To be really cross about the proposed cuts?

[Byjimminy]

And feel really effing sorry for those with genuine anxiety and depression - it is disabling!

Already seeing threads in MH with people despairing in anticipation of cuts. As if mental health services haven't already been decimated beyond recognition already. GP appointments as rare as hen's teeth, CAMHS and access to decent therapy is next to non-existent, the conservatiives slashed all the support workers and sure start centres and we've had the worst pandemic in decades (centuries?) - long covid is thing too! And now people are just self diagnosing/making up mental health issues? How the hell anyone believes anyone manages to claim PIP without a proper diagnosis is insanity itself.

I completely agree with this article: https://www.independent.co.uk/voices/wes-streeting-overdiagnosis-mental-health-adhd-b2716618.html

I know there will be umpteen threads on this already, but maybe some others like me just want to let stuff out in frustration and have a fresh place to say it. To think this is a labour government making these decisions BEFORE putting the services in place to actually help and treat people is beyond comprehension.

In physical health services nobody expects doctors who have ran out of evidence-based NICE-recommended treatments to start going off piste and experiment. But that's exactly what is expected of mental health service clinicians.

I agree, part of the problem though is that NICE have a pretty tight criteria of what constitutes an evidence base. Most therapeutic processes don’t lend themselves to randomised controlled trials, because you can’t recreate therapeutic relationships exactly and research shows that the relationship is the biggest determinant of effective therapy. It means that therapies that are effective aren’t offered because there’s not a clinical evidence base. It’s under because finite NHS resources need to be carefully allocated but it means the NHS offering is limited.

The approach to trauma is a good example in that the NHS offering is fairly limited compared to the US where research isn’t quite so limited.

I'm curious, in the UK the evidence-based treatments for PTSD (not 'trauma' because that in itself isn't a medical diagnosis, it's an event that deeply impacts someone, which can go on to lead to PTSD) are Cognitive Processing Therapy (Resick), Prolonged Exposure Therapy (Foa and Rothbaum), Cognitive Therapy for PTSD (Ehlers and Clark), EMDR, and Narrative Exposure Therapy (Schauer, Neuner and Elbert). It's pretty great tbh that there are several different options. What extra is available in the US?

I wish there was a thread that people worried about the cuts could let out their frustration without being jumped on all the time and told they are faking, or that my relative has the same thing and works 70 hours, why cant you, sort of thing.
Many people on this thread and others have had to justify their disabilities and existence to total strangers. That is not acceptable.
Who sits at home and sees a post from someone expressing distress about the cuts and thinks it is a good idea to make them feel more useless and crap?

For balance. Whenever I hear a ‘going on fancy holidays and claim benefits’ story I always think of my Aunt. She had multiple and complex disabilities for decades and claimed not a penny because of the stigma she felt about it. I also think about my work colleague who doesn’t claim, and battles on because she feels she can’t give in and be left vulnerable to cuts. And my friend who is trying to help her daughter claim but is struggling with the system as well as dealing with multiple other family issues and health problems.

All those benefits that people should be entitled to but are left unclaimed. I wonder what that adds up to? I bet it’s more than a couple of holidays.

You are absolutely right.

That’s why I left the private school VAT threads. There was always someone running in and gloating.

There should be some safe threads on here.

Likewise, there was an article in the BMJ in February, talking about the health inequalities in the most deprived areas of the North, after the mass redundancies of the 80s, where men’s life expectancy is 12 years less than some other areas. If the government removed those area’s health inequalities, those people could contribute another £12 - £13 billion to the economy. We don’t hear the government admitting it’s not the fault of the people in the deprived areas, their communities were destroyed by Thatcher’s political decisions to break the power of the unions, like the coal miners; and it still impacts on their health today?

OMG! This was 40 years ago, two new generations since then! why don't you blame damages caused by WWI?? Some people get on small boats in search of better life and a society we hate them, millions world wide uproot and move to other countries in a much more civilised way but still in search of better life, but these people are still destroyed by mines closure? did they try to do anything about their lives?

