Mental Health: Assessment

Debate between Angela Crawley and Andrea Jenkyns

Tuesday 22nd January 2019 Westminster Hall

[Angela Crawley]

Absolutely, and I am sorry to hear about that constituent’s experience. It is harrowing. The assessment process has a detrimental impact on the lives of people who are already vulnerable and already not in control of their circumstances in many regards. For them to be put through a harrowing process and feel that way is simply unacceptable.

[Andrea Jenkyns (Morley and Outwood) (Con)]

Does the hon. Lady agree that the number of forms that people suffering with mental health conditions have to complete is a real problem? It can cause unnecessary stress during difficult times, especially when many of the forms are duplicated.

[Angela Crawley]

I could not agree more. During last week’s debate on fibromyalgia, she explained how the process and the application forms simply do not pay respect to mental health conditions. I champion her calls to the Government to change that process.

I urge the Minister to look through the comments, to get an idea of how the policies really impact people and to understand what they have gone through. Standing here and reading out the comments does them no justice; it is only by reading them that she will get an understanding of their point of view.

--- Later in debate ---

[Angela Crawley]

I completely agree. The point is that mental illness is a disability—that is what we have argued in previous debates—and should be recognised as such and handled appropriately. I am grateful for the point made by the hon. Member for Central Suffolk and North Ipswich, but we are not having this debate because there is an issue with the healthcare system; I am arguing that there is an issue with the practitioners in the Department for Work and Pensions.

The question to which I have referred has been asked without any follow-up, without any understanding and without the qualification and experience to handle it appropriately. I just cannot understand how it is appropriate or why it is necessary for the assessor to ask that. The ultimate fact is that it can be devastating for people with suicidal depression to have to justify such a dark thought; it can shake the foundations of their wellbeing and make them question their worth. It is not uncommon to hear from people that their personal independence payment or work capability assessments have made them feel worthless. It is not uncommon to hear that from my constituents; indeed, it is all too regular. That is why I am raising this matter with the Minister.

Since 2011, assessors are meant to have had, as part of the assessment process, access to a mental function champion or mental health champion for support and training. I am not sure whether that is working in practice, which is why I urge the Minister to look at it. In not one of the cases that I have dealt with regarding mental health problems has a mental function champion been used. That prompts the question: if the training and capacity are there, why is that not being used by the local DWP jobcentre staff? Why is it not being used to assess people appropriately? Why are assessors not using the support that is available to them if it is in fact there, provided by the Department for Work and Pensions?

I have made challenges in a number of cases in which some support for the assessor on mental health issues would have been appropriate, yet such an intervention has never been used. I have had trouble trying to find concrete figures for how many mental function champions there are across the service and what their role is. I would be grateful if the Minister could enlighten us on exactly what the mental function champions are supposed to do, what role they are supposed to play in the assessments, and how their effectiveness is being measured, because ultimately I was unable to get relevant or accurate statistics from the Department outlining how well that function is being used. If it is there and not being used, it seems that assessors are doing a disservice to the individuals who come face to face with them every day.

When someone is found fit for work but in fact is not, they need to go through the arduous process of appeals. For people with a depressive or other mental illness, that process is extremely difficult and can exacerbate their symptoms. For some, the process is too daunting and they will simply go without the support that they need. I can only imagine the number, because we will not have accurate statistics for how many people go without as they are unwilling to go through that process. I do not believe that that is the right approach to mental illness—or to public expenditure; it would save the Government time and money if assessments were correct, and the correct benefits were awarded at the first stage, in the first instance. The fact that people are having to go through the appeals process and decisions are being overturned at the mandatory reconsideration stage tells us that there is something wrong with the system that could be fixed.

Not only is this a waste of resources for the Department for Work and Pensions and our courts system, but it depletes the mental resources of people who do not have the energy to spare to go through the process. I believe that, ultimately, discrimination against mentally ill people is built into the whole culture of this system. If people disagree with that, they can just ask the High Court. The Government were found in 2018 to have discriminated against mentally ill people in the High Court ruling on regulations that meant that people who were unable to travel for reasons of psychological distress were debarred from the enhanced rate of the mobility component of personal independence payment.

I do not even know where to start with that. If someone has identified under the previous, legacy system that they are unable to travel or have limitations, and then that is undermined in the new system, that seems counter-intuitive. There is surely a better way of operating. The transition from DLA to personal independence payment has been anything but smooth; in fact, there are still flaws and errors in the system. That is all that I am trying to get to here. I really want the system to work better for people, because ultimately I would rather not have to deal with individuals having this horrible experience every day. They should not have to come to me to get things improved; the system should just work better.

The regulation to which I referred was introduced in March 2017 without any stakeholder consultation. I urge the Minister to reconsider that. There are mental health charities and experts outside the House who would be able to provide the relevant and necessary information to the Minister, if she were willing to hear it. That civic engagement would get things correct for those who have used the service and had an adverse experience; it could only enhance and improve the experience.

The High Court ruling represents just a small part of the benefits system, but I think that it represents well the Government’s approach to people with mental health problems. The personal independence payment system, contrary to the Government rhetoric, was designed so that fewer people would be eligible for it than were for the legacy benefit of DLA. If the entire concept and design of a system is to get more people out of the system, it is not really doing what it was designed for, which was to help people. It just seems ridiculous that we are working to these arbitrary targets; that is the only way I can understand this. If we are trying to reduce the number of people on the benefit, even if there is no reduction in the number of people who need the support, ultimately we are just letting people fall through the net. That is a dereliction of our duty of care to the people we serve.

One quarter of people claiming DLA for mental health conditions do not qualify for PIP when reassessed, so they lose the support that they need.

[Andrea Jenkyns]

I welcome a lot of the comments that the hon. Lady has made. I do feel that, as a society and as a Government, we still have a long way to go. However, does she acknowledge that mental health funding has reached record levels? We are talking about £12 billion of funding. Does she at least welcome the fact that the Government have now made big commitments to mental health funding?

[Angela Crawley]

On the one hand, I wholeheartedly agree that any additional funding for mental health will always be welcomed, because we are more aware of the condition and its lifelong effects, but ultimately why are we throwing money against the wall, when at the other end of the process people have to undergo a horrible and unnecessary experience? Join the dots: to improve the health service, improve the service in another Department that gives people the financial support they need. If improvements can be made through one Department, that should be done for another. I have spoken for longer than I intended, and a lot of other hon. Members want to speak, so I will press on.

The Government need to rethink their approach to the needs of people making benefit claims. They must be cognisant of the effect of mental health. Assessments must be more in line with best practice on mental health, so I ask the Minister to meet charities and organisations calling for reform of the benefits system.

I do not know how else to convey to the Government how much I just want to make the system better. I am not trying to make political points for the sake of it. There are flaws in the system, and I would like to improve it. I would like to give as many hon. Members a chance to speak as possible, so I end by quoting from the film “I, Daniel Blake”, because I think it captures this issue perfectly.

“I am not a client, a customer, nor a service user… I demand my rights. I demand you treat me with respect… I…am a citizen, nothing more, nothing less.”

In this day and age, and in this process, it is easy to refer to people as constituents, clients, service users or customers, but we forget that they are just people who ultimately rely on our support. Most people would not chose to rely on that support, especially under the arbitrary measures of the system, which are completely off-putting and attempt to reduce their reliance. People do not tend to want to rely on the state. Every day, my constituents are left feeling demoralised, degraded and ignored. These people elected us to represent them, and we must do more and do better, because at the moment it is simply not good enough. I want to do the best I can for my constituents, and I would not be doing that if I did not call on the Minister to improve this service.