory Instrument related to benefits and they are holding a consultation on the proposed changes to the test for ESA. If you want to read more and respond to the proposed changes please visit www.ssac.org.uk/press/press23.asp . The deadline for responding is 10th September 2010.

Benefits overall
The Government are currently looking at changing the benefits system and are currently asking people for their ideas on what they think the benefits system should look like. If you want to find out more and submit your own ideas then please visit www.dwp.gov.uk/consultations/2010/21st-century-welfare . The deadline for responding is 1st October 2010.

Behind the media furore lies the real cost of disability benefit fraud

It's a bad time to be disabled.

The populist way to solve the massive UK deficit, in large part due to multiple bank bail-outs, is to reduce the welfare budget. And attention has turned itself time and again to the cost of supporting disabled people with the media often misrepresenting or even falsely presenting the facts.

In a recent Telegraph article about the intended government use of credit agency Experian to weed out fraudulent benefit claimants, the paper stated: "The agencies will get a “bounty” payment for each fraudster they identify under government plans to cut the £5.2billion annual fraud bill". Except that this figure is not correct.

When publishing data on benefit monies, the Government bundles erroneous payments and fraudulent payments into one headline figure. In fact, last year the cost of fraud  was £1.5 billion compared to payments made due to error of £3.7 billion. So why the media misrepresentation?

The Sun similarly misreported benefits statistics on Monday. In its campaign against benefit scroungers (surely a campaign against overtly risky banking practices would save this country more money in the long-run) it highlighted the fact that almost 900,000 people have claimed incapacity benefits for over a decade. It went on to say: "A scheme introduced in 2008 by the previous government has so far found three-quarters of those claiming incapacity benefit were able to work". The scheme it alludes to is the Employment Support Allowance medical test that has been heavily criticised by disabled charities, doctors and even the Government for passing too many claimants as fit to work when they are clearly not - one extreme example was telling a man with terminal lung cancer to go back to work when he only had five months left to live.

The Government itself  is surprised at the volume of people declared fit to work by the new ESA medical test and has asked for an urgent review. Labour was previously expecting to cut the incapacity benefit recipients by 20% but instead this new test is so inflexible and basic that more than 60 per cent are being declared fit to work - three times the initial estimate.


The Sun reported none of the controversy surrounding this new test, clearly using the statistics to persuade the average reader that most long-term sick are faking it. Moreover, the paper talks about the cost to the taxpayer but makes no allowance for the fact that many disabled people who find themselves on long-term benefits have worked at some point during their life and contributed taxes like everyone else.

In fact government figures published by the House of Commons Work and Pensions committee suggest that benefit fraud has REDUCED since 2001 from 2.2 per cent to 0.8 per cent between 2008-2009 (the most recent year for which statistics are available). This fraud figure represents housing benefit, Disability Living Allowance, pension credit and carers' and attendance allowance. It does not include data for fraudulent claims for ESA, incapacity benefit, Job Seeker's or Income Support as the Government had not been able to provide statistics for publication! Extrapolating out from this statistic it is fair to say that out of 889,000 long-term disability claimants only 7,192 are tricking the system. Or to put it another way of the estimated £460 million spent each year on incapacity benefit for the 889,000 long-term sick, only £3,600,000 was misspent. I bet you'll never find that statistic printed in The Sun.

The harsh truth isn't that the long-term sick are scrounging benefits but that there are actually many serious illnesses that are incurable and highly debilitating. Medical advances often mean it's possible to keep someone alive but not keep them well enough to allow them to work.

So hiding behind all this anger at disabled benefits is this: Does society want to pay out money to support disabled people whom it clearly sees as no benefit to society as they are unable to pay taxes? Perhaps it's easier for a Government to complain about people tricking the system than to admit that it no longer wishes to pick up the bill for caring for the sick?

Mind/body dualism at heart of lack of sympathy for mental illness

I read a really great story today about a new MRI brain scan that seems able to accurately diagnose Autism Spectrum Disorder, which covers illnesses such as severe autism right through to Asperger's syndrome. It's been all over the news so you can read the details in depth yourself, but what great news it is!
A new way of diagnosing any illness is great but even more so for a mental illness. Having a hidden illness myself I know what it's like for people not to think I'm genuinely disabled or in need of help. I rarely ever get offered a seat on a bus even if I'm panting and gasping for breath.

But it's so much worse for those who have a mental illness. Right through Western philosophy, from Descartes infamous, "I think therefore I am", we as humans have tended to think of our brain and the way we think as separate from our body. This dualism is right at the heart of why we find it so hard to understand and sympathise with mental illness. "I can't work many hours because my lungs don't work" is much easier to empathise with than, "I find work difficult because I find social interaction impossible." I can't make my lungs work harder but it seems impossible to argue that you can't think differently.

So this news, that there are clear differences in the brain scans of those with autism and those without, gives society a chance to stop and rethink how they view mental illness. ASD is the result, at least in part, of a physical problem in just another one of the body's organs, the brain.

And for those who suffer from ASD they can have a better understanding of their condition and can start to find tools to cope with situations they find hard. Rather than feel stupid or a social outcast they can view themselves as just someone else in society who has a disability and can start to work to overcome the limitations it presents.