The Unspoken Illness - We Need to Talk About Mental Health

Each year on the 10th October organisations and charities from around the globe take part in World Mental Health Day to raise awareness of mental health issues.

WoW Petition will be joining the discussion. You can follow us on twitter @WOWpetition and @WOWpetitionchat and on facebook

We urge you to sign
http://epetitions.direct.gov.uk/petitions/43154
to demand that no one with a mental illness should suffer hardship and distress as a result of welfare reforms. 

WoW Petition calls for an independent, committee-based inquiry into welfare reform including "universal mental health treatments." What does this mean? The answer is simple. We believe that no one experiencing a mental health condition, illness or mental distress should be denied access to the support, care and treatment that they deserve and need.

Mental health problems are widespread in the UK:

• Mental illness accounts for half of all illness in the under 65s. 

• According to the World Health Organisation, one in four of us will have a mental illness at some point in our lifetime.

• One in six people are currently affected by a mental illness.

• 6,000,000 people have depression or crippling anxiety conditions.

• 700,000 children have problem behaviours, anxiety or depression.

• One third of all families include someone who is currently mentally ill.

The human impact of mental illness :

• Suicide is the most common cause of death in men up to the age of 35.

• Around 4,400 people end their own lives in England each year. That's one death every two hours. At least 10 times that number attempt suicide. Around 90% of suicide victims suffer from a psychiatric disorder at the time of their death.

• Mental illness has the same effect on life-expectancy as smoking, and more than obesity.

• Mental illness is generally more debilitating than most chronic physical conditions. On average, a person with depression is at least 50% more disabled than someone with angina, arthritis, asthma or diabetes. 

• Mental pain is as real as physical pain, and it is often more severe. 

• The UK has one of the highest rates of self harm in Europe at 400 per 100,000 population. 

• People with serious mental illnesses die on average 20 years earlier than the rest of the population.

Neglecting mental health blights millions of lives, and yet, despite the huge cost to the economy and our society, three-quarters of people with common mental heath conditions are not receiving any treatment, therapy or support. 

Lack of funding and cuts:

For the first time in a decade there has been a cut in the total spending on mental health with a reduction of £150 million, including cuts in crisis services and out-reach programmes. This at a time of austerity when cuts to the welfare system further compound mental health problems. In many parts of the country, crisis care teams are under-resourced, understaffed and overstretched.

Mind chief executive Paul Farmer. "The current economic climate, unemployment and benefits cuts are likely to be having an impact, but we know too that people in a mental health crisis aren't always getting the help and support they need from the services there to support them."

"Good services can make a huge difference to whether someone recovers from a mental health crisis, yet we often hear from people who have been turned away because they 'aren't suicidal enough' or who have been made to wait for hours to be assessed and offered help."

"When people in crisis don't get the help they need, the consequences can be catastrophic."

• In 2012 the number of suicides among mental health patients rose from 1,175 to 1,333.

• Suicides are three times higher among unemployed people.

WoW Petition calls for an Independent, Committee-Based Inquiry into Welfare Reform, covering "excess claimant deaths".

We don't know how many people with mental illness have died after being judged fit-to-work following a work capability assessment or were appealing a fit-to-work decision because the Department of Work and Pensions say that they don't hold this information. As stories of suicides and deaths linked to the assessment appear in the media we can be sure that people have died as a consequence. The tick-box assessment is completely inadequate in recognising the many difficulties and limitations endured by mentally ill people. The stress and fear surrounding the assessment can be unbearable for many, making symptoms much worse. Medical evidence is disregarded and failure to collect supportive documentation at the start of the process means that people with learning disabilities, autism and psychotic illness especially, are discriminated against by the system. The High Court has ruled that the assessment for employment and support allowance breaches equalities laws but the government are appealing this judgement.

WoW Petition calls for an immediate end to the Work Capability Assessment as voted for by the BMA & RCN.

Mental health services are not regarded as a priority. The government have given local NHS service commissioners £400 million to complete the roll out of improving access to psychological therapies. By 2014 the programme should have been treating 900,000 people suffering with anxiety and depression but the budgets have not always been used for their intended purpose. 50% of these people receiving treatment would be expected to recover. Mental illness can make existing physical illness worse and it can cause physical symptoms. Physical healthcare caused by mental illness costs the NHS at least £10 billion. Not only does therapy help recovery and improves quality of life but economically it would be cost-effective to invest more on psychological therapies now saving on costs for other health services later.

