Guest Post: Benefits Who?

This is a guest post from Blu.

Slowly but surely over the last few years, I've watched tolerance and understanding of mental health issues evaporate in the benefits system - not that there was much there to start with. The latest portfolio of idiots in power appear to view mental health as something that's guaranteed by the ability to earn money, and those whose mental health is poor need only to take the tablets, stop thinking about those damned problems, and just get on with earning already.

If only it were that easy, I'd currently be preparing for the start of a new teaching term whilst nursing my Seychelles tan and planning for a long weekend away in Singapore in October. I've got the qualifications. Schools are crying out for teachers. The pay is far more than any amount of DLA, ESA, IS or other benefits combined. So why don't I just 'pull myself together', 'get a grip' and 'stop scrounging'?

I have mental health issues. Big, f*ck-off issues. And yes, they prevent me from working. But I know, I'm making it all up, because mental health problems are easy to fake, aren't they? And what a great way to scrounge some benefit money whilst I'm at it! I should get up off my arse, stop making excuses and WORK, DAMMIT.

It's at this point that many people would go into detail as to why they can't work, and what caused them to be this way. I lost patience with justifying myself a long time ago. I shouldn't have to carry a potted medical history around with me to prove to all comers that yes, I am actually ill and deserving of benefits. It's nobody's business but my own. Unfortunately, in the current climate of ‘pick on the poor’ my right to privacy is winging its merry way out of the window, to be replaced by ‘work-focused interviews’, medicals by unqualified staff and financial compulsion (not forgetting the baying masses who believe what they read in the Daily Mail).
Treatment for my condition is my choice – or so I thought. So you can understand my ire when, after re-applying for DLA a couple of years ago, I received a letter stating that my benefit had been revised to a lower level...and when I called to ask why, I was told that the reason for this was because I wasn’t under the care of a hospital psychiatrist.

In other words, if you don’t take treatment, we’ll cut your money.

This was a new one on me. Having patiently explained on the multitude of DLA forms my reasons for not using the NHS psychiatric services – because they don’t listen to me, because they only want to give me tablets and not tangible help, because I never see the same member of staff twice, because having to explain your history and feelings week in and week out to a different person every time actually makes mental health issues worse, not better, and because I won’t make myself worse by being forced to talk about my history and feelings with someone I don’t know and who patently isn’t interested anyway – I’m told that my reasons are invalid, and I must receive NHS psychiatric care (subtext: or you’re either trying to stay ill, or you’re not really ill anyway and a psychiatrist would find you out).

I couldn’t quite believe it. But the (admittedly very helpful) lady on the other end of the phone at DLA Central confirmed that it was true – I couldn’t receive the level of DLA I’d been previously getting if I wasn’t seeing some sort of mental health professional. I noted that she’d softened from ‘hospital psychiatrist’ to ‘mental health professional’. I mentioned that I was currently attending the Rape Crisis Centre for counselling (which I had also included on the DLA forms). This, apparently, was enough. She filled in an appeal for me. My DLA was reinstated at the previous level, although no explanation was received as to why non-NHS counselling was ignored as ‘treatment’ in the first instance.

I thought it was a one-off. And then I read the mass of legalese that made up the newfangled ESA benefit small print. Lo and behold, the benefits office are now perfectly within their rights to remove a claimant’s benefits if said claimant refuses to take treatment ‘recommended by a healthcare professional’. Given that the government and benefits agencies seem to regard anyone who can spell ‘disability’ as a healthcare professional nowadays, that doesn’t bode well for the ongoing treatment of people with mental health issues, thinks I.

Why shouldn’t people with mental health issues be forced to take NHS psychiatric (or psychological) treatments? It’ll make them better, and able to go back to work, won’t it?

