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Completing PIP form re.mental health

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5 years 11 months ago #210286 by craigd
Completing PIP form re.mental health was created by craigd
Hi

First of all manynthanks to all involved in compiling the PIP information leaflet. It really has been invaluable in comprehending the entire process and has certainly been illuminating with regards to how to approach completing the form. With that in mind I have a couple of questions with regards to establishing the need for supervision.

Just to quickly outline our situation:

I’m the full time carer of my pertner who has Paranoid Schizophrenia. She has had this diagnoses since around 1994 and over the intervening years has struggled enormously with the symptoms of this condition. She has been sectioned on several occasions, spending months in psychiatric care. She has made innumerable attempts at suicide, has repeatedly self harmed and at points proved a danger to medical staff. Over the course of many years and with full intervention of the mental health services she has eventually been able to establish a stable daily living pattern and a relative situation of independence. However this is dependent on her having full control of her social and domestic arrangements, where any changes need to be discussed and negotiated to her satisfaction. At present she experiences bouts of depression, anxiety, chronic insomnia and fleeting psychotic symptoms. She has excellent insight into her condition and employs CBT to manage her daily symptoms. Her condition is relapsing and remitting, at present she is in a period of remission and if you met her you probably wouldn’t assume any of the above.She takes a high end dose of Quetiapine and has extra anti psychotic and benzodiazepines as and when required. In the last year she has accessed extra medication for worsening symptoms on 10 or so occasions (on average once every 6 weeks).Her consultant psychiatrist has provided a detailed letter supporting this situation.

From having read your advice leaflet it is my understanding that I may be able to establish that she has a need for constant supervision. My reasoning for this is based around the tribunal ruling which held that consideration needs to be given to the severity of the risk rather than the probability. As I see it, when applying this definition, my partner is at risk from self harm in a multitude of various ways, the fact that the likelihood of this is small at present due to her remission would be over ruled by the fact that even though small, the risk of self harm still exists and the severity of that is extreme. I have plenty of documented historical evidence from health professionals to support this but none of them are from the last year or so. Would I be right in assuming that although she has not attempted self harm in this period, although she has considered it, that the risk still exists with regards to the definition described by the tribunal?

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5 years 11 months ago #210305 by Gordon
Replied by Gordon on topic Completing PIP form re.mental health
Craig

I'm afraid PIP has no concept of constant supervision so you cannot score for this. Any need for supervision must be linked to the PIP activities and specifically to those that have a Descriptor that includes supervision.

If there are no examples of self-harm in the last year or so, then I think that the panel will consider the risk to be quite low reducing the likelihood that she will score.

Gordon

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5 years 11 months ago #210322 by craigd
Replied by craigd on topic Completing PIP form re.mental health
Hi Gordon and thanks for the reply.

Apologies for the reference to constant supervision, I know that it only applies in certain questions, I guess I was just over generalising.

Sorry to,persist with the same line but I’m pretty confused now. Does there have to be actual documented self harm for my partner to require supervision? Our situation at present is that I monitor my partners behaviour and intervene when I suspect that she is moving towards relapse. This intervention takes the form of asking how she is feeling on a scale of 1 to 10, if she is experiencing any form of command hallucination, if she has any ideation of suicide or self harm, does she feel that she may act upon this ideation and what may be the appropriate course of action resulting from this Discussion. In this way we have managed to control any actual suicide attempts or acts of self harm. There have been numerous occasions over the last year where this intervention has occurred. The course of action she has generally taken is to order a prescription of extra medication and for us to closely monitor how she responds to this. This course of action has been set out in her care plan agreed with her consultant. I can obtain documentary evidence that she has received this extra medication and that it is for these circumstances. It was my thinking that even though she has not self harmed that without my supervision there would be a much greater chance that she would. Sorry if I’m coming across as being argumentative I’m just really concerned that my partner is going to be penalised because she’s avoided acting on her impulses

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5 years 11 months ago - 5 years 11 months ago #210324 by Gordon
Replied by Gordon on topic Completing PIP form re.mental health
Craig

If the supervision that she currently receives prevents an act of self-harm then you can make this argument although I think you will need to explain this in detail, however, unless the self-harm is associated with a PIP activity then I would not expect her to score.

So as an example; if they are about to cook a meal and is clear that their being near to knives may lead to an incident, then this would be relevant to PIP, but if you thought she was struggling in the middle of the afternoon, then it would not.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 5 years 11 months ago by Gordon.

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5 years 11 months ago #210329 by craigd
Replied by craigd on topic Completing PIP form re.mental health
Ah, I think I’m beginning to see how this applies. Sorry yes of course it must be applied to the context of each question. I was getting caught up in trying to establish an overall need for supervision which as you say won’t really get me anywhere.

So in the context of going out etc it could be argued that my partner will require me to keep her safe etc. She has in the past attempted to step out into traffic and often thinks that road signs and advertisements contain messages specifically directed at her, which can obviously be pretty confusing. This type of ideation can and often does materialise quite suddenly. This is a bit of a hypothetical question as she often doesn’t leave the house for days at time.

However I’m still confused. In the advice leaflet it talks of tribunal rulings where a person suffering from epilepsy was considered to require supervision because they could have seizure at any given time. Is this because of the nature of epilepsy, where a seizure can occur at any given moment?

Also in the advice it states that the guidance for the DWP is that if a descriptor applies at any point during a 24 hour period then it is deemed to apply for the whole day. In the example you give of preparing food you say that if my partner was struggling in the afternoon then she would score no points for needing supervision to prepare a meal in the evening. I’m confused by this as it seems contradictory

If so could it not be argued that a person suffering from suicidal ideation would require the same level of supervision as they could act upon that at any given moment?

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5 years 11 months ago #210344 by Gordon
Replied by Gordon on topic Completing PIP form re.mental health
Craig

Your example for Going Out is good but it must be presented in the context to the Descriptors for that activity. So Descriptors (d) and (f) are all about following a route, you need to show that her problems prevent her from doing this reliably and on the majority of days. See the PIP guide for more information about these terms.

Be aware. problems with leaving the house are mutually exclusive with problems following a route, you may want to describe her problems with doing both of these but ultimately she can only score for one or the other.

Yes, epilepsy can present a daily/hourly risk, some sufferers get no warning of an attack and therefore cannot take any action to avoid harm.

My use of "afternoon" was simply to illustrate the difference between a situation that was relevant to the PIP activities and one that was not. However, you need to apply context to the activities, any time in the day is not as simple as it sounds.

So as an example, someone with severe pain when they wake up may be unable to do anything until their pain killers have taken effect several hours later, it is reasonable to argue that dressing is an activity that would be done shortly after rising in the morning and that their pain would prevent them from doing this, but the same argument would be unlikely to apply to preparing a meal as this could be done later in the day when the pain killers had taken effect.

Gordon

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