• Despite the widespread prevalence of mental illness within the UK, mental health services only receive 13% of NHS health expenditure.

Anxiety conditions such as social phobia, agoraphobia, PTSD, OCD, panic disorder and generalised anxiety account for half of mental illness. They can be debilitating and disabling and if not treated they frequently become lifelong. Recovery is made much more difficult the longer these conditions are left to persist untreated. There is no right to therapies within the NHS which NICE recommend as an effictive form of treatment for such conditions.

People are often afraid to admit they have a problem due to the stigma attached with having a mental illness and do not seek help when symptoms first appear. They need to get help as soon as possible to prevent their symptoms from escalating to crisis point but when they go to see their GP they may not get the referral to the local mental health services that they require.

GPs themselves are often not adequately trained in mental illness and the patient comes away with nothing more than a prescription. There can be very long waiting times for psychological and talking therapies and counselling and sometimes no local services to help at all.

Mind Charity revealed that one in five people had been waiting over a year to receive treatment and one in ten over two years. They say:

"Waiting times can have a devastating impact on a person's life. They can exacerbate mental illness and cause relationships to break down, jobs to be lost, people to be isolated and, in extreme cases, lead to suicide attempts. But far too many people are still waiting far too long to receive treatment."

Employment:

• Mental illness accounts for nearly half of all people on sickness benefits.

• People with severe mental health problems have a lower employment rate than any other disabled group and yet they are more likely to want to work. 90% say they'd like to have employment compared to people with 52% of disabled people generally. 

• However, only 21% of people with a disabling mental health condition are in paid employment compared with 47% of all people with other disabilities. This is even less for people with a severe mental illness. Just 9% are working full time and 19% part-time.

•  70% of those with a common mental disorder who are unemployed and seeking work and have been unemployed for over a year or more are unlikely to return to work.

People with mental illness judged unfit to work in the short to medium term have not been excluded from the Work Programme. The scheme is mandatory and failure to participate can lead to mentally ill people being stripped of their benefits.

• 93% of disabled people put onto the Work Programme are not finding long-term work. Just 6.8% of new ESA claimants with a general range of disabilities referred to the scheme in the latest three months have found employment. 

The public are not so sympathetic. 75% said people who were ‘mentally disabled’ (judged fit) should be made to work unpaid for their benefits.

Mind chief executive Paul Farmer. “Pressuring people into working, under the threat of losing their benefits, often serves to exacerbate their mental health problems, pushing them even further from the job market. Currently there’s still too little specialised support available and too much focus on sanctions and conditionality. People with mental health problems face significant barriers to finding and staying in work, such as stigma from employers, and often dealing with an invisible and fluctuating condition. The Government should be ensuring they provide tailored support to help people find appropriate employment.”

WoW Petition is opposed to workfare for people claiming social security benefits. WoW Petition calls for "an end to forced work under threat of sanctions for people on disability benefits".

Stigma and discrimination:

• Fewer than 4 in 10 employers say that they would consider employing someone with a history of mental illness compared with 6 out of 10 who would consider giving work to someone with a physical disability.

Public attitudes towards mentally ill people have hardened.

• More than half of the UK public said if they were employers they would not offer people with a history of depression a job, even if they were the best candidate. 

However, we probably each already know and work with someone suffering from a mental health problem, only because of stigma and discrimination, we don't know that they have an illness.

The media have shaped our attitudes towards mental illness and particularly our misinformed view that 'mental patients' are prone to violence. The stark reality is that sufferers are significantly more likely to harm themselves than other people and be the victims of crime and abuse.

Supermarkets Asda and Tesco recently had to remove offensive "mental patient" fancy dress costumes from their stores after a public outcry.

People with mental health problems are often too afraid to seek help or even to say they are unwell because of fear of being harshly judged and misunderstood. Sensational headlines can only make people more fearful of opening up, less likely to talk about their concerns and get the support they need. Stigma blights lives.

• Nearly nine out of ten people (87%) with mental health problems say that have been affected by stigma and discrimination.

