Philippa Day: Young mother ‘took her own life after being told to attend PIP assessment’
A young disabled mother killed herself after hearing she would have to attend a face-to-face interview at a benefits assessment centre, following repeated warnings that she could not cope with such a meeting, an inquest has heard.
Philippa Day left an apparent suicide note blaming the way the government had dealt with her benefits, and had previously told her sister that she believed the Department for Work and Pensions (DWP) was trying to kill her.
Her unconscious body was found by her sister and father on 8 August 2019, just days after she had been told she would need to attend an assessment centre for a face-to-face appointment to decide her new personal independence payment (PIP) claim.
They found her lying on her bed at her home in Nottingham. On the pillow next to her was the letter from outsourcing giant Capita telling her that she would have to attend the appointment at the assessment centre in Nottingham.
On previous occasions, she had always told family or friends that she was intending to take such an action, which allowed them to call an ambulance. This time, she had not told anyone what she planned to do.
She was taken to hospital but later died after more than two months in a coma.
Philippa’s father later found notes on a laptop he had lent his daughter and which was also found on the bed, including one which appeared to be a suicide note.
It said: “I have been trapped for so long and then along comes a government who people would assume are there to help.
“Since January the 11th 2019 my benefits have been severely cut, this has caused me to get payday loans to simply live and that has escalated into a hole I can never get out of.
“Not just that, having nothing has isolated me from the world, has affected my identity.”
The inquest heard how Philippa had experienced months of distress due to DWP’s decisions to remove her disability benefits when it appears to have lost her claim form, and then to confirm that decision, as well as the length of time it took to reinstate her benefits, and deal with a new claim.
It also heard how multiple errors were made by those working in the system (see separate story).
Both DWP and Capita had been told of her history of significant mental distress and mental health inpatient admissions, that she was agoraphobic, and that she would be unable to cope with attending the assessment centre.
The inquest heard that the decision to force her to attend the centre had caused her “immense distress” and that she was “terrified” of having to attend the assessment centre.
Philippa’s trusted community psychiatric nurse, Tessa Rand, had spoken with her on 7 August about the assessment, which was going to take place 12 days later.
Rand told the inquest: “She was very, very distressed that it wasn’t an appointment at home. She was distressed about having an appointment in general.
“She felt she would not be able to cope. She would not be able to communicate what she needed to communicate.
“She said: ‘I’m done. I can’t do this anymore.’”
Despite Rand informing Capita of the distress the imminent assessment was causing Philippa, the company refused to offer a home assessment.
Her sister Imogen had spoken to Philippa and exchanged texts with her on the evening and night of 7 August and had attempted to persuade her that they would be able to secure a home assessment for her.
Her sister had denied that she had any thoughts of self-harm at that time, and “gave no indication” that she planned to take her own life.
When Imogen was asked by DWP’s barrister, Simon Hilton, if she thought that the difficulties she had with DWP and Capita in 2019 was “a big reason why she took her own life”, she said: “Yes.”
When Hilton asked if there were other reasons, she said: “No, I feel [it] was directly related.”
He had suggested earlier in the inquest that there could have been other reasons for her distress and actions, including her “complicated” relationship with her family, and not being able to be a full-time mother for her young son.
But Imogen said she agreed with Tessa Rand that the PIP assessment situation was “the straw that broke the camel’s back”.
Philippa had been diagnosed with type one diabetes when she was 18 months old, and had also been diagnosed with emotionally unstable personality disorder (EUPD), anxiety, depression and agoraphobia.
She lived a “chaotic” life characterised by repeated self-harm, suicidal ideation and drug and alcohol misuse, as well as repeated inpatient admissions to mental health units, but the inquest heard she received constant, dedicated and close support from her family and mental health professionals, particularly Rand.
The inquest heard that she had also been concerned about the impact of her mental health and frequent admissions to hospital on her son, who was being cared for by her parents.
Philippa, who was 27, had been claiming disability living allowance (DLA) for her diabetes since she was 16 but had started a new claim for PIP in November 2018, hoping to secure further support for needs related to her mental health.
Her PIP application form appears to have been lost by DWP, the inquest heard, after she posted it in January 2019, and her DLA was stopped that month because she had failed to return it.
Because of the challenges she faced in managing her life, linked to the EUPD, she only realised her DLA had been stopped – and that her weekly benefits had plunged from £294 a week to £138 – in March, and then had to start a second new PIP claim, the inquest heard.
Although she was supported financially by her parents, she was unable to prepare food herself and so often had to rely on takeaways.
She also appeared to be spending a significant amount on cannabis, alcohol and cocaine, habits she was ashamed of but were at least partly used to self-medicate to deal with her mental distress, the inquest heard.
Rand had made 11 calls to DWP in early June to try to sort out her PIP claim, after Philippa had made a call to DWP that had left her “very distressed” (see separate story).
She eventually received a back-payment of about £2,000 from DWP in June, but is believed to have used it all almost immediately to pay off some of the debts she had built up, including to payday lenders.
Imogen told the inquest that Philippa (known to her family as Pip) had asked her in April, during one of her frequent stays in a mental health inpatient unit, “to advocate for her in the event of her death if her claim killed her”.
She added: “It was specifically in relation to the PIP claim.
“She said: ‘They are trying to fucking kill me.’ She explained that they were aware of her recent inpatient admissions, that Tessa [her community psychiatric nurse] had told them about her severe mental health problems.”
Imogen said her sister had believed DWP’s negligence was “an intentional effort to kill her because it was cheaper than paying her”.
She said: “I would say to Pip: ‘Nobody is sitting behind a desk cackling evilly… these claims are very difficult, very long, very drawn out.’
“I would try to assure her it was not personal. Pip felt it was personal.”
She said it was “completely impossible” for her sister to attend an interview in an assessment centre.
“She would have sobbed, she would have screamed, she would have experienced immense distress and frustration and would have been unable to communicate.
“I would have been very concerned about an overdose directly after the assessment. I think that’s quite likely.”
Their father, Charles, who was very close to Philippa, said she had been “highly distressed” at the idea of attending the assessment centre.
He said the idea of “meeting people she didn’t know to be interrogated by them would have frightened the hell out of her”.
Their mother, Jane, said Philippa had been “loved immeasurably since birth” and was “very kind” and “very thoughtful” and would “always offer help to someone in need”.
She spent 66 of the 69 days Philippa spent in a coma before she died at her hospital bedside.
Giving evidence to the inquest, she sent a message to her deceased daughter, saying that she hoped “lessons can be learned from your very tragic and untimely death”.
The inquest is expected to end next week.
14 January 2021
Philippa Day: DWP phone agent ignored sobbing claimant who later ‘took her own life’
Evidence from Department for Work and Pensions (DWP) staff to an inquest has revealed a series of failings in dealing with the disability benefit claim of a young disabled mother, in the months leading up to her apparent suicide.
Assistant coroner Gordon Clow made clear at the start of the inquest into the death of Philippa Day – who had a long history of self-harm and suicidal ideation – that he would examine the extent to which problems with her personal independence payment (PIP) claim had caused her mental distress.
Yesterday (Wednesday), the inquest heard from two DWP staff members who worked on PIP claims at the time, one of them a telephone agent and the other a more senior decision-maker.
Philippa was found unconscious by her sister and father on 9 August 2019 after months experiencing significant distress about the way DWP was dealing with her benefits, and then the insistence of Capita, a DWP contractor, that she would need to attend a face-to-face interview at an assessment centre.
She had been diagnosed with type one diabetes when she was 18 months old, and later with emotionally unstable personality disorder (EUPD), anxiety, depression and agoraphobia.
The inquest heard that she lived a “chaotic” life characterised by repeated self-harm, suicidal ideation, frequent admissions to mental health inpatient units, and drug and alcohol misuse, but with constant, dedicated and close support from her family and mental health professionals, including community psychiatric nurse (CPN) Tessa Rand.