I’ve suffered with my MH for my whole life. I had an NHS assessment in my early twenties but they couldn’t help as apparently my depression ‘wasn’t bad enough’. I wasn’t in a position to pay for private therapy.

My point is that I couldn’t get mental health support twenty years ago, so has it really got worse, or has it always been awful?

Things have moved on quite a bit since 20 years ago! I work in mental health.

OMG! This was 40 years ago, two new generations since then! why don't you blame damages caused by WWI??

Not me, the BMJ!

@BlueandWhitePorcelain

Honestly it has never crossed our minds to claim benefits. That doesn’t mean that we are not badly affected at times. But we do have well paid jobs and are very good at them. DH has had suicidal thoughts on 4 occasions, but with my support and medication got through it.
My eldest doesn’t want to seek a diagnosis - says they are just them. We constantly push them to face their fears, but I know their future earning potential will be limited by their condition. But we support and hope they will achieve their potential - whatever that may be. They are affected in a very different way to myself and so couldn’t do the job I do.

I incur additional weekly costs due to my condition for:

• having a cleaner (I’m inefficient and disorganised at home),
• a daily dog walker (I work long hours as inefficient),
• higher cost of shopping (I shop online as I got overwhelmed in large supermarkets and Aldi/Lidl don’t do on-line)
• I struggle on the tube so take Ubers (due to anxiety in close shared spaces I sweat profusely)
• and probably most expensive of all I struggle to manage finances and plan ahead, meaning i have little savings and I pay more for things such as holidays …

OP I’ll leave this thread now. I did not intend to upset you. We just have very different points of view of what is an exceptional difficult challenge facing the British government. There is simply not enough money to go around to support people as they currently are.

@Pandersmum you haven't upset me that Im aware of. I appreciate your concern and that people can hold different opinions, and that's okay. Tbh I'm only just catching up with the thread after a busy day. It's not an easy topic but am grateful to hear others views and experiences, even if we disagree - we all grow and learn from that. I could explain a lot more about how I've formulated my views from my own experiences and that of those around me, which is actually pretty extensive, but sadly way more identifying than I'm comfortable with, and that's a frustrating thing. Mh is a very personal matter and probably means different things to different people. But I've seen minor illness develop into full blown debilitating conditions due to lack of appropriate services and support. The direction we're taking scares me.

It's interesting the post upthread around the tick box forms that seem to be a key issue and perhaps taken advantage of more than I was aware. Maybe I've been exceptionally lucky with the Drs I've seen over the years, who have only ever taken time to talk things over and get a clear picture of how to help me best back to work. Perhaps that's what's missing? Human to human conversations, people feeling like others have got time to listen and that there is support that can be put in place, rather than tick boxes, AI and waiting lists.

Just wanting to leave this here for anyone affected/interested particularly around PTSD to add their support.

https://www.ptsduk.org/benefit-changes-template-letter

Cognitive Processing Therapy (Resick), Prolonged Exposure Therapy (Foa and Rothbaum), Cognitive Therapy for PTSD (Ehlers and Clark), EMDR, and Narrative Exposure Therapy (Schauer, Neuner and Elbert). It's pretty great tbh that there are several different options. What extra is available in the US?

Offerings in the US would include psychodynamic therapies, personal centred therapy, neuro feedback, embodied therapies.

The way they speak about trauma work is completely different with none of the infighting around modalities that you find in the UK. They are both more relaxed about therapeutic approaches and more prepared to be innovative - the difference in funding models mean they are less tied to a fairly narrow set of clinical approaches and tend towards relational therapies particularly for CPTSD.

You’ve listed 5 types of therapy, skewed towards cognitive processing which isn’t a huge amount of variety.

