"The restrictions placed on us by our government as a result of the declaration of pandemic Covid-19 by the World Health Organisation (on 11th March 2020), have without question placed unusual stresses upon the body politic and these have exposed previously somewhat hidden flaws. These flaws have, however, never been hidden from those who experience their effects.
Being a sometime “service-user” myself here in Southampton, a treatment centre for mental health conditions, I have many friends and acquaintances who also use the service and as a result I have a catalogue of very harrowing stories which I could relate, however, one recent tale stands out particularly with regard to the effect of lock-down restrictions. Last November, my good friend Jonathan*, who has a paranoid-schizophrenic condition (episodically hearing voices, feeling persecuted and occasionally compelled to act by these delusions), received notice from the Dept. of Work and Pensions (“DWP”), requiring him to reapply for his Personal Independence Payment (“PIP”). He was then telephoned by the benefit service in order to complete a reassessment which he did, therefore, Jonathon underwent his reassessment for PIP over the phone whilst sat alone in his flat. The assessor even rang Jonathan back two or so days after his initial assessment to; “check some things” (again an inquisitor questioned Jonathan in his home whilst there was no advocate, or psychological/emotional support, present). Following this, Jonathan was informed that his reapplication for PIP had been unsuccessful. He immediately sought advocacy (he usually uses the Citizen's Advice Bureau -"CAB"-), but found that initially he could not get through on the phone (waiting 45 minutes to speak to someone), then that, due to lock-down restrictions, no one at the CAB could help him fill out his form for mandatory reconsideration and that they would send one to him. We agreed that he should inform the DWP that he had no help from an advocate whilst filling out the form and that he could only refer the dept. to the information they already had.
I spoke to him on the phone myself several times during this period and over the subsequent weeks, he was clearly very stressed and “elevated” but although the stress eventually triggered a paranoid-schizophrenic response he was well grounded enough to seek the advice of his psychiatrist. When the psychiatrist heard that Jonathan was suffering from paranoid-delusions she immediately increased his “Olanzapine” dose from 15mg-20mg/day and put him on an anti-depressant (that she hadn't previously prescribed), called “Sertraline”, at a dose of 100mg/day, she then wrote a letter in support of his claim informing the DWP/Tribunal benefit service that (paraphr.); “this man is unwell, he has a serious mental health condition”.
Then something very odd happened; a week or so after his psychiatrist had contacted the benefit service, Jonathan received a phone call from a member of staff who told him, whilst not specifying the decision to which she was referring; “I am on your side. I want to help you overturn this decision!” When he told me this I remarked what good news I thought it was, however, a week or so later Jonathan, rang to tell me that he had received a letter from the benefit service telling him that despite the fact that they had received his psychiatrist's letter and taken on board her remarks they would not overturn their decision following mandatory reconsideration. When I asked him when it was dated he told me that it was dated the very same day he had received a phone call from the member of staff who had told him that she wanted to help. I told him that I wasn't surprised and that I have encountered things like this before, the initial bad decision was affecting the claimant's subsequent dealings with the service (as it desperately tried to cover for itself), however, to ignore a psychiatrist's letter is a breach that probably should be challenged in law (esp. considering that this mentally-ill man was now receiving contradictory advice from authorities he desperately needed to be able to trust). They started paying regular amounts, and some back pay, into his bank during this period but did so whilst still not informing him of their final decision. He's paranoid schizophrenic for Ch****-sake who is going to take responsibility for his reaction to the self-serving two-faced-ness of the benefit service? They sent him confirmation of his award in the end (and gave him a year or two more than his usual apportion of PIP -very generous-), but left him with the legacy of the experience.
I find the story very instructive concerning the isolation and concomitant problems that claimants experience as a result of lock-down. It also shines a light on a wider truth that dare not be spoken of between advocates/claimants and the benefit service (believe me I know this to be a fact, having been a; Disability Living Allowance -“DLA”-, Employment and Support Allowance -“ESA”-, PIP, Universal Credit -“UC”-, and Limited Capability for Work Related Activities -“LCRWRA”-, claimant and ridden on the roller-coaster that is benefit entitlement here in Britain myself), financial insecurity causes mental-health problems! For goodness sake the principle is accepted within the wider population (ie. those not as subject to our government's openly eugenicist agenda)!