Pippa, who was 27, had been claiming disability living allowance (DLA) for her diabetes since she was 16 but had started a new claim for PIP in November 2018.
Her application form appears to have been lost by DWP, the inquest heard, after she posted it in January 2019, and her DLA was stopped that month because she had failed to return it.
Because of the challenges she faced linked to the EUPD, she only realised her benefits had been stopped in March 2019, and then had to start another new claim, the inquest heard.
Jane, a DWP telephone agent at the time but no longer working for the department, described taking a call from Philippa on 11 June 2019, as she tried to find out why her benefits were still suspended.
The inquest heard that Philippa, from Nottingham, had told the agent that she was “literally starving and cold”, “genuinely can’t survive like this for much longer”, was “in so much debt”, “literally cannot leave the house”, and needed “a reason to live”.
But Jane told the inquest she had heard many claimants expressing distress after losing their benefits because they had not returned the correct forms.
She said she could have left a note on Philippa’s file to summarise what had happened, but had not done so. She said she could not remember why she had failed to do so.
She also admitted that Philippa had been “sobbing” during the call.
Barrister Sam Jacobs, representing the Day family, said: “Help us understand why you wouldn’t raise that with the case manager.”
Jane told him: “I can’t remember… why I wouldn’t have raised it.”
Asked if she had passed any information to Capita, she said: “I’m not sure.”
Jane said that telephone agents were not allowed to keep a claimant on hold for longer than three minutes if they wanted to raise immediate concerns with a case manager, and would instead have to offer a call back within 48 hours.
She also said that telephone agents who spent an average of more than six minutes on calls with claimants were spoken to by their team leader at monthly meetings.
Jacobs suggested there was no acknowledgement by Jane of Philippa’s distress during the call.
He asked why she had not followed DWP’s “six point plan” – which instructs staff how to deal with statements by customers that they intend to self-harm or take their own lives – even though Philippa was in “significant distress” and had said she was “cold, starving and needing a reason to live”.
But Jane said Philippa had appeared “content” at the end of the call that she would need to speak to Capita about the assessment for her new claim.
She said this was why she did not make any attempt to “escalate” any concerns about her mental distress.
She also said it was “quite usual” to hear claimants crying.
The inquest also heard from a DWP PIP case manager, who examined Philippa’s case in March 2019 and confirmed the decision to stop her DLA payments.
She was questioned on why no “additional support” marker had been placed on Philippa’s file, despite her significant experience of mental distress and a note in her file which stated she was “quite unwell with mental health”.
She said DWP guidance on support markers had now changed and staff now “look at people’s conditions and gather further information to see if they need additional support”.
She claimed the department had now “become more holistic and empathetic about how we deal with these sorts of things” and that staff had been told that they can “follow the PIP instructions not quite as stringently as we used to”.
The case manager agreed there was nothing in the records to show if Philippa was asked for more information about her mental health.
She also admitted that information about Philippa’s history of mental distress that was passed to DWP in a call made to a telephone agent the previous week by a CPN colleague of Tessa Rand had not been available to her when making the decision on her claim.
DWP’s files mistakenly showed that that call had been made by Philippa, and not a CPN.
Jacobs asked if she would have sought further information from the CPN if that call had been recorded accurately.
She said: “Yes, I would probably have phoned the CPN to gather more information.”
The inquest continues and is expected to end next week.
14 January 2021
Philippa Day: DNS wins legal fight with DWP over ground-breaking release of secret report into benefit death
Disability News Service (DNS) has won a ground-breaking legal battle with the Department for Work and Pensions (DWP) over the release of a secret government report into the death of a disabled benefit claimant.
A DWP barrister told an inquest yesterday that the department’s attempt to prevent the publication of the draft internal process review (IPR) was “not some kind of cover-up”.
But Gordon Clow, assistant coroner for Nottingham and Nottinghamshire, ruled this morning (Thursday) that he would release the document to DNS.