For a start off, no-one should be forced into medical treatments they don’t want, don’t consent to, or that may make their condition worse. Forcible medical treatment happened under regimes like Hitler’s and Stalin’s. It shouldn’t happen in a supposedly free country like the UK. That the basis for such compulsion is financial rather than ideological (although I’d dispute that the two were that much different) makes no odds. Forcing people in any way to take medical treatments that they don’t want is assault, pure and simple.

Added to that, there’s the way in which the NHS has been increasingly co-opted by the government in the last few years. CBT used to be absolutely impossible to get in the Midlands city where I used to live. A friend of mine who had a serious phobia spent years begging and pleading with various doctors and mental health services for CBT to be made available in the area, as it would’ve been the best thing to help her. It’s available now, of course – so available, in fact, that every wallah with any form of mental health issue (and a fair few physical ones too) is packed off to CBT. Hey, if it works for a phobia of buses, it must work for every other form of anxiety, right?

Perhaps your experience of CBT has been positive. I’m not doubting that it helps some people and some issues. But CBT is in no way the cure-all the government seems to crow that it is. I’m very wary of the way in which it’s being pushed on all people with mental health issues, because many mental health issues are caused by very real physical and societal problems. Changing the way the person with mental health issues thinks about these problems smacks of blaming (and silencing) the victim, rather than dealing with the problem. Of course, it’s cheaper that way – which is why, I suspect, CBT is being recommended for absolutely everything and its dog. Blame it on your head. Think differently. Get a grip. Get a job. It doesn’t take much to join the dots.

Outside of CBT, the waiting lists for psychiatric and psychological treatments are astronomical. You’ll need an assessment, which involves going through past history and current issues with someone whom you’ve never met before and may not ever see again. Unsurprisingly, this has the potential to leave people with mental health issues in serious crisis. Yet there’s no after-care – and if the current coalition government has its way, there’ll be precious little in the way of voluntary or charity-based support available either. If you manage to sit though the months of waiting to get a regular appointment with psychiatry or psychology, there’s no guarantee that you’ll see the same person twice (this seems to be the case especially in psychiatry) – and going through your history yet again with someone you don’t know or trust is at best not helpful, and at worst positively damaging. You might not want to take certain medications, based on potential side-effects. You might not want to talk about particular subjects. You might not want to go through any of this at all, as placing your very survival in the hands of someone you don’t know or trust is an incredibly vulnerable position to be in. Most people who don’t have mental health issues would find that uncomfortable. For someone like an abuse survivor, for example, such a situation may feel like the height of terror. But the benefits system doesn’t care if this negatively affects you. Whether or not it makes you better is besides the point – you have to show that you’re willing to ‘get over it’, shut up, take the tablets, IMPROVE, dammit, and WORK. Pretend that everything’s okay for someone else’s benefit, when it so obviously isn’t. I’ve been here before. And I’ve learnt through hard experience that the only way out is to shout – loudly – that the emperor is indeed in the nip.

All this DWP compulsion does is create more of a barrier to treatment for people with mental health issues, rather than less. I don’t want to talk to someone I don’t know about personal and uncomfortable things. I’m even less likely to want to talk to them if we both know that the only reason I’m there is to check up that I’m not faking, and that I’m trying to get better. I already know I can’t trust the DWP to take me seriously. Setting the NHS up for the same thing is a grave mistake – especially as the DWP’s medical ‘assessments’ take not one jot of notice of your NHS medical records anyway!

The current benefits ‘shake-up’ is designed to save money, pure and simple. People with mental health issues will be a prime target because they’re easy to dismiss. Our disabilities aren’t always visually obvious, and the government quite clearly thinks that this means we’re lying about having them. Conversely, if we do have them, then we’re evidently unable to think clearly and make our own decisions – therefore our views should be ignored. As people who are either lying or incapable, we can then be made to take treatments that will make us capable of being financially productive, and anyone who disagrees or can’t manage this is proven to be the very worst of benefit scrounging ungrateful scum.

Which leaves me wondering what will happen to those of us whose mental health conditions leave us, for whatever reason, outside of their glorious ‘Arbeit macht Frei’ future.