Monday 28 August 2017

Diagnosis

It occurred to me, on the way back from Tesco earlier (always fun), that the notion of mental health diagnosis is completely wrong. Or at least inflexible.

As those who follow this blog may recall, I've been chasing an ASD (autism spectrum disorder) for several years; specifically in regards to Aspergers syndrome.

My diagnosis was based on a mode selected by the diagnostic team with a binary outcome: either I 'pass' or 'fail'. That is to say: either I meet their criteria, or I don't. I didn't and so they dismissed me as being 'ok' and leaving me to the tender mercies of societal expectations and norms. Something that I (and one of the reasons for seeking a diagnosis) find difficult.

This binary approach seems to me incredibly flawed. It does nothing to address the reality of the patients experience - even if we consider whether or not that experience is 'real'. What does it even mean for an experience of mental health to be real? If I feel that I struggle with ASD-like symptoms - regardless of the specific condition - then surely that is enough?

But the diagnostic process doesn't address that. It simply measures patient responses to a series of situations or questions. In my case I maintain those questions were based on tools suited for childhood diagnosis. In fact I was told that, without corroborating evidence from my childhood, I couldn't expect to secure a diagnosis. It didn't help that, when I questioned this, as I have consistently to anyone that'll listen (including YOU!), I was told it wouldn't have mattered either way - so they'd decided against me either way.

They were not prepared to consider maybe a different cognitive model might fit. They didn't take into account issues of anxiety or depression. In fact the presence of such conditions - a credible consequence of being someone trying to live in our society with something like an ASD - inhibits the process. I don't really know why, since I see no connection between the conditions in terms of teasing out a diagnosis. But even if they accept the presence of such conditions, receiving a negative diagnosis still doesn't concern them enough to do...something.

So my question: why can they not grant me a diagnosis even if doing so doesn't fit their model? I need to be able to live in this society. I need the protection (however toothless that might be) that a recognised official diagnosis can provide. Surely it is no different that expecting a disabled driver to present a blue badge in order to use a specific parking bay? Ok maybe that's an egregious example, but the point is made I think.

As I've said before, we do not have a holistic all encompassing approach to mental health that treats it as part of someones entire life. Not just a singular aspect they are to effectively ignore and cope in spite of. This is the model of health espoused by the DWP and in my view, certainly int he context of mental health, it is destructive.

Surely part of supporting people is to accept what they say as true - within reason. That must mean that, even if I don't fit a particular diagnostic model, the weight of circumstantial evidence, surely must entail some sort of recognition. But that recognition is too specific and granted only in highly specific, stingy, circumstances.

I've spoken to many people when explaining these problems, be they doctors, counsellors, or people from the various social enterprises I've engaged with. Even including a DWP Work Psychologist (with psychology credentials, though I STILL have no idea what Work Psychologists are meant to do in the system). All of them have recognised or agreed that something is there; that, within my cognitive makeup, there is something that isn't 'normal'. This is important. But the diagnostic process will not recognise this and, to the point of my writing this, isn't interested in granting in anyway.

This is a problem because it shuts down the possibility of investigation and support or, where necessary, treatment - whatever that may encompass. Obviously there's no cure for being neuro diverse, but without a recognised label dealing with the likes of a WCA become that much harder.

And I bet I'm not alone in thinking this. I hope I was clear today: I think granting the person, within reason, a diagnosis, even in lieu of meeting all formal criteria, is a necessary part of the support and healing process. It is no different than the problem with DWP WCA tests that, if you fail, just abandon you as soon as you do. If you fail that test, you're cut off and left to your own devices with the stroke of a pen.

Saturday 26 August 2017

The New Support...Same As the Old?

So I've taken up with a new social enterprise; they are called Team North Somerset (or something - it's hard differentiating actual names from buzzwords and slogans). They get lottery funding until the end of 2019 (Brexit? Coincidence?) with which to help.

And to be fair, so far, they seem pretty decent. I'm not going to lie - they are certainly a vast improvement over previous agencies. I think that's because it doesn't come with a DWP pricetag. So far they are not holding my ESA to ransom, unfortunately the government are.

I should caveat that this could change at any moment. It's been my experience with these agencies that, at first they are willing to put you at ease. But later on they stop caring. Again this might be because of the connection of these groups to the DWP and a payment by results motif. But one must always be guarded dealing with these groups. That's unfortunate, but necessary.

