Has the government got it right on PIP and mental health?
Since coming to power the Prime Minister has made mental health a priority for her government. Seeing mental health move up the political agenda is hugely positive but a recent change to benefit rules puts some of this progress in jeopardy. Last week the government tightened rules on disability benefits in response to two legal judgements, including one which was set to confirm eligibility for Personal Independence Payment (PIP) for 159,500 people with mental health problems. Two of the claimants in this decision were represented by Citizens Advice Sheffield.
PIP is the single biggest enquiry area across our network of Citizens Advice offices. Disabled people and those with long-term health conditions make up 31% of the those we advise and mental health is the most common health problem affecting our clients. As PIP continues to roll out across the country we have seen a 37% annual increase in the number of PIP issues we are helping with. Last quarter we advised over 50,000 people on PIP, ensuring they get the amount of benefit they are eligible for. We helped over a third of these clients with challenges and appeals as the assessment of need doesn’t always get it right first time.
Personal Independence Payment is awarded to claimants based on ability to carry out a list of indicative day-to-day activities such as preparing food or getting dressed. For each of these activities you score zero points if you can complete it unaided and more points for higher levels of need. The descriptors and points for ‘planning and following a journey’ are:
A. Can plan and follow the route of a journey unaided. 0 points
B. Needs prompting to be able to undertake any journey to avoid overwhelming psychological distress to the claimant. 4 points
C. Cannot plan the route of a journey. 8 points
D. Cannot follow the route of an unfamiliar journey without another person, assistance dog or orientation aid. 10 points
E. Cannot undertake any journey because it would cause overwhelming psychological distress to the claimant. 10 points
F. Cannot follow the route of a familiar journey without another person, an assistance dog or an orientation aid. 12 points
Descriptors B and E refer to ‘overwhelming psychological distress’ as the underlying cause for difficulties with planning and following a journey. A panel of judges has confirmed that a claimant affected by this level of mental health problem could also satisfy the higher scoring descriptors. The government disagrees and argues that these higher scoring descriptors should be reserved for those with physical or cognitive impairments only.
Case study: Janice has complex mental health problems including agoraphobia, anxiety and panic attacks. She cannot undertake a familiar journey without supervision and cannot enter unfamiliar buildings. She applied for PIP and was assessed at home. The assessor awarded her zero points for mobility so she came to Citizens Advice for help. Janice requested a reconsideration and was awarded 10 points under the ‘Planning and Following a Journey’ section. Janice feels that she should score 12 points as she needs supervision to follow familiar journeys. These two additional points would take her award from £21.80 per week to £57.45 per week. The situation has had a negative impact on her mental health causing her to feel increasingly stressed, anxious and worried.
PIP was designed to treat mental health problems on a more equal footing than Disability Living Allowance (DLA), the benefit it replaced. There has been progress here — over two thirds of PIP claimants with mental health conditions get the higher Daily Living award compared to 22% under DLA. However, this judgement and the Government’s subsequent change to the law have exposed where parity has not been achieved yet. The types of condition, mental health related or otherwise, are not central to how points are awarded for other activities. Instead — in line with the principles behind the design of PIP — the focus is on the impact of the claimant’s impairment or health condition. People with mental health problems, however, are eligible for fewer points if they need help to plan and follow a journey, than those with other conditions.
The Prime Minister recently set out her ambitions for reforming mental health support and achieving parity between mental health and other conditions. Through the advice we provide, we know that people with mental health conditions are more likely to face problems with finances, housing, welfare and employment. For many of these people, having a secure income from PIP means that they can cover the extra costs relating to their health condition. Problems with this benefit can cause considerable hardship for people.
The government is also currently in the process of consulting on how it can support more disabled people and those with health conditions to move into employment and sustain employment if they are working. There has been a focus on reforming Employment Support Allowance (ESA) in this conversation but it is important to consider PIP and the role it plays. As it is not exclusively an out-of-work benefit, PIP provides support to working people. Without this source of secure income many with mental health problems would experience financial problems and related issues which make it more difficult to focus on moving towards employment or maintaining their job.
The government needs to ensure that policy decisions it takes are aligned with its overall strategies in areas like mental health and the disability employment gap. Decisions like this one on PIP and the upcoming £30 a week cut to disability benefits for ESA-WRAG claimants can pull in the opposite direction to these objectives.
The government should look again at how mental health is treated under the mobility component of PIP to ensure it is aligned with its wider ambitions on mental health and halving the disability employment gap. It is important, as we set out plans to improve the mental health of our country and to halve the disability employment gap, that mental health conditions are treated with parity to physical conditions across our public services.