Stigma can affect all aspects of daily life. Work, education, going shopping and leisure activities, friendships, socialising, talking to other people, and getting support. People feel that they get a negative reaction and are blamed for their illness. That they will be seen as weak if they can't 'pull up their socks' or 'pull themselves together'. Asking a person with depression to 'cheer up' is like asking someone with a heart condition to make themselves better.

Stigma creates isolation and loneliness as people withdraw from social contact, which lowers their self-esteem and confidence. Two thirds of people with mental health problems live alone, four times more than the general population. Few people send get well messages as they do when someone is ill with a physical condition. The general message is that if you have a mental illness you suffer in secret, hidden away from the world and you don't talk about it. When someone asks how you are, few would venture to say that they're feeling down or anxious or depressed.

It's time that people with mental health issues were treated fairly. People with mental health problems can and do recover to lead rewarding and fulfilling lives. Not everybody can and will be cured, but equality and accessibility to treatment and support to enjoy life's potential should be the same experience for everybody.

Attitudes to mental health need to change.


Please support our campaign by signing WoW Petition



Sources:
http://www.who.int/mental_health/world-mental-health-day/en/index.html
http://cep.lse.ac.uk/pubs/download/special/cepsp26.pdf
http://www.mentalhealth.org.uk/content/assets/PDF/publications/fundamental_facts_2007.pdf?view=Standard
http://www.nmhdu.org.uk/silo/files/nmhdu-factfile-6.pdf
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212266/hwwb-mental-health-and-work.pdf
http://www.parliament.uk/business/committees/committees-a-z/commons-select/public-accounts-committee/news/contract-management-of-medical-services/
http://www.samaritans.org/sites/default/files/kcfinder/files/research/Samaritans%20Suicide%20Statistics%20Report%202013.pdf
http://www.telegraph.co.uk/health/healthnews/10074192/Judges-rule-back-to-work-assessments-unfair-to-mentally-ill.html
http://www.time-to-change.org.uk/sites/default/files/Stigma%20Shout.pdf
http://mentalhealthcop.files.wordpress.com/2013/10/vssummary.pdf
http://www.newstatesman.com/economics/2013/10/disabled-and-work-programme-cold-calling-companies-8-16-hours-week
http://www.mind.org.uk/assets/0001/0027/Mind_We_need_to_talk_Report.pdf
http://www.bbc.co.uk/news/health-23163724

The Perils of Being a "Vulnerable" Benefit Claimant

Today, the Commons Public Accounts Committee published its report into some of the activities of JobCentre Plus (JCP), managed by the Department for Work & Pensions (DWP). Despite being snowed under with other work, I’ve read some of the report with interest, since I know very well that sick & disabled people who are dependent on benefits are often treated very badly indeed by the system that’s supposed to support them.

As an aside, I dislike the word “vulnerable”, as it tends to be used in relation to most or all sick & disabled people, and there’s no automatic reason why people have to be considered vulnerable just because they happen to be disabled. However, I do think  most sick or disabled people who are dependent on benefits are made vulnerable by the benefits system itself, which is steadily becoming less supportive and more punitive. Indeed, in a meeting I attended yesterday, we were reflecting that we really don’t believe punishing people and making their lives more and more stressful is going to “change their behaviour”, which in DWP-speak means “make them get a job”. Quite the reverse; the more punitive the measures taken against sick & disabled people and the more hardship they suffer, the more stressed they will become and the more their health will worsen. It’s not rocket science! If DWP doesn’t understand that, it’s because they don’t want to.

Anyway, back to the report. It doesn’t pull its punches, but it’s written dispassionately, of course, as befits a Parliamentary report. One of its principal concerns is that:

The Department [DWP] measures the performance of jobcentres by the number of people that stop claiming benefits.

As a disabled campaigner, this seems to me to encapsulate all that is wrong with the way DWP, JCP and their staff operate, at the behest of their ministerial team. The organisation is driven by the aim of removing support from claimants, rather than a more positive, humane and civilised aim of maximising their well-being – through work if that’s possible or through the support of benefits if it’s not.

I think the report strikes a good balance – it acknowledges that claimants need to do their bit to get a job if they can, but it points out that measuring how many people come off benefits is not the same as measuring how many get into work. Crucially, the Committee says:

The Department does not measure, however, how many people each jobcentre has helped into work or have a complete understanding of why claimants have left the benefit system.