However the fundamental, structural, issues remain: this group, like all the others, doesn't have the power to change the systems that govern us. While my adviser, who seems perfectly friendly and willing to help, says they can help, if I lose my ESA - which is likely - they aren't going to be able to do much. They certainly won't be in a position to put food on my table.

While they may agree that the system is shit, and they may shake my head at the nonsense, they aren't doing anything to change that. I don't even know what they can do. It might seem unfair to hold them to that standard, but I believe if you're operating a these kinds of social enterprises then you do have that responsibility. Particularly if you're dealing with people on benefits, knowing that entitlement can be called into question at the drop of a hat.

So far the focus has been on voluntary work. I have to say this is a little frustrating, if predictable. Voluntary work is the easy answer, but, for all it can do (which I do not dispute), the fundamental flaw remains: you are not earning an income. It's no good me doing volunteer work if I don't have any money because my ESA gets stopped, and, like the agency itself, my employer certainly won't do anything to help. If I end up signing on there's every chance I'd have to give that up just to abide by an arbitrary claimant commitment. We've seen that before.

I'm not against voluntary work at all; far from it. My issue is that it's a dead end. I don't really want to do a job I wouldn't do for a wage just because it's 'experience' - and employers won't care about that anyway because that's the nature of the labour market. It's been my experience they've never cared about voluntary work experience anyway. They can always find a candidate who has 'real' experience and that's how they vuew it. I've no desire to work for free just to work for free.

As regards mental health support? Well that's the other reason for promoting voluntary work (and one of the reasons the pursuit of it frustrates me). It feeds into, in a very soft way, the arbeit macht frei worldview.

Unfortunately, as with all these agencies, this group has no mental health support. They are not doctors. This is just what I've commented on before: the lack of connection between all these different aspects. Mental health affects all of life, but we do not take a commensurately holistic approach to dealing with it. Sure there is a greater chance of finding a more compassionate work environment in a voluntary capacity - I guess - but it doesn't alter the fact that work, in the capitalist mode (and voluntary work operates within that system), is alienating and exploitative. If you don't find the right volunteer capacity that could become even worse since you don't have the comfort of a wage to live on - and you're still dependent on a fickle benefit system.

So it's a tentative 'ok' from me, for now, for this group. They have shown a willingness to help, in some degree, but that support is limited because of structural reasons beyond their control. They do offer support with bus trips, but that's not the same as endorsing a full time bus pass which would be the most useful thing, and that's perfectly illustrative of the way things are. Bus travel is still horrifically overpriced, but nobody is willing/able to endorse the solution to that for people who need it. Instead help is offered piecemeal.

Time will tell.

Monday 21 August 2017

Hell Bound for Kekistan

What is happening in the world?

It seems there has been a noticeable lurch to the right. Not just under the Tory jackboot of austerity, but in general, across the western world, for a lot longer than seven years.

It seems the systems that exist are being challenged such that what we are now seeing with the shiny whitey faces of the so called 'alt right' is the screaming voice of aggrieved privilege. These are people who think they are entitled to be the dominant group; white makes right, apparently. So that when other groups in society speak out and say "what about us?" the response isn't to address the systemic oppression and inequality they face, but to call them entitled and castigate them for daring to even speak.

We are told that multiculturalism has failed. Of course it hasn't. How many times during the day do you interact in a society that has a diverse melting pot of peoples? How often during that day do you suffer because of it? If you got cut up by another road user, was it because he's a Muslim, or was it in spite of that?

Thankfully, even despite the craziness all around, these terrorist events that happen are rare. They are perpetrated for political ends by those for whom Islam is a cultural backdrop. It is not the driving force, but a lens through which political ideology can be filtered. It is the language, not the message.

Society is changing, there is a rejection of anachronistic values: patriarchal culture is being challenged. I'm sorry if you like that culture, but you cannot demonstrate why it should be dominant. Why do we need to propagate sexist views of women as well as hold men to damaging standards that, if they fail, inform the dreadful statistics on male suicide. Why can't people accept that some don't fall into those accepted norms. I don't pretend to understand the complexities of the trans experience, I'm cis, but I can be open minded enough to identify them as the gender they choose. Doing so doesn't diminish me, this is not a slippery slope.

These alt right people are scum. They don't care about you or I. They are aggrieved children who act up because their toys are being taken away. Well guess what, it's time to grow up. Instead we have a world where trolls are paid to behave as badly as they can, to outdo each other for the approval of lonely people in video game chatrooms or guild halls. People who don't want women in 'their' safe space, but will sneer at anyone else's idea of a safe space. The whole discourse is based on mockery and ridicule. This is the social media world and it's out of control.