I myself am currently accessing advocacy and I can tell you that being re-assessed for or having to re-apply for benefits is an even more stressful process under lock-down that it usually is and, like I said, it's already a (lethal), roller-coaster.
I should have been informed that my PIP was up for reassessment in November, however, it wasn't until I received this year's Council Tax Bill (informing me that I was under different consideration because I was no longer in receipt of PIP), that I realised why it had seemed to me that my February entitlements had been reduced. On receiving my Council Tax Bill I immediately contacted one of my advocates (I use one for debt/benefits and another for medical/NHS issues), who questioned the DWP eliciting the admission that I should have been informed of my change of status. Despite this the DWP have so far refused to reinstate my payments for the few months I would have had to seek a continuation of my award, I am, therefore, being forced to make a new application (not something, I suspect, that will sit well with any possible future tribunal).
Lock-down restrictions mean that I cannot meet my advocate face-to-face to prepare my case, all the filing and referencing my advocate usually does for me is useless because we are not in the same room to go through the documentation together. There is no possible way that a phone call can replace an in-person advocacy appointment, many clients desperately need the psychological and emotional support that the presence of an advocate represents, otherwise they feel trapped, persecuted and isolated and as a result are incapable of rational response. Many claiming PIP, ESA and LCWRA have stress-sensitive mental and physical health conditions and the support an advocate gives is often in the form of help with the stress of dealing with correspondence, something that can only properly be dealt with if the client and advocate are in the same room but this cannot happen under lock-down either.
Advocacy represents the port of last resort for many claimants. Both accessing and making use of advocacy services is difficult at the best of times, but lock-down compounds these problems making of the advocacy process a truly “cruel and unusual” form of torture. I have a stress-related self-harm condition, who will take responsibility should I have an episode? My previous PIP entitlement lasted only 18 months and my condition hasn't changed in that time, in fact under lock-down certain aspects of it have worsened.
The advocates are stressed and over-worked too which doesn't help!
I will be making a paper application for PIP (face-to-face assessment in the presence of an advocate being completely out of the question), as I do not wish to go through the stress of an interrogation on the telephone alone. One can “share” phone calls but the physical presence of a supportive companion is supposed to be a right.
I have managed to get myself to A&E at Southampton General twice, on each occasion under lock-down and whilst “shielding”. On both occasions I was suffering from the worsening of a chronic condition due to lock-down stress. The worsening of these conditions was directly related to my inability to access the proper prescribed therapy, that of swimming/aqua-yoga/aqua-aerobics, for the serious and life-changing injuries I sustained as a teenager which caused me to suffer from tissue-damage, muscle-loss, nerve-damage, skeletal, spinal cord and circulatory problems.
I managed to secure a “Smart Cities” card from the Southampton Unitary Authority only because I paid my GP £30 to write a report stating that I need to have access to less-expensive (Nb. not free), swimming in the city's various public facilities. In the past being a recipient of PIP would have been enough, but now the claimant must receive certain components of the PIP award to qualify for a free Smart Cities card (although the holder is still only entitled to “half-price” access to swimming and/or gym sessions), or seek what is basically a “doctor's note” (the G.P surgeries now charging for such services). What this means, of-course, is that my physician recommends that I engage in certain forms of therapy regularly and that I have a “smart-chipped” card with my photograph on it that entitles me to greater access to such therapy.
As a result of not undergoing therapy I over-strained two old injuries one of which (to my back, pelvis and leg), has become considerably more troublesome and I can be virtually unable to move for days at a stretch. The A&E doctor prescribed a change of pain medication that increased my opioid dose from 4/day Co-codamol 8/500 to 6/day Dihydrocodeine 30mg and I reported to the doctor that the worsening of my condition had induced a self-harm episode. My GP has since concurred with the decision to increase my opioid dose and I now receive Dihydrocodeine on repeat prescription, this is not a solution for chronic pain but medical marijuana (not useless CBD “extract”), is still not available on prescription in Britain.
As I have been shielding I was unable to attend my appointment with Southampton NHS neurology last year but do intend to attend one in August. With various aspects of my conditions worsening and having already attended A&E twice I don't intend to wait any longer.