DNS had asked the coroner holding the inquest into the apparent suicide of Philippa Day, from Nottingham, to agree to release key documents that are set to be used as evidence.
One of those documents is the draft IPR completed by DWP in the months following the 27-year-old’s death in October 2019.
Philippa had been diagnosed with type one diabetes when she was 18 months old, and later with emotionally unstable personality disorder, anxiety, depression and agoraphobia.
The inquest, which is set to continue into next week, has already heard repeated evidence of DWP’s failings from Philippa Day’s family, the mental health professionals who worked closely with her, and DWP staff (see separate stories).
Those mental health professionals had tried repeatedly to persuade DWP and its private sector contractor Capita to restore benefits that had been wrongly removed from her, and then ensure that she did not have to attend a face-to-face interview in a personal independence payment assessment centre.
Philippa appears to have taken her own life soon after learning that she would be forced to attend that assessment, a prospect that had left her “highly distressed” and even terrified.
DWP has been fighting since August 2014 to prevent the release of any of the scores of IPRs (previously known as peer reviews) carried out following the deaths of benefit claimants like Philippa over the last decade.
It eventually was forced by a tribunal in 2016 to release heavily-redacted versions of these documents, but they reveal only the recommendations made by the reviews.
But DNS learned that the legal team representing Philippa Day’s family – solicitors at Leigh Day and barristers at Doughty Street – had secured an unredacted copy of the draft IPR into her death.
The family this week supported the bid by DNS for the coroner to release the IPR, and internal reports prepared by its private sector contractor Capita.
DNS editor John Pring* addressed the inquest yesterday (Wednesday) and told the coroner that the IPR should be released “in the interests of transparency and accountability”.
He said this was particularly important “because the issue relates to whether their actions and/or policies are causing or contributing to the deaths of disabled people claiming benefits”.
He said the draft IPR was an “important historical document that will help to cast a light” on the government’s welfare reforms.
Pring said he believed that no IPR or peer review had ever previously been released outside DWP, even to the families of benefit claimants whose deaths have been closely linked to the department’s failings.
Simon Hilton, a barrister representing DWP, suggested to the coroner – mistakenly – that DNS would be able to secure a copy of the completed IPR into Philippa’s death through the Freedom of Information Act, which he said DNS had previously used successfully to secure such documents.
But DNS told the coroner that that was not true, as DWP was continuing to prevent the release of all but the recommendations of anonymised IPRs.
This means it is impossible to identify from these heavily-redacted documents which claimants they refer to.
Hilton said in response that it was possible he had misunderstood his instructions from DWP, and told Pring: “This is not some kind of cover-up, which is what you appeared to be implying earlier.”
Hilton also suggested that those reading news stories about the draft IPR would not realise that the recommendations were only in draft form, and that the final recommendations – which might impact on future government policy “in the benefits arena” – were “still being developed” and might yet change.
He also questioned how seeing the document would help in reporting the case and said it was “invidious and undesirable” that the draft IPR should be reported on, other than any mentions which occurred during the inquest.
Pring told the coroner that he would stress in any news stories that it was a draft document, and said that he trusted his readers to know the difference between draft and final reports, and was “disappointed that the DWP would not share that view”.
Sam Jacobs, a barrister representing the Day family, backed the DNS bid and told the coroner: “It is the family’s strong view that these documents should be disclosed in the interests of accountability and transparency.”
He said there was a “very significant public interest in understanding how DWP identifies whether there are problems in its systems” and “how quickly it is able to rectify those problems”.
The coroner said this morning, in delivering his decision: “In Philippa Day’s case, it is arguable that there was a breach by the state of its general duty to put systems in place which protects the lives of its citizens.
“It is also arguable that there was a breach of a duty which arose to take specific steps to seek to ameliorate the risk of Miss Day taking her own life.
“These are important matters and they therefore weigh in favour of the press being assisted in exercising the right to freedom of expression by access to a copy of evidence which has been presented within the inquest.”