And it's enabling the worst amongst us. People walking through an American town assaulting residents and killing protesters. What happened wasn't an accident, these people, in their digital cockroach nests, propagate ideas of the most vile hatred and talk about a literal arms race against 'the left' - as if the ideas that challenge them are so dangerous they must be shot and run over.

Meanwhile the president laps it up. These people are his voter base. He doesn't condemn them; it takes him several days to get off his arse (or Twitter) and speak at all. When he does all he offers is false equivalence and the unwitting expression of admiration for these Nazi killers. There's no admiration from me, these people are dangerous. They must be stopped, deplatformed and resisted. We don't need to debate them, we've already had that conversation, we know their ideas and we know where they lead: death and even genocide. It's happened before, and it will happen again as our society slides into digital slumber; slipping into a realm where facts are pixelated assertions and truth is merely subjective.

This is a world where all you need is access to a decent webcam a shoddy grasp of facts and an aversion to proper research. Just record your latest dogwhistle bullshit and watch the patreon money flow in.

It makes me sick. Who wouldn't love to be paid thousands a month and all that's required in return is mouth off on social media. It's a world I simply don't recognise. I wasn't built for it and I don't understand why hate comes so easily to people.

Wednesday 16 August 2017

That Time Again

All it takes is one snap of the letterbox, a single envelope glides onto the carpet, and there it is...that time again.

I knew what it was even before I picked it up. I could tell by the shape and size of the letter, even the amount of creasing at the corners. Another ESA form to fill in; the precursor to another WCA.

How I've gotten this far I don't know, but I really don't fancy my chances this time.

The machine never sleeps. There is no respite.

I have a month to fill it in and return it and then who knows how long before the second letter appears telling me to attend at their pleasure. Whatever the time, whatever the day or month. That's how it works. You have absolutely no say in the matter, you don't have any voice in how this process is carried out. That's the level of intrinsic distrust that operates in this society. Why should we accommodate your needs, they say, we think you're taking the piss. 

And then after that ordeal, the gnawing tension of waiting, waiting, waiting, (not least of all within their waiting room), the final letter. The decision. Maybe I'll get lucky one more time, but I suspect not; in which case you're cut adrift and expected to find your own way forward. No support exists, and nobody gives a damn.

They expect this because that's how they live. Only it isn't; the ruling class have all sorts of unique social safety nets. They exist as a community, the old school tie network, the binding of privilege. If they need help there's always those who can help out. Our class are atomised and impoverished. That letter will be an epitaph, all that remains then is to haunt your own life. I don't really see a future there.

Still that's not going to happen in the next few weeks. Maybe there's a, slim admittedly, chance that this new social enterprise might be able to help. Maybe these will finally be the crew that really understand this process and can offer real help - unlike everyone else, including the medical profession, who back away like scared rabbits when faced with a patient dealing with the WCA and ESA.

But that's the likely reality. Organisations like to pretend they care, like to pretend they have help to offer, but in truth, when confronted with the reality of this nightmare system and it's Orwellian assumptions, they run screaming. Not our problem.

It's going to take me a month just to fill in this form. I can't face doing it all at once, even though, thanks to the intransigence of the medical profession, it will not be overflowing with medical information. All I can do is say that I suffer from what is rapidly becoming dismissed as 'low mood' (see my discussions about Positive Step earlier). That's not good enough for the Tories and their DWP boot boys.

So somehow I'll be thrown to the wolves of the labour market with just the shirt on my back, figuratively speaking. Luckily I've kept a few quid in the bank for just this occasion, but who am I kidding? That amount won't last long these days. The price of living is dear and only getting dearer. The bus fare alone, to do my weekly shopping, is extreme.

All these issues come flooding into though like an angry wave. What else is there now? This will consume my thought from the moment I post out the form, through the daily wait for the appointment letter to arrive, to the final decision arriving. I already have dysfunctional thinking, that's what 'low mood' (lol!) is! Do you think this helps?

Of course not. This isn't about helping people at all. It's about using poverty against people. It's about one class weaponising it and using that as a cudgel. It's not even as subtle as social engineering. It's simply about beating people down and maintaining control of a system they cling to with a tenacity that would make Charlton Heston question his love of firearms.

Tuesday 15 August 2017

More Support?

Perhaps my cup runneth over. Another social enterprise has appeared; they are called Team North Somerset. They have lottery funding that lasts until the end of 2019 (at which point...who knows).