It is my contention that provision should be made during a pandemic for patients who require access to prescribed/recommended therapies and if this means only letting those who can prove (and with a Smart Cities card such verification is easy), their status have such access then so be it. This may sound harsh but I reiterate I've had to attend A&E twice, whilst shielding, during lock-down!
Even worse though (esp. considering that; "isolation is the worst form of torture"), has been the lack of provision made to ensure that the vulnerable have proper access to the internet during the pandemic and its concomitant lock-down restrictions. The notion that those with physical and/or mental health problems might have difficulty if their already poor access (for those on restricted incomes the option of utilising commercial companies often being a non-starter), to technical support for their internet connection be further restricted does not seem to have occurred to the Powers that Be. This was brought home to me when I tried to get in contact with "Jamie's" (a local charitable business organisation set-up in order to support the vulnerable both at home and with regard to employment and training in computer science and I.T skills; go to: https://jamies.org.uk/about/about-us/?v=79cba1185463), which proved impossible during lock-down as there was no-one in the office and, therefore, no-one who would have been able to help if my p.c had suffered from any technical issues or needed repairing.
Recently I have had trouble preparing to take up my place on a "Steps to Wellbeing" ten week webinar course ("S2W", go to: https://www.steps2wellbeing.co.uk/ -Nb. their courses would usually be face-to-face in groups but, of-course, this is impossible at the moment meaning that a stable connection, working equipment and a capable client base are essential-), although Jamie's are now open again they (unsurprisingly), have a considerable back-log of repair/programming work to do. Even my clinical psychologist with S2W was unaware (as I was), of the existence of; "SO: Let’s Connect/a new project starting in Southampton, with the aim of reducing isolation by enabling people to get connected online.
You can find out more about the project here: SO:Let’s Connect – Digitally Connecting People
Following substantial investment from SO18 Big Local, TWICS, SO:Linked, Drop The Mask Productions CIC, Jamie’s Computers and more, SO:Let’s Connect can provide IT equipment, internet connectivity and support to enable more residents to get online.
Our team of volunteer Digital Connectors are here to provide support – for example teaching people to video chat with their family, access their GP online, take part in online groups and activities and more. They can support even the most tech-anxious people and we can also provide recycled equipment for those who need it.
To refer someone (including yourself) to the project for support, contact SO:Linked and ask for SO:Let’s Connect. You can do this in 3 ways:
By filling out and submitting the form below
By calling us on 023 8021 6050
or via email email@example.com and quote “SO:Let’s Connect”." Go to: https://www.solinked.org.uk/so-lets-connect but this is a somewhat low-profile, local and voluntary organisation set up as a direct result of the need for such a service during a pandemic, it was not in existence prior to lock-down neither does it utilise professionals trained in pandemic response (esp. important when visiting the client at home and remaining in close proximity to them whilst the work is done may be essential). I do not know what provision of such services has been like in the rest of the country but I suspect the story to be similar, if not considerably worse, elsewhere.
These issues should have been considered but given the Tory default setting they, of-course, were not.
Does it not seem odd that a government so keen that we should all be part of the "connected society" should fail such a large portion of the body politic in this regard? Perhaps not if one considers what a eugenicist agenda its leader espouses; "In 2000, while Johnson was editor of the Spectator, the magazine carried an article from columnist Taki which said: “On average, Orientals are slower to mature, less randy, less fertile, and have larger brains and higher IQ scores. Blacks are at the other pole, and whites fall somewhere in the middle, although closer to the Orientals than the blacks.”".."Downing Street repeatedly refused to say whether Johnson supported the views expressed by Sabisky on eugenics – the selective breeding of humans – or the IQ of black people." (Go to: https://www.thenational.scot/news/18240765.downing-street-refuse-clarify-boris-johnsons-views-eugenics/ ), he says this on his own website; "We seem to have given up on population control, and all sorts of explanations are offered for the surrender" (Go to: https://www.boris-johnson.com/2007/10/ ). "One" may have given up Boris but her majesty's government don't seem to.