He added: “I agree with the point advanced by Ms Imogen Day, sister of the deceased, that there is legitimate public interest in the press reporting as to whether or not the DWP operates in such a way as to avoid harm being suffered by persons with significant mental health problems.”
He concluded: “The reason for [Pring’s] request is to report on this inquest.
“It is in the public interest for this reporting to be facilitated and it is not contrary to the public interest for this report, notwithstanding that the findings and conclusions may change over time, to be provided to a member of the press to assist in the public’s participation in this inquest.”
He also noted that DWP had initially resisted releasing the IPR to him as the coroner.
The IPR – apart from one paragraph that is not relevant to the inquest and relates to proposed government policy, and so will be redacted – and an incident report prepared by Capita will be released to DNS at the point they are introduced into evidence during the inquest.
The coroner said that he had reserved his decision on whether to release another Capita report.
The inquest continues.
14 January 2021
New figures set to provide clearer picture of disproportionate pandemic deaths of disabled people
New official figures, set to be released early next month, should provide a clearer picture of why so many disabled people have died from COVID-19 during the pandemic.
The Office for National Statistics (ONS) has told Disability News Service that it expects to publish the figures during the first fortnight in February.
It also plans to use GP records to provide further statistics on the excess risk of COVID-related deaths among people with learning difficulties.
This follows the publication of Public Health England figures which showed younger people with learning difficulties in England were more than 30 times more likely to die from coronavirus than non-disabled people of the same age.
Previous ONS figures have shown that about three-fifths of all COVID-related deaths in England and Wales were of disabled people, while ONS has admitted that this was likely to be an under-estimate.
But ONS has been fine-tuning its previous work, and now hopes to show how many of the excess deaths have been due to underlying health conditions, and how many could be caused by other factors.
It will also isolate the impact of factors such as the part of the country where a disabled person lives, the population density of the area where they live, the make-up of their household, and their occupation.
Allowing for all these factors should provide a clearer picture of any excess risk of death disabled people have faced that is on top of the COVID-related risks posed by any existing health conditions.
Such excess risks – if they exist – could have been caused by factors such as discrimination in the provision of medical treatment or other services, and political decisions relating to social care, care homes and financial support, as previously highlighted by DNS.
These factors could include delays in testing social care staff for coronavirus and the decision to discharge hospital patients into care homes without testing them for COVID-19, in the early weeks of the pandemic.
This means the figures could help to show if the government violated its obligation to protect disabled people’s right to life, under article two of the European Convention on Human Rights (ECHR), and breached the Equality Act, other ECHR articles, and the UN Convention on the Rights of Persons with Disabilities.
An ONS spokesperson said the new figures aimed to show “how much of a role diagnosed diseases or medical conditions play when it comes to the relationship between disability and COVID-19 mortality”.
Only last month, the Commons women and equalities committee called for an independent inquiry into the causes of the “starkly disproportionate and tragic” death rates of disabled people during the pandemic.
The committee suggested these causes could include decisions and policies of the government and other public bodies.
14 January 2021
Peer calls for disabled people to ‘take control’ over PA vaccinations
A disabled peer is calling on other disabled people seen as clinically extremely vulnerable (CEV) to coronavirus to “be proactive” and ask their GPs to vaccinate them and their personal assistants, following the publication of new government guidance.
The advice from the crossbench peer and campaigner Baroness [Jane] Campbell, who has spent months shielding during the pandemic because she has spinal muscular atrophy, came after the new government guidance helped persuade her GP to vaccinate her, her partner and four personal assistants (PAs).
But she has called for further clarification on how other disabled people in her situation can secure a vaccination as soon as possible, as the government pushes ahead with “the biggest vaccination programme in NHS history”.
Baroness Campbell had been pushing the government in the House of Lords and through letters to change its guidance to ensure that PAs are included in the second highest priority group for vaccination, along with other social care workers.
