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Forum Home  →  Discussion  →  Work capability issues and ESA  →  Thread

Mental Health Safeguards thread

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Owen Stevens
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Our team has increasingly been finding that people with mental health problems are experiencing problems negotiating the benefit system, sometimes meaning that they end up destitute.
We have found that ensuring that JCP/DWP/work programme providers comply with Mental Health Safeguards in these cases has been vital to resolving many of these clients’ benefit problems.
Given the lack or reference to Mental Health Safeguards in either the CPAG handbook or in the Rightsnet forum I thought it was time we had a thread where we could share MH safeguarding information, tactics, problems.
It is particularly relevant at the moment given the lack of lack of application of safeguards (I wonder what proportion of these sanctions involved proper application of mental health safeguards? http://www.rightsnet.org.uk/news/story/number-of-esa-claimants-sanctioned-more-than-doubled-between-july-and-decem) or the inconsistent application mental health safeguards within and between organisations (e.g. http://www.mwcscot.org.uk/media/180939/who_benefits_final.pdf).
The following is a simplified version of work carried out by Andy Campbell and others within our team.

‘Mental Health Safeguards’ should be observed before suspending benefit payments of customers affected by a mental health condition, learning disability or substance misuse. For example, these include:
• liaising closely with Social Services if Jobcentre Plus know there is a designated social worker
• referring cases to a manager before making a decision to suspend benefits where there is a known history of mental illness.
• a safeguarding home visit from the pension service (acting as the welfare arm of Jobcentre Plus)

Mental Health Safeguards typically apply when a claimant fails to complete an ESA50 questionnaire, or fails to attend a medical. However, local office staff and ESA managers in Belfast often accept their failure to implement the mental health safeguards as being a good reason to reinstate benefit when a claimant has had their award terminated or reduced.

Note that the safeguards also apply to external organisations that are contracted by the DWP to carry out work with people in the work-related activity group (this includes the Work Programme Providers, sub-prime providers and Atos).

An ESA claimant may be sanctioned if they fail the requirement to take part in work-related activity or attend a work-focused interview and do not have a good reason for failing to comply.

However, note that Work Programme Providers are under a duty to identify vulnerable ESA participants and consider this before notifying the DWP that the claimant has failed to comply with a requirement. They also have a responsibility to liaise with the keyworker if there is one, or carry out a home visit if necessary to consider what further help can be given before deciding to refer a customer in this situation for a sanction.

I have attached the bulletins where Mental Health Safeguards originated.

Our team have gone into a lot more detail identifying the responsibilities of DWP/JCP/work programme providers but I hope this gives a good starting point for advisers on Mental Health Safeguards.

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1964
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Deputy Manager, Reading Community Welfare Rights Unit

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Thanks for this, which will be most useful Owen. Much appreciated.

Dan Manville
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Unless the claimant is subject to a Multi Agency Public Protection Agreement (MAPPA) the only information passed to a Work Programme provider is whether the claimant being referred has been identified as vulnerable by the JCP Personal Adviser and whether they have a disability; it doesn’t even specifiy the disability type in the PRaPs referral.

The days of a designated Social Worker are long gone in most authorities; the “social worker for life” model is long dead. Include in that the cuts to Mental Health Trust’s budgets and the fact that low risk patients are often pushed into IAPT provision in Primary Care rather than secondary care in a CMHT and that leaves an even larger demographic falling through the gaps of these supposed “safeguards”.

The WPP is mandated to raise a WP08 “sanctionable doubt” form if a person does not comply with a mandatory requirment; very little information is then passed to the Labour Market Decision Making team so their “checking with a manager” or referring for a safeguarding visit is a hollow promise becase the LMDM doesn’t know the medical history unless someone from our side intervenes to make them aware there’s a problem.

There’s hardly any information passing up and down the system about claimants other than “they didn’t go to their appoinment and here’s the BF223 with their explanation that their dog had eaten their appointment letter”

In a nutshell, these safeguards are an exercise in lipservice. The only effective safeguard is a proactive Welf or, on occasion, a JCP Personal Adviser with their head screwed on (you know who you are :) ) but even then the PAs don’t hear about WP sanctions unless someone tells them.

I dearly hope someone can prove me wrong but I’ve had to look at this very hard recently and it was a bleak view.