Clearly our government was not properly prepared for Covid-19. Institutions need to be prepared to run as normally as possible during a pandemic, therefore, prioritising the mental and physical health of the body politic is essential. A triage system only works if physicians are able to correctly prioritise response. Any government's first priority should be the welfare of the citizens it governs and the modelling must reflect this. As E.F Schumacher pointed out, the economy is dependent on the health of each individual, this means that each must be treated equally and proportionately to their needs. Needs not wants!
Our current administration only serves the wants of the few. What the Tories have been doing to the vulnerable during this Covid-19 pandemic is just a worsening, for the sake of expediency (and eugenics), of what they have been doing for years, marginalising the response to genuine concerns and maximising profit for themselves and their supporters, however, I believe we can challenge some of the hubris for there must be many stories like the two I’ve recounted.
We need to seek a moratorium on re-assessment/re-application for those on PIP, ESA and LCWRA during a pandemic. The risk of inflicting lasting harm and even death on claimants who do not have the resources to respond to the increased stresses imposed by lock-down, including the near impossibility of securing appropriate advocacy, by forcing them to undergo re-assessment and/or to have to re-apply for entitlements, is far too great. If you are, or were, a PIP, ESA or LCRWRA claimant who has been affected by Covid-19 pandemic lock-down restrictions, especially with regard to seeking advocacy, please contact https://dpac.uk.net/contact/.
If we need to challenge our government's actions in the international courts, so much the better. These are human rights issues and the solutions to the problems should be enshrined in international law (if they are not already), that way we can ensure that we are better prepared to protect the whole body politic in future."
by Kevin Francis
*Names of those mentioned in this article have been changed in order to protect their identity.
Quote; "Those particularly impacted negatively by the pandemic, it says, include disabled people and those with long-term health conditions; black, Asian and minority ethnic groups; people living in deprived areas and poor housing; and older people.
But these are the groups who have largely been ignored in developing responses to the crisis, and as a result have been “further detrimentally impacted by it – in many cases fatally”"..
“Disabled people with vast experience of social isolation could have made valuable contributions to ‘shielding’ policies and social care provision and yet typically were not invited to contribute to decision-making processes,”* it adds.
The collection of chapters by a range of authors, including leading disabled campaigners, calls for marginalised voices to be better heard through co-production.
In his chapter, Professor Peter Beresford, chair of Shaping Our Lives, compares the pandemic efforts of frontline NHS health workers with the “arbitrary and sweeping decisions” of senior NHS managers to “clear out thousands of older, long-term patients” into care homes and domiciliary services, which “then caused the infection to spread on a massive scale”.
He says that the NHS’s actions, which used “social care as a dustbin for COVID-19 casualties” were made “doubly dangerous and discriminatory by the appalling state of social care in England”."..."They say that the scale of the disproportionate impact of COVID-19 on disabled people –about three-fifths (59 per cent) of COVID-19-related deaths in England during the pandemic have been of disabled people – has “not been reflected in the response to the crisis”*." Go to: https://www.disabilitynewsservice.com/disabled-people-largely-ignored-in-response-to-pandemic-says-new-book/ for full article.
Psychosis and COVID-19: is it time to pre-emptively revise advanced directives?
Quote; “Revised advanced directives might be necessary to indicate
preferred treatment choices, given the re-assessment of the risks and
benefits of health-care delivery during the pandemic. Decisions
regarding hospitalisation, initiating clozapine, receiving long-acting
injectables, and electroconvulsive therapy might pose different
risk–benefit profiles after the pandemic onset. Additionally, given the
increased mortality rates in people with psychosis secondary to
dynamic revisions in advanced directives should also reflect the decisions regarding COVID-19 treatment—eg, whether to receive the vaccine or not, type of vaccine, and the mode of delivery.
Pandemics might come and go but medical ethics principles should stand resolute against mitigated or unmitigated disasters. Dynamic, advanced directives in line with the rapidly evolving pandemic situation will add more value to patients’ autonomy.” Go to: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(21)00119-X/fulltext for full article.
The Lancet seem, despite their posturing, to be prioritising enabling legislation for their own agenda not promoting individual autonomy for their patients, it’s a good example of bad-modelling by the institutions. One has no choice but to advise; “follow the money!”