This week, the new guidance stated that it was “vital that we identify and reach directly employed Personal Assistants, who support people within any of the JCVI* priority groups (the clinically vulnerable and adults) as part of our efforts to ensure full coverage of the priority 2 cohort”.
The government has promised to offer a first vaccine dose to everyone in the top four priority groups – including all those in the CEV group – by 15 February.
Baroness Campbell’s concerns about the lack of clarity were mirrored by disabled campaigner Fleur Perry, who is also in the CEV group and has been shielding since the start of the pandemic.
She welcomed the new guidance, but she said: “What I’m hearing from some disabled people is that not all local authorities seem to be aware that they are expected to take a lead role in identifying social care staff [who should receive the vaccine as a priority].
“This means that some people employing PAs through direct payments or personal health budgets are being bounced between GP, clinical commissioning group, and council, with no organisation taking responsibility for getting this done.
“This is resulting in disabled people and their PAs being left behind, extending the length of time they are at preventable risk of infection.
“Quite frankly, I don’t want to lose a friend this year due to a council not writing a list.”
Baroness Campbell had previously been told by her GP that he was waiting for government guidance on where she and her PAs should come in the vaccine queue.
She immediately emailed him this week with the new guidance, “quoting significant paragraphs and asked very politely whether he would now consider vaccinating me, my partner who is essential to my support and my PAs.
“Late last night I received an email from my GP telling me that he had secured six vaccination slots at our local vaccine centre at midday today (Tuesday). And that was that.”
She published on Twitter a picture of herself being injected, and urged others in her situation to do the same.
She told Disability News Service that she could not say whether her lobbying of the government had had any impact.
But she said: “I think that GPs require the evidence set out for them and it helps to make a personal case for your vaccination.”
She said the vaccination programme appeared to be “somewhat ad hoc across the country” and so she would advise anyone who is CEV and requires care and support “to be proactive in getting themselves and their PAs vaccinated”.
She added: “I was surprised to receive my invitation so quickly although I have made it my business to establish a good relationship with all the people involved in my health and social care support over the years. Communication is the key.”
If the direct GP route had failed, she said, she would have tried her other health and social care providers.
She described the new guidance on PAs as “wise and timely”.
But she said: “I am personally relieved and thankful. However, I do think that there needs to be further clarification as to how people in this cohort can easily access the vaccination swiftly.”
Those seen as CEV who are under 70 years old are currently in the fourth priority group for the vaccine, but their PAs are now in the second group, which is why Baroness Campbell has been able to secure a vaccine along with her PAs.
She said: “What’s the point of vaccinated care workers when they can still carry the virus and give it to the CEV person? I made that point to my GP.”
She added: “I would advise all disabled people’s organisations and other disability organisations to inform and help this group of disabled people to get the vaccination as soon as possible.”
DHSC had not responded to a request to clarify the position by noon today (Thursday).
*The Joint Committee on Vaccination and Immunisation
14 January 2021
Rights concerns over major Mental Health Act reforms
User-led grassroots groups have raised serious concerns about the government’s new mental health white paper, particularly its failure to offer the full human rights set out in the UN disability convention.
The white paper, published yesterday (Wednesday), aims to deliver “major reform” of the Mental Health Act (MHA), providing service-users with more control over their care and treatment, and ensure the act’s powers “are used in the least restrictive way”.
Ministers also said that it would address the disproportionate detention of people from black, Asian and minority ethnic communities, and the use of the act to detain people with learning difficulties and autistic people, as well as improving the treatment of people with mental health issues within the criminal justice system.
Among proposed changes are the introduction of new “advance choice documents”, which would allow people to express their wishes for their care when they are well, before they need to go into hospital.
Another proposal is to allow individuals to choose a “nominated person” who is best placed to look after their interests under the act if they cannot do so themselves.
Initial coverage of the white paper in the mainstream media – before it had been published, and based on the government’s press release – was overwhelmingly positive.
But the Reforming the Mental Health Act white paper – which is now out for consultation until 21 April, and will eventually be followed by a new mental health bill – builds on recommendations made by Sir Simon Wessely’s independent review of the Mental Health Act in 2018.
