Wednesday 1 February 2012

Fighting for Legitimacy: What is the impact of being labelled a scrounger?

Yesterday I read an article by Penny about the “Psychological impact of being labelled a scrounger” which has prompted me to share with you the following realisation.

All sick and disabled people are beginning to experience the same social implications that people with MUS (Medically “Unexplained” Conditions) suffer:

  • Lack of Support
  • Uncertainty, 
  • Lack of credibility and legitimacy, and 
  • An impact on self and social identity, to name a few. 

According to Dr Sarah Nettleton, who has researched the impact of not being given a disease label or diagnosis, these are just some of the themes which characterise the MUS experience. In this article I will be explaining that the MUS experience is no longer exclusive to people with MUS.

In this article will draw some parallels between the MUS experience and what is happening to all long-term sick and disabled people in this country. This is my analysis, using some of the headings from Dr Sarah Nettleton’s research paper:

Lack of Support

  • Disabled people are facing the removal of recognition, understanding, and compassion. