Pushed to the Brink


By Ruth Hunt Morning Star

Alice Kirby tells Ruth Hunt how DWP benefit assessment practices contribute to the deterioration of claimants’ mental health, causing an increase in suicidal feelings

Of late, there have been great strides made regarding the understanding of mental illness and suicide, attempted suicide and suicidal feelings. Unfortunately, this hasn’t reached the Department for Work and Pensions (DWP), despite its “disability-confident” slogans.

You would think it would want to avoid any more bad press but this dysfunctional and dangerous department can’t seem to help it, especially with regard to the now-notorious Work Capability Assessment (WCA) for Employment Support Allowance (ESA) and the Personal Independence Payment (PIP) assessment.

Recent research conducted by Jemina Napier from Edinburgh’s Heriot-Watt University has found that the ESA assessment process “caused a deterioration in people’s mental health, which individuals did not recover from. In the worst case, the WCA experience led to thoughts of suicide.”

Debbie Abrahams, shadow secretary for Work and Pensions, said this proved the system is “not only unfit for purpose but is causing harm to some disabled people.”

The despair and suicidal feelings some people experience are hardly surprising as they live for months with the threat of financial insecurity hanging over them. Once on such benefit, they still face arbitrary and bewildering decisions to sanction them by removing their benefit for a period of time.

A freedom of information request in 2013 showed that six out of 10 sanctions were given to those with a mental health condition and/or a learning disability — so when Tories talk about the “safety net’ for the vulnerable, those affected know it’s so threadbare many fall through.

Suicide and suicidal feelings are complex — often there is more than a single reason why someone takes their own life. Research has pointed to various indicators that would alert a nurse or doctor. Financial insecurity or the threat of financial insecurity — the brown envelope on the doormat — and previous suicide attempts should be an automatic red flag.

Thankfully, most organisations and mental health professionals have moved on from the days where suicidal feelings or attempted suicide were seen as just “attention seeking.”

However, the DWP is one of those organisations still stuck in the past. Its WCA and PIP assessments are based on an outdated medical model of disability, with little interest being shown in what actually disables someone.

It takes a lot of courage for someone to reply to questions about suicidal feelings and/or suicide attempts especially in the high-pressured environment of a benefits assessment, but we have to ask why these questions are asked at all.

Both the WCA and PIP assessments are based on testing a person’s ability to carry out certain tasks, so whatever answer a claimant gives makes no difference to the final outcome.

John Pring from The Disability News Service (DNS) asked about this in a recent FOI request. The response he got was that it was the “duty” of an assessor to ask about suicidal ideation and intent if there is a risk of selfharm or suicide. They state: “Of course, if an assessor has concerns that a claimant is at substantial and imminent risk… they have a professional duty to act quickly to safeguard the claimant’s welfare.” Yet despite this stated “duty” they’ve not got a safeguarding policy in place.

One of the first people to report on this was writer and activist Alice Kirby who has both physical disabilities and mental illnesses. She says that during her PIP assessment — which took place at her home — she was already very apprehensive and emotional, a state not helped by the fact Atos had already cancelled one assessment at very short notice.

“I was made to feel incredibly uncomfortable throughout the assessment and there was no concern or compassion shown by my assessor. I was then asked if I had attempted suicide in the past and if so to provide details,” she recalls.

Kirby was also asked how often she thought about killing herself each week, and finally: “Can you tell me why you haven’t killed yourself yet?”

She was left absolutely distraught after the assessment and despite answering questions on suicide was not signposted to any services for further support.

“These questions were not necessary or relevant to my assessment, and my answers made no difference to the points I was awarded,” Kirby tells me, adding that she finds the behaviour of Atos and the DWP irresponsible and extremely unsafe.

She made the brave decision to talk about her experience publicly via social media and was shocked at the overwhelming number of people who contacted her saying they had to endure similar questions in the PIP as well as the WCA assessments.

The proof of that came from campaigner Jonathan Hume who recorded his own interview. Any questions on the subject of suicide need to be carefully worded. The interviewee needs be with a person they trust and who has proper training. And finally the environment itself should be safe and supportive, backed up with practical help to keep a person safe.

“The WCA is a hostile, stressful and coercive situation and the carelessness and bullying way which these questions are asked has the potential to do a great deal of harm to vulnerable people,” Hume told Disability News Service.

Eminent psychiatrist and author of The Other Side of Silence Linda Gask says: “Being able to talk honestly about suicide and self-harm in any setting requires the questioner to demonstrate empathic understanding for the interviewee, who in turn needs to feel safe enough to share very painful thoughts and feelings with the interviewer. When you think about these necessary conditions, the PIP assessment is hardly a place where a person is encouraged to feel safe — quite the opposite. Furthermore, asking: ‘Can you tell me why you haven’t killed yourself yet?’ not only shows a lack of empathy but also seems to suggest that the interviewer is even surprised you haven’t done so already. That they think your life isn’t worth very much at all — a thought that might already be crossing a desperately vulnerable person’s mind.”

It’s no wonder the UN found that assessments caused people’s mental health to “severely deteriorate.”

If the DWP is truly concerned about the risk to claimants, its focus should be on abolishing the current assessment and sanctions regime, which punishes claimants and, far too often, pushes them over the edge.

  • Ruth F Hunt is the author of The Single Feather. If you are feeling suicidal, or need to talk to someone about whatever you are going through, call the Samaritans on 116 123 (UK) or by email at jo@samaritans.org.


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