That review was criticised for falling “significantly short” of recommending full human rights for people in mental distress.
Although disabled activists have not yet had time to analyse the white paper in depth, they are already raising similar concerns, while also welcoming aspects of the reforms.
Dorothy Gould, co-founder of the new user-led, rights-based organisation Liberation*, said: “It is undoubtedly true that the MHA white paper is extensive and looks at a large number of much-needed improvements to the current act.
“However, these improvements fall well short of the government’s claim that it is bringing the law ‘into the 21st century’.
“It is also intensely worrying that Matt Hancock regards the Wessely review, on which the white paper is based, as ‘one of the finest pieces of work on the treatment of mental health that has been done anywhere in the world’.
“It is devastating that, so far from drawing adequately on promising international developments elsewhere and the full human rights set out in the UN Convention on the Rights of Persons with Disabilities, the white paper repeats many major flaws in the Wessely review.”
She said the white paper “retains a dominant medical model focus”, and added: “It aims to reduce, but not bring to an end, the fundamental breach of human rights represented by involuntary detention in psychiatric hospitals and forced treatment.
“It has an inadequate focus on the full range of multiple discrimination that exists. We want so much more than this.”
The grassroots, user-led mental health group Recovery in the Bin (RITB) was also critical in its initial response to the white paper.
An RITB spokesperson said: “We welcome proposed changes in the MHA white paper such as a nominated person and increased right to advocacy, but it falls short of a social justice approach and as with the existing act, in the absence of funding and the continuing hostile environment of the DWP [Department for Work and Pensions] and wider systemic racism, the act is irrelevant to the actual conditions people have to endure.”
POhWER, the UK’s largest advocacy charity, which was founded by disabled people in 1996 and has a majority of disabled people on its board, welcomed “some progress” in reforming the act, “particularly where it strengthens relationships, empowers individuals, further upholds human rights and builds dignity for people supported by public services or in government-run institutions”.
But Helen Moulinos, its chief executive, said there were “still many concerns” about the proposed changes.
Among its concerns are the need for better investigations and regulatory oversight for non-natural deaths in mental health settings; more work on discrimination in how the act is applied, such as the disproportionate use of the act’s powers of detention on black people; more clarity on funding for advocacy; more safeguards for patients being treated informally with their consent; and more thought given to the needs of people with learning difficulties and autistic people.
Health and social care secretary Matt Hancock said: “I want to ensure our health service works for all, yet the Mental Health Act is now 40 years old.
“We need to bring mental health laws into the 21st century.
“These reforms will rightly see people not just as patients, but as individuals, with rights, preferences, and expertise, who are able to rely on a system which supports them and only intervenes proportionately, and which has their health and wellbeing as its centre.
“This is a significant moment in how we support those with serious mental health issues, which will give people more autonomy over their care and will tackle disparities for all who access services, in particular for people from minority ethnic backgrounds.”
*Liberation can be contacted via email at: Liberationrights@gmail.com
14 January 2021
High court hears of ‘catastrophic’ impact of ‘fitness for work’ system
The high court has this week been asked to consider evidence of the “unbearable” and “catastrophic” impact of the government’s “fitness for work” system on people with experience of mental distress.
The evidence was submitted to the high court in support of a judicial review claim being brought by the family of Errol Graham, who starved to death in June 2018 after his employment and support allowance (ESA) was wrongly removed.
A two-day hearing this week heard evidence to back the family’s claim that the decision to halt his ESA in 2017 was unlawful because it breached the Equality Act and the government’s own ESA regulations.
The family are also arguing that the ESA safeguarding policy of the Department for Work and Pensions (DWP) on terminating benefits is still unlawful, despite changes made after they began their legal fight.
The claim is being brought on behalf of the family by Alison Turner, the fiancée of Graham’s son.
Errol Graham had missed a fitness for work assessment and had failed to respond when DWP tried to contact him by phone and in person.
