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Client with poor self-perception
I am due to represent client at the Tribunal regarding his PIP claim.
Client has schizophrenia and very poor medication compliance. Which means that he is frequently detached from reality. He has very little in terms of medical evidence as he does not attend appointments, follow ups etc.
I know the client fairly well, as I have been assisting him for past few years. I know how his illness impacts on his life. And this makes me a bit worried. Client sometimes will cheerfully and firmly confirm that he is absolutely fine when is he out and about or when he is “engaging with others”.
Whilst I know that for example he “came to” surrounded by the police because his bizarre and dangerous behaviour when he is out.
I am worried that my client will sabotage himself, no matter how much I explain things to him (without coaching- that’s another nightmare), because when he is “under the spell”, he is not rational or clear.
I know I can be a witness but I am worried about awkwardly contradicting my client in front of the panel, and damaging his credibility, even for the things he said that were right.
And the ultimate horror scenario- client denying my witness statements- which can happen as his condition is really unpredictable.
I am looking for help with tactics during the hearing, please.
A decent tribunal will be able to recognise when an appellant does not have insight into the impact of their condition and as a consequence overestimates their ability. What you describe is a recognised symptom of his condition - emphasise that.
That said, of course, it isn’t possible to guarantee that you will have a tribunal live to those issues. So;
1. Be absolutely up-front about the issue in your written subs - that precisely as a symptom of his condition, he lacks insight and is at times liable to claim he can manage activities without assistance when this is not the case. Give some clear examples. State in your subs that he may well do this in the hearing.
2. I may have misunderstood, but it does sound to me that your client does at times have insight? That he does recognise that propensity to state he can manage when he can’t? If that is right, what are the prospects of getting him to agree both your written subs and your witness statement? - i.e. to confirm in writing he has agreed the contents.
what are the prospects of getting him to agree both your written subs and your witness statement? - i.e. to confirm in writing he has agreed the contents.
Yes, I think he can see clearly sometimes. I can certainly try. That would strengthen my point, if we could show he has signed off on it.
Thanks :)
See also CA/14336/1996 that is about ‘stoic’ clients but also, could be helpful for you, that regardless of what the client says the Tribunal has to evaluate the evidence as otherwise they could misdirect themselves to if it is, for example majority of the time and within Reg 4 etc
“I agree with the claimant’s representative that in considering sub paragraph (a) the emphasis is on whether the claimant “reasonably requires” frequent attention in connection with her bodily functions. The DAT misdirected themselves because they applied the wrong test and manifestly erred in law. They accepted that “despite her afflictions” the claimant was able to cope with her care needs albeit in ways that were unreasonable and totally unacceptable. “
Thanks, Roehampton, very useful 😊
Hi Jo, I am a member of a support group for families experiencing the effects of psychosis. Your client has a condition which is labelled Anosognosia and presents as a lack of insight into their mental illness. It is generally treated with atypical antipsychotics such as risperidone and aripiprazole. However these meds usually come with unpleasant side effects, so patients stop taking them and then believe that the problems are not with them but with the world they are part of ( Anosognosia ).
You mention Police involvement, that would indicate an AMHP making a decision about a ” place of safety “. The AMHP ( Approved Mental Health Professional ) teams are usually approachable in my experience. I would phone them and enquire if they could endorse the seriousness of your clients illness. I have located your AMHP team at the Riverside Centre Uxbridge and the phone number is within the link.
https://www.cnwl.nhs.uk/services/mental-health-services/adult-and-older-adult/hillingdon-hospital/riverside-centre