Prof Wendy Burn

President of the Royal College of Psychiatrists

11 September 2019

Dear Professor Burn,

I am writing to you on behalf of Mental Health Resistance Network (MHRN), Disabled People Against Cuts (DPAC), WinVisbile (women with visible & invisible disabilities), Recovery in the Bin (RITB) and Black Triangle to express our deep concern that job coaches have been given the authority to assess the mental health of Universal Credit claimants, not for the purpose of establishing reasonable adjustment requirements but to refer them for treatment. Such a scheme is currently being piloted in Cornwall. Job coaches can fast track patients/claimants for specialist mental health treatment without the need for the involvement of a GP. We are dismayed that the Royal College of Psychiatrists has not opposed this.

Link to DWP press release, https://www.gov.uk/government/news/100000-fund-to-boost-mental-health-support-across-cornwall

As mental health services are now being forced to promote a highly biased political view of mental distress and treatment, we profoundly regret that mental health professionals’ bodies, along with major mental health charities, are so keenly colluding with the embedding of a contested political ideology into the treatment of people who live with mental distress. This ideology involves both blaming and punishing individuals who fail to conform to the demands of the free market, regardless of whether these demands are reasonable or might cause harm to the claimant. It also requires that social security is restricted to such an extent that people live with the constant fear of destitution and with actual destitution. As you know, this has resulted in a number of deaths from suicide. It is extraordinary that the Royal College of Psychiatrists is going along with this.

It would seem that, with its vigorous promotion of what we know as the ‘work cure’, the psychiatric profession has learned nothing from its foray into gay conversion therapy. Can we refer to this new direction as “political ideology compliance therapy”?

We have the following questions for the Royal College of Psychiatrists:

• Is the Royal College of Psychiatrists satisfied that mental health assessment by job coaches does not carry a risk of severe and complex mental health problems being mistaken for less serious problems resulting in incorrect referrals and failure to seek appropriate medical attention? This risk is surely particularly high given that the DWP and their contractors have become accustomed to minimizing the experience of mental distress for the purposes of denying social security entitlements.
• Is there a possibility that a physical health condition might underlie the mental health problem and could be missed by not seeing a GP?
• If people who are presumed to be well enough to see a job coach are fast tracked for treatment, does this mean that those with more serious conditions will drop down the queue? I would refer you to the case of Mr Julian Gaunt of Norfolk who took his own life last year. Link to news article https://www.edp24.co.uk/news/gaunt-inquest-norfolk-nsft-prevention-future-deaths-report-1-6025120 The senior coroner for Norfolk Jacqueline Lake said she was “particularly concerned by a statement from Michael Cummings, acute services manager at NSFT, who told the inquest that people with less serious problems could receive treatment from the county’s wellbeing service faster than those with more complex conditions.” Do you agree with a two-tier system where the provision of mental health treatment prioritizes those who are considered well enough to work over those who are unable to work?
• Job coaches are not deemed appropriately qualified to refer people with physical conditions directly to specialists without reference to a GP. Does allowing such unqualified people to assess claimants with mental health conditions suggest to you that the government has abandoned its commitment to achieving parity of esteem between physical and mental health conditions? If so, how will the Royal College of Psychiatrists respond to this?
• Does the Royal College of Psychiatrists consider the offices of job coaches, which are usually open plan, to be suitable places for mental health assessments?
• Will the results of these assessment be recorded in the person’s NHS medical records or in their DWP records?
• Given the punitive nature of the social security system, how readily do you think claimants will confide in job coaches?
• Finally, does the Royal College of Psychiatrists believe that psychiatrists’ collusion with the ‘work cure’ enhances the patient/clinician relationship?

We now readily accept same sex marriage which is evidence that public opinion and political ideas are subject to change. The Royal College of Psychiatrists has apologized for the harm caused to LGBT people by aversion therapy. When the hostile environment for disabled people comes to an end, and we are determined that it will, how long will we have to wait for an apology from the psychiatric profession for the role it has played in enabling DWP abuse of people in mental distress?

We call on the Royal College of Psychiatrists to recommend most strongly that where a job coach is concerned about the mental health of a Universal Credit claimant that they seek to persuade the claimant to make an urgent visit to their GP, and that you support the claimant getting the full benefits the claimant is entitled to, with no sanctions, as any cut in benefit could endanger the claimant’s mental health and even their lives.

 

Yours sincerely,

 

Mental Health Resistance Network

Disabled People Against Cuts

WinVisible (women with visible & invisible disabilities)

Recovery in the Bin

Black Triangle

Psychotherapists and Counsellors for Social Responsibility