Some Symptoms of Mental Illness that might relate to the ESA50

1. Some Symptoms of Mental Illness that might relate to the ESA50 Assaulted member of public on bus (2-17 a or b or c) Has large debts (2-13- a or b or c) Screaming and Shouting abuse in public (2-17 a or b or c) (3-14) Locked self in home and discovered in a dehydrated state (3-10-a) (EC?) Found walking in the middle of a busy road (2-12-a(i)) (3-10-a) No social contacts (2-16-a) (3-13) Disengagement with family members (2-16-a) (3-13) Physically abusive to mother (2-17-a or b or c) (3-14) Home untidy and cluttered (2-13-a)

2. Symptoms continued Can’t cope with letters and bills through the post; often ignores them ((2-13-a) Voices on a daily basis; set fire to home as ordered to by Guy Fawkes (2-12-a(i)) (3-10)(EC) (2-16-a) Threatened father with a knife (2-17-a or b or c) (3-14?) (EC?) Untidy unhygienic house (2-13-a) Two assaults on the police (2-17-a or b or c) (3-14?) Isolated (3-13) (2-16 a or b or c) When I was found fit for work he was upset and angry. He was arrested for assault to a bus driver (2-17 (3-14) (EC)

3. Symptoms continued Neglects self-care (2-13 a or b or c) Chaotic (EC?) (2-13 a or b or c) (3-14 a or b or c) Depressive episodes (EC?) (???) Negative thinking about his future (EC?) (???) Preoccupied about what others think of him (EC?) (???) Suicidal behaviour (3-10-a) (EC?) Easily discouraged when faced with challenges (2-13 a or b or c) Physical appearance is neglected (2-13 a or b or c)

4. Medication and side effects • Many of the medication used in treatment of mental health issues can cause unwanted side effect including: • Tremors ranging from mild to profound shaking of hands, jaw neck, restless legs • Anti psychotic Ant Depressants and Anxiolytic (Anti Anxiety) • Drowsiness and over sedation is also an important symptom that should be considered in other aspects of the physical descriptors

5. Sch 2 descriptor 12 - Awareness of everyday hazards There are many times when Ms. S is in a state of confusion. She is a danger to herself and, for example, has been found walking in the middle of a busy road. But for the timely intervention of a passerby, I dread to imagine the possible consequences. Mr. B experiences voices on a daily basis; these make commands on him and he had set fire to home, being ordered to do so by Guy Fawkes. Mr. H frequently experiences delusional and grandiose thinking. At these times he has been known to stand on the parapet of high buildings, thinking he can fly. N.B. All of the above Satisfied Schedule 3 part 10 (a) - Support Group

6. Schedule 2 descriptor 13 – Initiating and completing personal action My life is chaotic and I loads of problems with my day to day tasks. I am so lethargic that I rarely, if ever bother to open envelopes or pay bills. I’m in loads of debt with water and gas and stuff. I owe that much rent that my Landlord is telling me to pay up or I’ll be out. The debt is making me more ill and I’m more nervous everyday. I’m so confused and forgetful it means that I take too many pills or none at all. My CPN helps me take the right amount when I should. My Landlord has threatened to evict me if I don’t tidy up my flat. It’s got so bad that I can’t face it. I know I shouldn’t have let it get so bad but things just seem to get on top of me. My family and friends are always on at me about how I don’t look after myself properly. I know I should take better care of myself but I can’t be bothered. My washing machine is broke but I can’t be bothered getting it fixed. N.B. All of the above responses satisfied Part 11 of Schedule 3 and claimants were placed in a Support Group.

7. Sch 2 descriptor 14 – Coping with change. This is not easy to describe. I think a better way of addressing this is to say that my life is so chaotic that I have nothing to change as I have no schedule as such. I do not cope with life generally, so I suppose it would be fair to say that as change is part of life then I do not cope with it. One of the things that really gets me down is the constant changing of my Care Coordinator. I just get used to someone and somebody changes them. It then takes ages and ages to get to know the new one and sometimes I don’t like them. This gets me more nervous and didn’t let the new one in to give me my Depot injection last week. N.B. Both of the above claimants satisfied part 12 of Schedule 3 and were placed in a support group.

8. Sch 2 descriptor 15 – Getting about I hate travelling on public transport. It’s not that I’m scared of crowds, it’s more that I think they’re talking about me and It’s all I can do to stop me attacking them. Las Thursday I got off the tram two stops before I should have as I could feel my stomach churning and the anger building up as the laughing of the three girls behind me started to get to me. I wanted to stop them but I walked away. My friend took me in his car to see the Christmas lights being turned in Manchester last week. We didn’t even get out of the car. He saw that I had started to pull frantically at my collar and the beads of sweat appear on my forehead as I saw the crowds and turned the car around and took me home

9. Sch 2 descriptor 16 – Coping with social engagement • I sit alone in my home and choose not to go out. Since the trauma of the attack on me, I have been too afraid to see or speak to other people. Things are so bad I even discourage my family from visiting. I do not answer the door to anyone and my Social Worker has to ring ahead to give the time that they will visit. If they do not, they know that I will not come to the door. My mum tells me to pull myself together and that I am imagining things. • My self-esteem is rock bottom and I cannot bear the thought of the certain judgement of others judgments that will hold me in negative ways. I always think the worst of me and do not get on well with people at all. • N.B. The above claimants satisfied part 13 to Schedule 3 and were placed in a support group.

10. Sch 2 descriptor 17 – Appropriateness of behaviour with other people due to…mental disorder Since I became ill I have lost what few friends I had. It is not uncommon to find me screaming and shouting abuse in public to people I do not know. I have a terrible temper. Only last week I walked up to a bloke and slapped him across the face for no reason; I just couldn’t stop myself. Mum and dad have stopped coming round as they are sick of and, I think, afraid of me. I have punched my mum in the face blacking her eyes and even threatened my dad with a knife. The last time I got one of these forms they found me fit for work. I was so angry and upset I didn’t know what to do and was arrested for assaulting a bus driver. N.B. The first two of the above satisfied part 14 to Schedule 3 and were placed in a support group. The last one won an appeal in exceptional circumstances

11. Where might these be placed? I hear voices on a daily basis - Brittle in manner - Noncompliant with medication Delusional - thinks she is wife of President Bush - Tried to buy £40,000 sports car - States that she communicates telepathically - Mood fluctuation - Excessively happy inability to sleep - Buzzy feeling in head - Delusional and grandiose thinking - Paranoia about gangsters - No structure to her day so uses illicit substances for “something to do” - Three children in care (Is this relevant?) – Evicted from former home for anti-social behaviour (Is this relevant?) – Tearful – No sleep pattern – No appetite (3 – 15 – (c) or D(ii)?)

12. Outcomes • Medical Services telephoned the above claimants’ Care Coordinators and asked them a few questions about their clients such as their professional opinion on: • General information about mental health • Diagnosis • Medication • The CPNs say that the telephone calls were easy-going, appeared not to be scripted and were helpful. They were ended by the Medical Services person by them saying that claimant would not be sent for a medical and would not need to go to the Jobcentre for appointments.

13. Outcomes continued Another claimant didn’t tell us that he had received two ESA50s to complete and that he had not completed either. He was awarded 0 points following his first medical and 9points following his second. We represented at the appeals. His first was allowed on exceptional circumstances (Claimant was in prison being found guilty of assault). His second appeal achieved 15points but the representative did not pursue placement into a support group via Schedule 3.