I wonder if the PP is referring to trauma more generally, rather than PTSD specifically?
To receive a PTSD diagnosis the trauma has to be of a specific type - it's not done on symptoms alone. There is better recognition of complex trauma and the huge part trauma plays in many mental health problems, but presumably only an actual PTSD diagnosis qualifies one for the therapies you mention?

I was out of work for a long time (and unable to hold down a job for long before that) due to a mix of trauma and autism. As I have managed to heal from the trauma I have been amazed as that was the real disabling thing, not my autism per se. But although I had typical trauma symptoms these were not recognised by the MH system, let alone diagnosed as such, as the traumatic events didn't fit the bill for a PTSD diagnosis.

There's a school of thought that suggests some symptoms/traits of autism may in fact be trauma symptoms (or at least "trauma+autism"), but it's so common for autistic people to be traumatised that it's just seen as part of autism.

Although trauma is becoming better recognised, support is still very patchy on the NHS. Many need long-term trauma informed therapy, especially for more complex trauma (which the short-term (and cheaper) therapies like cbt are not suitable for) and that just isn't available on NHS, leaving people to self fund long term. That's one area definitely that PIP cuts will have impact, with knock on effects.

I believe they are. Counselling/therapy for someone who has experienced trauma is a very different thing to therapy which is treating PTSD. Person-centred counselling has never been an evidence-based treatment for symptoms of PTSD. Personally I prefer that the UK is cautious around only delivering evidence-based and effective treatments, especially as the NHS has a duty to deliver the best care possible with the resources available. If someone wants to pay privately they can access anything they can find. And unscrupulous therapists will sometimes take the money, or be unable to recognise they'd be working outside their scope of practice.

Person-centred counselling has never been an evidence-based treatment for symptoms of PTSD.

Nottingham university have established an evidence base for person centred therapy working with trauma, Stephen Joseph and David Murphy have been working on it for at least the last decade.

That's really helpful to know thanks @Jellycatspyjamas.

Better than being cut by £47/week simply because unlucky enough to be sick or disabled or both.

Work is often bad for MH. The correlation between good MH and being able to work is you need a minimum level of good MH to be able to work. If you don’t have that minimum level, then work is bad for your MH.

I think that should be looked at. Most of those affected by the green paper would also have not gotten the £25/week extra UC given to new UC claimants during COVID either.

I also think it is disgraceful that MPs have given themselves a £20k/yr salary rise over the past 5 years. Everything for the poor is unaffordable, but pay rises, expense accounts, free second home, free utilities for MPs never seems to be unaffordable.

GPs can’t diagnose the actual MH disorders though. They can only diagnose psychiatric symptoms- things like anxiety or depression or trauma and if the symptoms of depression, anxiety, trauma appear to be more than mild, they then have to refer you to MH for assessment.
They can’t diagnose Major Depressive Disorder, Psychotic Depression, or PTSD, or Schizophrenia, or OCD, etc. They have to refer for a psychiatric assessment by a consultant.

So, the “over diagnosis” of actual MH disorders is not a thing. And the fact you feel the GP was incorrect in identifying your bereavement as depression means that your symptoms were mild enough to not meet the threshold for referral to MH.

People really need to stop thinking they know about MH Disorders because they’ve experienced one mild symptom of one disorder.

https://www.standard.co.uk/comment/personal-independence-payments-labour-disability-cuts-b1218462.html

Powerful statement from the Chair of Scope, who risks losing his position in doing so.

Thank you. You worded this better than I could. Work made me ill. Not working is how I stay safe and stable.
You can be too ill to work, or be someone where work makes you ill.

You do realise MPs pay is utterly meaningless if we take a look at public spending. The size of MPs pay, expenses etc is so ridiculous tiny in comparison to e.g. the schools budget, and yet we have people harping on about MPs pay. They’re paid about the same as a qualified accountant with a few years experience for a job that is massive. There is no way I’d be an MP, and the terrible pay is a large part of that.