Edit; I was working in the area where that fella lived when he passed; it shook things up back in the day but these days HMG seem happy to see people exire on their watch; things are very different now!

[ Edited: 14 Jul 2014 at 10:03 am by Dan Manville ]
Owen Stevens
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Hi

Thanks for the responses.

I was hoping that this thread would be used as a way of increasing awareness of Mental Health Safeguarding guidance and of sharing tactics to ensure that DWP/JCP/WPPs adhere to them to protect clients with MH conditions.

I would agree that (where they are aware of them) BDCs/JCP/WPPs often just pay lip service to them but I don’t think this means that we should not attempt to ensure that agencies adhere to them. 

We have found escalation calls raising lack of adherence to MH safeguards to be very effective at getting benefit back into payment for some of our vulnerable customers.

Despite having originated in guidance some time ago they continue to be relevant (for example, they have been incorporated into recent DWP Work Programme Provider guidance).  Cases where DWP/JCP/WPP practice differs from policy (we would argue that this is very common e.g. we would argue that, contrary to current practice, WPPs and sub-contractors need to apply MH safeguards BEFORE referring for a compliance doubt) are those where good advice and representation can make a difference.

Again, we have found MH safeguards to be very effective in resolving problems with stopped or sanctioned benefit.

cheers, Owen

Paul_Treloar_CPAG
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This recent case of mine about someone appealing to be put into the support group but being sanctioned following poor treatment from a WP provider in the meantime illustrates exactly the points you’re raising Owen.

JCP singularly failed in their duties to check before imposing the sanction, the WP provider singularly failed in their duties regards safeguarding and making any kind of check before notifying alleged non-compliance to JCP, and to be quite honest with you, I think that the WP PA was actually actively bullying my client. When i spoke the PA, she showed absolutely zero understanding of what her responsibilities were and why we were taking the action that we were (preferring instead to try and blame JCP).

Complaints merely bought about an acknowledgment that the client had been treated wrongly as well as a small special payment, but we didn’t end up escalating as she was finding the on-going process of the complaints procedure to be starting to feel quite stressful as well. Which was a pity as we were trying to secure answers about what safeguards they should have internally and why they had failed quite so badly.

Similarly, a client came to our foodbank project recently, had been on ESA(SG) and DLA(MRC) with mental health problems and learning difficulties. He was emaciated and hadn’t had any ESA for over 3 months. Turns out he’d been sent an IS10 to check his on-going entitlement to the SDP, had failed to return the form, and instead of chasing up with him to find out why, they’d stopped his ESA.

nevip
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“Turns out he’d been sent an IS10 to check his on-going entitlement to the SDP, had failed to return the form, and instead of chasing up with him to find out why, they’d stopped his ESA”.

Is this the default position now?  Instead of following up, just stop benefit.  Was he sent notification that benefit had stopped?  If so, did he ask for a review (I know you said he has LD)?  What eventually happened to his ESA?  Was anyone hung, drawn and quartered for this?

1964
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nevip - 18 July 2014 12:58 PM

“ Was anyone hung, drawn and quartered for this?

And that’s the whole problem. They’re increasingly unaccountable and the government has a huge vested interest in it being that way. And, of course, Joe Public doesn’t give a damn because he believes all the anti-claimant spin & rhetoric.

Bryan R
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Safeguarding and Vulnerable Group Act 2006 S59

