The tragedy of Alice

How the Work Capability Assessment costs lives - its impact on people with mental health problems is more serious than Atos have acknowledged.

You probably won’t have heard much about the case of Alice (name changed). She’s a 33-year-old woman who lives in the West Country with her parents. She’s very poorly: she suffers from severe bipolar disorder, and has been sectioned on numerous occasions after harming herself.

In February last year, she received a letter from the outsourcing company Atos, which told her that she was about to lose her disability living allowance and would have to undergo an assessment before could receive employment support. Shortly after this, Alice was found by her mother in the bathroom. She'd slashed her throat in the bath. She was taken to hospital for treatment, and survived.

Alice’s community psychiatric nurse and a forensic psychologist contacted Atos, and told the company not to contact her directly again. The company agreed. The morning after she’d been released from hospital, she returned to find another letter concerning an appointment. She slashed her throat again, and was readmitted to hospital.

Alice’s mother got in touch with Bufferzone, a local benefit advice charity. They managed to restore her benefits without the need for further tribunals. But the last issue of Private Eye - thus far the only publication to have covered this story - carried a staggering update:

Last week, Atos wrote to Alice again. Fortunately the letter arrived while her condition was stable and she suffered no ill effects. Tony Lea of Bufferzone was again forced to take up her case. Atos told him the letter was computer-generated - and could not be stopped. Brilliant.

Perhaps, were it to concern another company, this ludicrous tale of cruel incompetence would be making more headlines. But the problem is, we’ve run out of ways of telling the story. Here’s a list of 30 similar tales where the outcome was worse: the victim died.

As John McDonnell MP has pointed out in Parliament:

The first [now second] example on the list was that of Paul Reekie. Some Members may have known Paul, an award-winning writer and poet in Leith, Scotland. He did not leave a suicide note, just two letters on the table beside him. One was about his loss of housing benefit and the other was about his loss of incapacity benefit.

 

Tony Lea, Alice’s advisor, has been working at the coal face for years. A garrulous, likeable man, (“Stop me if I’m going on: I’m just some bloke with a big mouth”) he set up Bufferzone six years ago, originally as an advocacy service for those suffering from mental illness. Its remit expanded - now he helps the homeless, alcoholics, those suffering from disability, victims of abuse, and other vulnerable. He’s got a whole load of stories, from meeting a mentally ill woman in the middle of a field at night with the police in tow because that was the only place she’d talk to him, to being attacked and having his car windscreen smashed. He’s seen it all: last year, on a budget of £16,000, which he secured from Lloyds TSB, the Co-Op, the Claire Milne Trust and Awards for All, he managed to support 187 people.

And one thing he’s sure of is that Alice’s case, though shocking, is hardly new. He wonders whether the rules should mean that a risk assessment has to be carried out before contact is made with people like her. “I was struck when I saw her in the ward,” he tells me. “I couldn’t believe how badly she’d damaged herself. But I’ve seen this sort of thing day in, day out. The simple fact is, the people behind the assessment don’t understand mental illness, nor do they understand invisible, fluctuating conditions like fibromyalgia or chronic fatigue syndrome. A question like “Can you switch off an alarm clock?” just doesn’t begin to cover these conditions or co-morbidity - the way that one affects the others. And they’re not just putting the lives of the mentally ill at risk - they’re putting the lives of the people with whom they could end up working at risk too.”

It’s not just the likes of Tony who have noticed this - or, here in more detail, charities like MIND. In January’s parliamentary debate, which I wrote about here, there was general condemnation of the Workplace Capability Assessment’s (WCA) performance when it comes to mental health. Michael Meacher said the “current criteria and descriptors do not sufficiently—or even at all—take into account fluctuating conditions, especially episodic mental health problems.” Pamela Nash described “Seeing people who have claimed employment and support allowance as a result of a physical disability or illness ending up with mental health problems owing to the stress of going through the system.”

Madeleine Moon described a female constituent, “Mrs E”, who had worked as an accounts officer, but suffered a vicious sexual assault which left her with post traumatic stress disorder. She went to an Atos assessment for Employment and Support Allowance, was found fit to work, and found herself in a similar situation to Alice, repeatedly having to attend appeal tribunals and having her payments stopped on several occasions due to “administrative errors,” the stress leading to a suicide attempt. She concluded: “This lady is being hounded by the state: there is no other way of describing it. There is no excuse for this behaviour. This is a company that is not playing fair by this country’s most vulnerable people.”