But DWP went ahead and stopped his ESA without trying to contact his family or public bodies or considering whether his known history of mental distress could have been the reason for his failure to respond.
When his body was found, he weighed just four-and-a-half stone, there was no food in his flat and no credit on his gas or electricity meters, while an unsent letter to DWP was found which pleaded: “Please judge me fairly.”
The mental health charity Mind provided a witness statement in support of the family’s judicial review claim, which includes testimony from benefit claimants with similar experience of mental distress – and the barriers within the system – to Errol Graham.
One described to Mind how they struggled to eat and sleep and had several panic attacks a day before every face-to-face benefit assessment.
They said in response to a 2018 survey: “I just could not face the thought of the DWP because of the power they had over my life.
“This stress led to me considering self-harm and suicide, which I had previously attempted and been hospitalised for.”
Another said, in response to a 2019 survey: “This is my third assessment in the last four years.
“All I can say is my mental health has deteriorated since these assessments started. I literally lived in fear of the letter arriving.
“I find the questions on the form utterly degrading and hate that I can’t fit into those boxes.
“They also bring about a deep sense of shame about not working.”
Others described how they avoided opening correspondence from DWP, with one saying in 2018: “Just the sight of a ‘brown envelope’ sends me in to a huge panic and I can often put off opening a letter in a brown envelope.
“If I were to use words and phrases such as ‘catastrophic thinking’ and ‘panic attacks’ you may get a fair idea of the way and route that this affects me.”
Mind told the court in its statement that it frequently heard from people who have had significant deteriorations in their mental health after their benefits have been stopped.
One said in 2017: “I stopped spending money on food and heating to save for an uncertain future and relapsed terribly with anorexia.
“I had to give up my voluntary work and go into hospital as I was physically and mentally very unwell: the admission lasted a year – costing hundreds of thousands of pounds which I feel terribly guilty about.
“But if I had felt more supported to take recovery at my own pace, and not feared financial repercussions and sanctioning, then I do not think (nor do my medical team) that I would have relapsed at that point.”
Ayaz Manji, a senior policy and campaigns officer with Mind, who wrote the statement, said the charity continues to hear from local Mind charities whose advisers say they are “fearful about what is happening to people in similar circumstances to Mr Graham who do not have access to the same kind of help”.
Turner said before the hearing: “The DWP decision to stop paying Errol’s benefits meant that, without money to buy food and to pay for heating and lighting, in the end, he starved to death.
“Although at first the DWP maintained that their safeguarding policy was lawful, faced with a court case, they have made some changes to the policy.
“But these changes are not enough. It still falls to the vulnerable claimant to make sure the DWP knows why they have good cause not to respond to DWP enquiries.
“That makes no sense when vulnerable claimants might be too mentally ill to respond.
“For Errol’s sake, I have to challenge this policy so that other people don’t suffer in the way that he and our family did.”
Tessa Gregory, from legal firm Leigh Day, who represents the family in their claim, said: “The DWP provide support to many others like Errol, who due to their significant mental health issues may miss appointments and may have difficulty responding to correspondence.
“It cannot be right that it falls to such vulnerable individuals to prove that they had a good cause for not responding and the DWP must require their staff where necessary to make further enquiries before taking the momentous decision of cutting off what is often a person’s only source of income.
“Unless and until the DWP changes its policies other vulnerable individuals will remain at risk of serious harm or death.”
The Equality and Human Rights Commission, which is intervening in the case, has made it clear that it agrees with the arguments put forward by Turner’s legal team.
It also makes further points of its own, including highlighting the importance of article three of the European Convention on Human Rights – which prohibits inhuman or degrading treatment – and the UN Convention on the Rights of Persons with Disabilities.
Judgement has been reserved until a future date.
A Department for Work and Pensions spokesperson said: “Our sympathies are with Mr Graham’s family.
“It would be inappropriate for us to comment further at this time.”
14 January 2021
News provided by John Pring at www.disabilitynewsservice.com