59 Vulnerable adults

(1)A person is a vulnerable adult if he has attained the age of 18 and—
(a)he is in residential accommodation,
(b)he is in sheltered housing,
(c)he receives domiciliary care,
(d)he receives any form of health care,
(e)he is detained in lawful custody,
(f)he is by virtue of an order of a court under supervision by a person exercising functions for the purposes of Part 1 of the Criminal Justice and Court Services Act 2000 (c. 43),
(g)he receives a welfare service of a prescribed description,
(h)he receives any service or participates in any activity provided specifically for persons who fall within subsection (9),
(i)payments are made to him (or to another on his behalf) in pursuance of arrangements under section 57 of the Health and Social Care Act 2001 (c. 15), or
(j)he requires assistance in the conduct of his own affairs.
(2)Residential accommodation is accommodation provided for a person—
(a)in connection with any care or nursing he requires, or
(b)who is or has been a pupil attending a residential special school.
(3)A residential special school is a school which provides residential accommodation for its pupils and which is—
(a)a special school within the meaning of section 337 of the Education Act 1996 (c. 56);
(b)an independent school (within the meaning of section 463 of that Act) which is approved by the Secretary of State in accordance with section 347 of that Act;
(c)an independent school (within the meaning of section 463 of that Act) not falling within paragraph (a) or (b) which, with the consent of the Secretary of State given under section 347(5)(b) of that Act, provides places for children with special educational needs (within the meaning of section 312 of that Act);
(d)an institution within the further education sector (within the meaning of section 91 of the Further and Higher Education Act 1992) which provides accommodation for children.
(4)Domiciliary care is care of any description or assistance falling within subsection (5) whether provided continuously or not which a person receives in a place where he is, for the time being, living.
(5)Assistance falls within this subsection if it is (to any extent) provided to a person by reason of—
(a)his age;
(b)his health;
(c)any disability he has.
(6)Health care includes treatment, therapy or palliative care of any description.
(7)A person is in lawful custody if he is—
(a)detained in a prison (within the meaning of the Prison Act 1952 (c. 52));
(b)detained in a remand centre, young offender institution or secure training centre (as mentioned in section 43 of that Act);
(c)detained in an attendance centre (within the meaning of section 53(1) of that Act);
(d)a detained person (within the meaning of Part 8 of the Immigration and Asylum Act 1999 (c. 33)) who is detained in a removal centre or short-term holding facility (within the meaning of that Part) or in pursuance of escort arrangements made under section 156 of that Act.
(8)The reference to a welfare service must be construed in accordance with section 16(5).
(9)A person falls within this subsection if—
(a)he has particular needs because of his age;
(b)he has any form of disability;
(c)he has a physical or mental problem of such description as is prescribed;
(d)she is an expectant or nursing mother in receipt of residential accommodation pursuant to arrangements made under section 21(1)(aa) of the National Assistance Act 1948 or care pursuant to paragraph 1 of Schedule 8 to the National Health Service Act 1977 (c. 49);
(e)he is a person of a prescribed description not falling within paragraphs (a) to (d).
(10)A person requires assistance in the conduct of his own affairs if—
(a)a lasting power of attorney is created in respect of him in accordance with section 9 of the Mental Capacity Act 2005 (c. 9) or an application is made under paragraph 4 of Schedule 1 to that Act for the registration of an instrument intended to create a lasting power of attorney in respect of him;
(b)an enduring power of attorney (within the meaning of Schedule 4 to that Act) in respect of him is registered in accordance with that Schedule or an application is made under that Schedule for the registration of an enduring power of attorney in respect of him;
(c)an order under section 16 of that Act has been made by the Court of Protection in relation to the making of decisions on his behalf, or such an order has been applied for;
(d)an independent mental capacity advocate is or is to be appointed in respect of him in pursuance of arrangements under section 35 of that Act;
(e)independent advocacy services (within the meaning of section 248 of the National Health Service Act 2006 (c. 41) or section 187 of the National Health Service (Wales) Act 2006 (c. 42)) are or are to be provided in respect of him;
(f)a representative is or is to be appointed to receive payments on his behalf in pursuance of regulations made under the Social Security Administration Act 1992 (c. 5).
(11)The Secretary of State may by order provide that a person specified in the order or of a description so specified who falls within subsection (1) is not to be treated as a vulnerable adult.

Dan Manville
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1964 - 18 July 2014 01:03 PM
nevip - 18 July 2014 12:58 PM

“ Was anyone hung, drawn and quartered for this?

And that’s the whole problem. They’re increasingly unaccountable and the government has a huge vested interest in it being that way. And, of course, Joe Public doesn’t give a damn because he believes all the anti-claimant spin & rhetoric.

And that’s why I try to drag them through the courts… I’ve got my first Work Programme Provider before the Employment Tribunal in a couple of weeks. Sadly it’s much more difficult to get DWP into court but we’ll keep trying.

Owen Stevens
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With the kind of case that Paul mentions the correct procedure for the DWP/WPP (or sub-contractor)/JCP (any who were relevant) to have followed would have been to apply Mental Health Safeguards before any decision to stop benefit.

There should be evidence of something being done over and above what would have been done for someone without a mental health disability.