Again, it’s not rocket science, and campaigners have long been especially concerned about what happens to people who are found “fit for work” at their Work Capability Assessment (WCA) but are unable to claim Jobseeker’s Allowance (JSA) because they’re actually not well enough to work. In theory, they could end up with no money to live on; this is likely to be an even bigger problem when mandatory reconsideration before appeal is implemented for Employment & Support Allowance (ESA).

The report also points out that the principal performance indicator (how many people stop claiming benefits) increases the risk that sanctions may be used to force people off benefits; the committee says:

The focus on how many people stop claiming benefits… raises the risk that jobcentres may unfairly apply sanctions to encourage claimants off the register.

They report evidence from Citizens Advice, who say they’re supporting increasing numbers of “vulnerable” clients who have been sanctioned – some of whom have little or no understanding of why their benefits have been stopped.

The report also finds that Employment & Support Allowance (ESA) claimants generally receive a worse service than those on JSA – unsurprisingly it seems it’s not only Work Programme providers who “park” sick & disabled claimants. However, the reality behind this finding is that in the real world, regardless of the Equality Act, an employer who receives hundreds of applications for a vacancy is much more likely to give the job to someone who is not sick or disabled. JCP advisers aren’t daft; on the contrary, I imagine they’ll be even more aware of this obvious reality than the rest of us, and when they’re under pressure to perform, will naturally prioritise those claimants who are more attractive to potential employers. In this context, the Government doesn’t appear to understand the basics of supply and demand in the labour market, so perhaps I should spell it out:  when there are many more potential employees than there are positions available, employers can be choosy; in these circumstances, blaming the sick or disabled person for not succeeding in finding employment is, frankly, cruel.

Finally, for this blog at least, there’s another humane conclusion from the committee:

DWP has a responsibility to ensure that more vulnerable individuals are able to claim the benefits to which they are entitled.

DWP managers need to repeat this mantra to themselves every morning and every night, for as long as necessary, and apply it in the way they run their Department and manage Jobcentre Plus. Otherwise, sick & disabled claimants, especially those with mental health needs or learning difficulties, will continue to suffer appallingly in a system that appears to neither know nor care what happens to them and their families.

And before I upload, I’ve just seen that the Telegraph has noticed the effectiveness and influence of the Chair of the Public Accounts Committee, Margaret Hodge. More power to her elbow!


This post was written and reproduced courtesy of Jane Young (@theyoungjane)

The Atos Inquisition

Guest post by Henry Benedict Tam @HenryBTam Author of the blog Question the Powerful

There was a time when the Spanish Inquisition hunted down those with the ‘wrong’ beliefs and made them recant their heresy. Now the British Government has rekindled its spirit, but with the aim of confronting the sick and the maimed so as to make them recant their disability.

Imagine you have been struck down by an illness, and according to your doctor, you will no longer be able to carry out work that would earn you a wage in today’s economy. For a time, you draw solace from the fact that you live under a state that maintains a genuine safety net for all, and you will not be left jobless, homeless, or having to beg for charity to keep you alive.

But then a Conservative-led Government comes along and decides that the best way to deflect public attention from its refusal to curb the excessive powers of the corporate elite is to serve up scapegoats. So it tells two and a half million people incapacitated by diverse forms of illness and injury that it will no longer pay any attention to what the doctors who have actually dealt with them have to say. Instead, it brings in the corporation, ATOS, to light the flame of recantation.

ATOS Inquisitors, armed with the mandate to interrogate and declare as many disabled people as undeserving of public support, have plunged countless vulnerable people into the deepest despair.

Examples of ATOS callousness and incompetence abound. Calling themselves ‘assessors’, they ask those summoned to appear before them questions such as “how long have you had Down’s Syndrome?” or “when did you catch autism?” A middle-aged woman, registered blind, was simply told that her benefit would be withdrawn. In another case, a 24-year-old epileptic, who was subject to grand mal seizures, had his benefit cut after he was ‘assessed’ to be fit for work. Just three months later, after living in fear that he could not pay his rent or buy food, he had a major seizure and died. People with debilitating and terminal cancer have also been told they had to surrender their benefits.

For those who managed to find help to appeal against ATOS, a third have had their assessments overturned. But many are too stressed or isolated to mount a challenge. Justice can only prevail if the entire inquisition regime is cast aside. The National Audit Office has investigated and found ATOS work to be unsatisfactory. The British Medical Association has asked for the assessment system to be scrapped.

