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“no specialist mental health input”
I’m getting a bit sick of clients mental health issues being completely ignored and disregarded purely because of the cut n paste phrase “No specialist mental health input” in PIP/ESA appeal bundles
As we know MH services are stretched, and in many cases there is only so much they can do before they are referred back to GP and hopefully kept stable via medication. Or some clients disengage, or are discharged due to lack of ability to engage.
Is there any caselaw out there to refute this assumption that people basically are OK if they don’t have a CPN or consultant psychiatrist?
I know that clients oral testimony at tribunal and other evidence at the time is helpful, but I would like to refer to such caselaw (if it exists or even mentioned) if need be.
Clutching at straws, but any help would be appreciated
Thanks
I know this pre-dates PIP, but the principle is the same and must still be good law. In R(DLA)3/06 the Tribunal of Commissioners held at [43]
43. “Those care needs have to be assessed on the basis of all the available evidence. As the authors of “Wikeley, Ogus & Barendt’s The Law of Social Security” (5th edition (Butterworths, 2002) at page 680) observe, clinical tests cannot themselves determine functional incapacity, e.g. an inability to self-care. However, we agree with Mrs Commissioner Levenson (at paragraph 8 of the Common Appendix) that medical evidence, although not essential, will in many cases be important in determining whether a claimant has a disability, and, if so, in determining the extent of the care needs to which the disability gives rise. For example, some medical conditions (such as the loss of a sense or a limb) give rise to obvious functional impairment. Others (particularly psychiatric conditions) are diagnosed by reference to a constellation of symptoms, and where such a diagnosis is made one might assume (or at least expect) certain symptoms or patterns of behaviour. But that does not mean that, in the absence of a diagnosis (or even in the absence of any medical evidence), the statutory criteria will necessarily fail to be satisfied. There will be cases in which there has been no medical diagnosis of a disabling condition for some particular reason, for example, because a person with a psychiatric condition is unwilling to undergo treatment, or perhaps because of a shortage of medical resources in a particular area. The absence of a diagnosis does not necessarily negate entitlement to DLA, and the absence of such a diagnosis does not lift from the shoulders of a decision maker or tribunal the burden of assessing the evidence of disability such as it is. For a tribunal, in the absence of a determinative diagnosis, all of the evidence of the functional abilities of the claimant will need to be considered, relevant findings of fact made in relation to those abilities, and a decision made as to whether the disability is such as to satisfy one or more of the statutory tests in section 72(1)(a) to (c) and section 73(1)(d). “
Further to Derek’s post above.
Here’s an extract arguable in appeals that puts ‘no specialist mental health input’ in perspective, from the Mental Health and Wellbeing in England Adult Psychiatric Morbidity Survey 2014 Chapter 3: Mental Health Treatment and Service use on page 73 found ‘Headline findings from APMS 2000 and APMS 2007 were that only one-quarter of adults with CMD (common mental disorders – our insert) were receiving psychotropic (mental health) medication or psychological therapy. Thus three-quarters of people who might have benefited from treatment were not receiving this at the time of interview. ‘One in four’ represented the proportion of people assessed by those surveys as having a CMD and who reported that they were receiving treatment. These findings are consistent with the two-thirds to three-quarters of people identified in other epidemiological surveys as meeting criteria for mental disorder and who are not receiving treatment’.
See link to summary and full report (its a study undertaken every 7 years).
Nice one Andy, I’m fed up arguing that one as well, will use in next submission!
From the commons library
INSIGHTS
Today we’ve published a briefing on mental health statistics in England, including information on how common mental health problems are, and how NHS mental health services are performing. Here I … Read More ›
Briefing paper Wednesday, April 25, 2018 How common are mental health problems? How long do people wait to access therapy for depression and anxiety? Do mental health services work for everyone? How much is spent on mental health services?
[ Edited: 26 Apr 2018 at 11:24 am by Andyp5 Citizens Advice Bridport & District ]I usually include reasons for no specialist Mental Health input into my submissions eg non theraupetic relationship with previous MH Team, unable to disclose, on a waiting list blah blah, but I agree it is most annoying. As if it discounts that they don’t have a MH condition just because they aren’t seeing someone. More annoying in cases with Autism, ASD conditions where seeing a MH specialist doesn’t really help!
There is a hierarchy of refusal in evidence
No specialist input for MH
then sees councillor but no PCMHT input
then sees PCMHT but no recent hospital admissions
then had hospital admission but discharged
ETC ETC
And this, despite Esther McVey having recently told the Commons that, apparently, PIP is -
‘... a brand new benefit that, for the first time, looks not just at people with physical disabilities, but looks fundamentally at all the disabilities people have - cognitive, sensory, health and mental health conditions ...’
I’m sure it does look at them but unfortunately doesn’t recognise them unless there is a label attached and a plan in place for treatment. How many times have we seen “fibro-fog” ignored as there isn’t a diagnosis of a mental health condition or there is “no evidence of cognitive impairment”. Almost as many times as the driving licence assumption, no doubt!
(Sorry Monday rant!)
A PIP medical report for a claimant with suicidal thoughts says that (i) the claimant has disengaged with support services, due to his anxiety, but (ii) his GP see him regularly to check that he is coping.
Somehow, both these facts are then held against the claimant in the PIP decision: (i) he has not used a support worker, so must not need support… and (ii) he is regularly seeing his GP to check that he is coping - which suggests that he must be coping.
“Newspeak” in action.