DLA on SMI grounds

The (potential) appellant has some type of dissociative disorder which at times renders them unable to walk outside (something like a refusal to walk) and can also cause ‘extreme’ behaviour. When they are not in the dissociative state they are clearly of normal intelligence.

The background to the difficulties is an autistic spectrum disorder so ‘arrested or incomplete development ’ would probably apply but it is not clear whether there is a severe impairment of intelligence or social functioning other that when the dissociation kicks in. I don’t, at present, know how often this happens or how long for but I felt I should see what everyone else thinks as I don’t want to raise any false hopes withthe appellant.

Any observations would be garefully recieved

I would suggest a diary in order to quantify and be prepared to send in with claim if made

also from past experience check if this client has medication he choses not to take or reduces potentially against medical advice

I have seen someone similar who did this and ultimately it went against him

oddly enough had we been dealing with him taking the medication (and the side effests of it) i suspect a claim may have been succesful
Fom what u have said a potentially difficult claim

Agree with above post re diary/event history and be clear how it is written or may face perverse argument that not dissociation if can state events !!If diagnosed with a dissociative disorder or has significant dissociative states this will without doubt severely affect social functioning. So someone may walk outside when in this state bur not safely and arguably will be at risk. One of the most powerful documents in Mental Health is the risk assessment and my experience is that DM take note of these. Clients may understandably not want this shared but will state risks associated with behaviours. Tickboxes plus summaries. Brief or full and done at each significant intervention including crisis interventions.

If no regular support from MH services then there may be a history of intervention from other agencies when in dissociative state - particularly police and ambulance service as will present as confused and vulnerable. There are many diagnosed with a MH disorder who wont ‘engage’ with services and therefore can’t access the usual support docs.Have successfully used police and A&E reports when other conventional supporting evidence unavailable- shows pattern and/or serious concern for safety.  MIND have very useful Information guides on this plus RSPsych.

Good luck!