But the Government is not relenting for one moment, even if people are dying from the fear and reality of losing what little money they had hitherto relied on to stay afloat. The Government is bringing in even more stringent inquisitional criteria to cut the provision of life-saving benefits. Meanwhile, they reward ATOS so handsomely that its chief executive is given a £1 million bonus.

If the ATOS Inquisition had featured in a dystopian novel about what a rightwing government might do, it would be decried as irresponsible scaremongering. Sadly it is all too real.

[To learn more about the Employment & Support Allowance (ESA), take the ESA Quiz. Note: the number of people claiming benefit as they are unable to work has not actually risen since 1997]

Emotional MPs Discuss Anxiety and Hardship Caused by Work Capability Assessments

Atos told incontinent woman to ‘wear nappy’

Thousands of sick or disabled people have died after undergoing assessments to find out whether they were fit to work, the House of Commons was told today.


Atos, the firm contracted to conduct work capability assessment (WCA) tests for the Government, was condemned by MPs for “ruthlessly” pressurising sick and disabled people into returning to their jobs.

The debate was told of cases of people who had committed suicide after being stripped of their benefits under the process and of an incontinence sufferer who was told she could return to work wearing a nappy.

Former Labour minister Michael Meacher opened the debate saying that 1,300 people had died after being placed in the “work-related activity group”, for those currently too ill to be employed but expected to start preparing for an eventual return to work...

...Kevan Jones, a former Labour minister, said suicides of claimants who were found fit to work by Atos had been reported. “There are...a number of well-publicised cases where people have taken their own lives because of this system,” he said. “It is not too strong to say that this Coalition Government has blood on their hands for the deaths of those individuals.”

Read the full article in The Independent

 

WOW To Save a Life

With our thanks to @kennyblong

Song Of Life - Work Capability Assessments Cause Suffering

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.


...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...

 Written by Ray Noble. Read the full post at Song of Life

GP Speaks Out About the Brutality of the Work Capability Assessment

Today in the Guardian, a doctor has written to express her fears that disadvantaged patients, especially those suffering from severe mental illness are being found fit to work by the Atos assessment. These people include patients who are extremely unwell and in their doctor's opnion, in no fit state to seek employment. They are being placed at high risk of homelessness and suicide as their income is stopped and their rent falls into arrears. The result of government policy is that vulnerable people with mental health conditions that were being managed by their GPs and local community health teams are now finding themselves on the streets. This cannot be right in a fair and caring society. Do we really believe that bullying vulnerable people to the point that their mental health breaks down and psychiatric crisis teams have to be called in, is a justifiable consequence of welfare reform? 
 

In the words of the GP,
 

"I have watched with mounting horror as my patient, an extremely vulnerable woman, has been put at risk of homelessness and deteriorating illness as a result of government policy. I am very aware of the importance of work, and as a GP will always encourage people to look for a suitable job if I think they can. But I also know my patients, and I am outraged that some are being put through the punishing stress this assessment causes. Many of my patients have gone through the Atos assessment to be told that they are fit for work with all their benefits stopped without notice. The financial impact is extreme. Several of my patients have shown worsening symptoms of depression, and some have become suicidal. Because we were so concerned about a patient's mental health – which worsened as a result of the stress caused by these assessments – we have had to involve a psychiatric crisis team."
 

"I am fearful that more of my patients will be put at risk of homelessness and suicide by this brutal new system."

Read the full article in The Guardian

Ministers Accused of Demonising Benefits Claimants

Brainwashed by Tory Welfare Myths 
Survey shows public ignorance of the level of benefits and who gets them.


Ministers were accused last night of demonising benefits claimants in an attempt to justify their controversial decision to increase most state handouts by less than inflation.

Polling commissioned by the Trades Union Congress suggests that a campaign by Tory ministers is turning voters against claimants – but only because the public is being fed "myths" about those who rely on benefits.

 "But you should not conduct policy, particularly when it hits some of the most vulnerable people in society, on the basis of prejudice and ignorance. And it is plainly immoral to spread such prejudice purely for party gain, as ministers and their advisers are doing, by deliberately misleading people about the value of benefits and who gets them."

 Read the full article in The Independent