So what’s being done? The answer is detailed on Atos’s company blog: “We have put in place a network of Mental Function Champions to spread best practice across the business and offer advice and coaching to other professionals carrying out WCAs. We invited leading external experts in mental health to help us shape the role for the Mental Function Champions, and we now have 60 Champions.” As Heather Wheeler MP made clear, not only are these “champions” only giving guidance (they won’t be sitting in on interviews), but given the WCA’s lack of suitability to deal with the issue of mental health, it’s patently clear that 60 is not enough of them.

And more to the point, what do they really do? The journalist Kate Belgrave has been monitoring the development closely and has recently written this excellent blog post on the lies, prevarication and lack of transparency that has characterised the initiative (as she told me on the phone last night: “At one point, we started to wonder if these people even existed”). Since that blog was published Atos has told her group that a face-to-face meeting is possible, but it would have to be off the record. They are waiting to find out if they’ll be able to report on any discussion.

Flawed, secretive and cruel: it’s the very worst of the shadow state. Or, as John McDonnell MP put it:

The concern expressed by Members about an issue of public administration in all [these stories] is unprecedented in recent decades. There is example after example of human suffering on a scale unacceptable in a civilised society.

 

 

Protesters carry placards during a protest against Atos in London in August 2012. Photograph: Getty Images

Alan White's work has appeared in the Observer, Times, Private Eye, The National and the TLS. As John Heale, he is the author of One Blood: Inside Britain's Gang Culture.

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Donald Trump vs Barack Obama: How the inauguration speeches compared

We compared the two presidents on trade, foreign affairs and climate change – so you (really, really) don't have to.

After watching Donald Trump's inaugural address, what better way to get rid of the last few dregs of hope than by comparing what he said with Barack Obama's address from 2009? 

Both thanked the previous President, with Trump calling the Obamas "magnificent", and pledged to reform Washington, but the comparison ended there. 

Here is what each of them said: 

On American jobs

Obama:

The state of our economy calls for action, bold and swift.  And we will act, not only to create new jobs, but to lay a new foundation for growth.  We will build the roads and bridges, the electric grids and digital lines that feed our commerce and bind us together.  We'll restore science to its rightful place, and wield technology's wonders to raise health care's quality and lower its cost.  We will harness the sun and the winds and the soil to fuel our cars and run our factories.  And we will transform our schools and colleges and universities to meet the demands of a new age.

Trump:

For many decades we've enriched foreign industry at the expense of American industry, subsidized the armies of other countries while allowing for the very sad depletion of our military.

One by one, the factories shuttered and left our shores with not even a thought about the millions and millions of American workers that were left behind.

Obama had a plan for growth. Trump just blames the rest of the world...

On global warming

Obama:

With old friends and former foes, we'll work tirelessly to lessen the nuclear threat, and roll back the specter of a warming planet.

Trump:

On the Middle East:

Obama:

To the Muslim world, we seek a new way forward, based on mutual interest and mutual respect. To those leaders around the globe who seek to sow conflict, or blame their society's ills on the West, know that your people will judge you on what you can build, not what you destroy. 

Trump:

We will re-enforce old alliances and form new ones and unite the civilized world against radical Islamic terrorism, which we will eradicate completely from the face of the earth.

On “greatness”

Obama:

In reaffirming the greatness of our nation we understand that greatness is never a given. It must be earned.

Trump:

America will start winning again, winning like never before.

 

On trade

Obama:

This is the journey we continue today.  We remain the most prosperous, powerful nation on Earth.  Our workers are no less productive than when this crisis began.  Our minds are no less inventive, our goods and services no less needed than they were last week, or last month, or last year.  Our capacity remains undiminished.  

Trump:

We must protect our borders from the ravages of other countries making our product, stealing our companies and destroying our jobs.

Protection will lead to great prosperity and strength. I will fight for you with every breath in my body, and I will never ever let you down.

Stephanie Boland is digital assistant at the New Statesman. She tweets at @stephanieboland