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SMI
Hi,
I keep seeing this same statement as part of the secretary of state’s response in DLA mob SMI appeal bundles :
“I submit that a person with severe behaviour problems will usually be reckless the dangerous things, destructive, aggressive, attention seeking, mutilating or abusing themselves, hyperactive, display persistent body movements and disrupt the household at night.”
It’s not in every bundle, but I see it often enough that it must be in the template they use. Usually you can see where they have got an idea from - but I don’t recognise any of this from any of the case law - can anyone direct me to a possible origin? Are others finding the same thing?
I do worry about this statement putting unrepresented appellants off pursuing their case, it could easily lead them to believe that this represents the SMI criteria.
many thanks
Jane
Actually - to clarify - obviously the bits about danger etc have clear origins in regs and case law. More specifically its the mutilating, abusing, hyperactive, and persistent body movement references that are odd. It just seems too specific for something they had just made up.
Thanks 😊
I’m just wondering exactly what the point is that the SoS is trying to make. When I do SMI cases the behaviour point is often conceded. It’s the severeity of the disability itself that they often argue against, i.e. “learning disability moderate so can’t be SMI”. I know: tribunals have had no truck with that line either.
That’s interesting, I always seem to have a struggle with what is or is not ‘extreme’ behaviour but I have never seen such a specific list of things that are supposed to signify either ‘extreme behaviour’ or SMI
It’s a bit like the stock phrases you see in ESA85 reports where the claimant has depression/anxiety (the stuff about ‘no rocking, shaking, made adequate eye contact’ etc). It always irritates the pants off me (like all people with mental health issues rock to & fro in manner of gothic horror movie set in Victorian asylum).
I agree that the SMI one sounds oddly specific so must have a common origin somewhere.
The rocking thing has always been a particular bugbear of mine.
What next? : “The claimant was not wearing a straightjacket so functional mental disability is unlikely”
A friend of mine is a psychiatric consultant who told me the rocking thing was a side effect of certain anti-psychotic medication that was phased out quite a while ago.
He was incredulous when I informed him that the DWP put these on ESA85s as evidence of mental health well being
Rocking is one of a whole group of symptoms known as extra pyramidal symptoms. The main culprits where the old anti-psychotic medications such as haloperidol and chlorpromazine, developed in the 1950’s, but have now largely fallen into disrepute because of the side effects. When I was working in mental health more than 20 years ago these drugs were regularly prescribed for conditions such as schizophrenia and psychosis. The side effects can be reduced in some patients by a drug called procyclidine so, yes, an absence of such symptoms, even in patients on the old style anti-psychotics, by itself, tells you nothing.
Rocking is one of a whole group of symptoms known as extra pyramidal symptoms. The main culprits where the old anti-psychotic medications such as haloperidol and chlorpromazine, developed in the 1950’s, but have now largely fallen into disrepute because of the side effects. When I was working in mental health more than 20 years ago these drugs were regularly prescribed for conditions such as schizophrenia and psychosis. The side effects can be reduced in some patients by a drug called procyclidine so, yes, an absence of such symptoms, even in patients on the old style anti-psychotics, by itself, tells you nothing.
I also used to do a regular clinic in a mental health ward where patients could be at their worst and rarely seen doing rocking etc.
Some of the older patients would also have permanent side affects from the older style drugs which are pretty bad to see.
I have seen haloperidol prescribed fairly recently though so it hasn’t gone away totally.
as long as they aren’t rocking and aren’t ruminating though then by and large they are fine according to atos.
The expression ‘ruminating’ in ESA85 reports irritates me too. Makes clients sound like cows chewing the cud. Mind you, I suppose ATOS assessments are reminiscent of a form of battery farming really.