If the DWPetc did not apply safeguards such as…
• liaising closely with Social Services if Jobcentre Plus know there is a designated social worker (or other professional)
• referring cases to a manager before making a decision to suspend benefits where there is a known history of mental illness.
• a safeguarding home visit from the pension service (acting as the welfare arm of Jobcentre Plus)

... then benefit should not have been stopped. 

An escalation call to the BDC pointing this out should quite quickly resolve this. 

Where the BDC is not aware of the MH problem they may ask for some sort of evidence to back this up.

We ask the following types of questions to draw out details of people’s MH and to help when talking to BDC:
a) Is there an alternative contact that DWP could use in the future e.g. friend/relative? This shows DWP that the problems in not one that will just recur.
b) Have they received professional mental health support other than from their GP?  Are there any named professionals or teams that DWP could contact?
c) Do they self-harm?  Are they ever suicidal?
d) Have they ever been compulsorily detained due to mental health?
e) Have they had any hospital admissions?  How long for?
f) What are the physical effects of their mental health condition?
g) What would the risk to mental and physical health be if the benefit is not put back into payment?

[ Edited: 18 Jul 2014 at 02:21 pm by Owen Stevens ]
nevip
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The Department should make further enquiries before stopping benefit in ALL cases where there is no evidence of alleged fraud.

Andrew Dutton
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Did you not know that claimants are grateful for having their benefits stopped, as it encourages them to contact DWP? This is not my usual satire, I have been in a meeting where we were told this, straight-faced. There is a culture of sheer denial at the DWP that we need to tackle.

And I clearly need to learn much more about safeguarding, several recent cases have come to mind when reading the above.

Paul_Treloar_CPAG
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nevip - 18 July 2014 12:58 PM

“Turns out he’d been sent an IS10 to check his on-going entitlement to the SDP, had failed to return the form, and instead of chasing up with him to find out why, they’d stopped his ESA”.

Is this the default position now?  Instead of following up, just stop benefit.  Was he sent notification that benefit had stopped?  If so, did he ask for a review (I know you said he has LD)?  What eventually happened to his ESA?  Was anyone hung, drawn and quartered for this?

Slightly more complicated than described as there was also a COA around the same time (although he says that he did notify this on various occasions previously). Even with a support worker trying to help him, they’d been entirely unable to resolve the problem when they came to see us 3 months down the line. Yet, our adviser’s initial discussion with DWP was certainly along the lines of “Client didn’t return form so we suspended payments pending contact”, which is very worrying - no suggestion that they might make some effort to follow up and find out why, despite knowing of his health problems.

nevip
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I’ve managed to find the following, which seems useful.  It is slanted toward JSA claimants but contains across the board principles.

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/332517/pg-chapter-2.pdf

Owen Stevens
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I feel that looking for a basis in legislation or at MAPPA are slightly distracting from the issue.  While raising interesting issues to be looked at I feel that they are a seperate topic.

MH safeguards originate in the bulletin attached to the post above and the principles from that bulletin permeate guidance and good practice. 

There may be some confusion about the definition of MH safeguards (I use it here to refer to the principles established in the bulletin above) - especially given that the term ‘safeguards’ crops up in all sorts of other contexts (including MH settings) to refer to all sorts of other things.  It is especially confusing given that it is not made explicit that the principles being built into WPP guidance etc originated as Mental Health Safeguards in these bulletins.

At a national level the DWP are well aware of the importance of MH safeguards.  At a local level there is often a lack of awareness or adherence to them.

I forgot to mention in my original post that MH safeguards also apply to people with learning disabilities and to people with substance abuse issues.

Over the next few months the team will be doing some more work on MH safeguards and will post any useful information here. 

Any information or tactics from others would be really appreciated.

*edited 5pm 18/07

[ Edited: 18 Jul 2014 at 04:56 pm by Owen Stevens ]
nevip
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All local authority staff, certainly in the social care sector, (which is where our team sits) are under a duty to be aware of safeguarding issues and should be aware of how to raise an alert.  It should not be left to the appointed safeguarding officer or team.  I know that is because LA’s are responsible for provision of social care services and the DWP are not, but I would hope that something similar is in place in the DWP.  Safeguarding is not just confined to the exploitation of vulnerable individuals by other individuals either acting privately or acting as employees where there is a clearly defined duty of care, such as care workers.

[ Edited: 18 Jul 2014 at 04:47 pm by nevip ]