I had a meeting with one of their "wellbeing and work coaches" the other day. She seemed nice, but then they all do. The person I saw years ago from Working Links was friendly at first, and then, once you're on board, they completely flip. Will that be the case? Who knows. I'm prepared to give them the benefit of the doubt, but I'm not confident.

To be fair, they are not beholden (as far as I can tell) to the DWP so there can be no threats of sanctions or penalties unlike on the Work Programme or any of their vile subsidiaries. But the fundamental problems still remain: these organisations at best mean well, but they can't address the root cause of people's problems caused by structural oppression.

What I suspect is that it will be the usual mild mannered mood music: casual talk of confidence building, based around simplistic self help notions (count to 10 and breathe), all the promises of support that amount to little more than listing some local charity shops you can work in. That's great, and anyone who gets something out of it is to be commended, but it's hardly ambitious. But that's because they can't address the fundamental cause I just mentioned.

As long as they don't fall into the trap of victim blaming and magic thinking ("it's your journey, we can't be bothered to help you despite getting funding for it") then I can't be too disappointed, but I've been down this road many times before. Perhaps this time these will be people aware of the real problems - or maybe not. I'm betting the latter, but if they can help address some of the fundamental issues of mental health (which would be a first around here) and isolation then it might be worth it.

I guess it all depends how much of their funding they are willing to commit to really helping people, and how aware of the reality of structural oppression and capitalist societal relations (not to sound too high minded about it) they understand. That understanding is desperately important if your goal is genuinely to help.

Tuesday 1 August 2017

Support - an example

So the latest instance of support predictably didn't materialise.

One of the more pernicious aspects of the 'doctor/patient' relationship (by doctor I mean any relevant authority) is that if you don't try whatever is put in front of you, you are deemed to be feckless. This of course isn't the sole purview of the mental health 'service'.

What makes it so pernicious is that, deep down, you just know that you are wasting your time. When it comes to actions intended for mental health, it is even more counter productive.

And so it is with the last piece of advice given to me by the 'Wellness Advisor' from Positive Step (the local sole purveyor of simplistic mental health solutions - ugh, solutions, what a word). In respect of help regarding a bus pass, which I sorely need given how isolated I am, he agreed that I needed one, but refused to sign off on one. Instead I was to speak to another social enterprise knowing full well that they couldn't. Guess what, they can't. Same old story; hopes slightly rise (just maybe these people can help), but nope. It really is a shit show.

But actually that's just a preamble, setting the scene. I wanted to illustrate the aspects of what support is like here. I'm using the example of a group called '1in4' who operate as a mental health support group, the key here is that they are primarily user led. That might sound positive, but in truth, in this age of cuts, it really means leaving people to their own devices while the people running the service (for whom I bear no ill will - this isn't personal) can't offer anything (except maybe some foot rubbing).

And therein lies the problem.

What you actually end up with is a room full of broken, fucked up, people. Folk who carry all the baggage of living in our society, with all its prejudices and preconceptions. That's fine as far as it goes, but people bring those views, their own baggage, into places like 1in4 - the problem is that the people running the service have no means to deal with that. When mental health is involved it becomes worse.

What I'm saying is that, as I've discussed, mental health issues are at least exacerbated (if not caused, in many cases) by the systems of oppression under which we live: capitalism, misogyny, race, etc. This can, and indeed has, manifest in the expression of everyday casual racism: I've sat and listened to users talk about 'them foreigners'. Otherwise seemingly nice people resorting to casual prejudice of the kind that people innocently soak up every day.

It's only when you start to look at these systems and the way our society and its economy are run (ie capitalism) that you see the truth of what's going on. That's the beginning of a lonely journey of realisation. But I believe that journey should be part of the healing process: we can't help people who suffer from issues such as anxiety and depression (arguably the greatest health threat facing humanity today).

The problem is that places such as 1in4 are just passive. They are subject to the whims of government policy and ideology when what they need to be is more proactive. This needs to manifest in taking a more proactive approach to the real reasons why issues such as depression are so prevalent. In short they need to get properly political. But they can't because of funding, because of capitalism!

So until that happens, 1in4 - and other places I'm sure - will be nothing more than a room where people that struggle in our convoluted high pressure society will be shepherded. Kept out of sight to sit on a couch and stare at a wall surrounded by others who, despite appearing to have common ground, may be as distant to them as the dream of a better society. What we need is unity and strength in a shared purpose informed by true awareness of the oppression to which we are subject.

I'm Back!

Years and years ago, before anyone had ever heard of disease and pandemics, I started this blog. I gave it a stupid name from an Alan Partri...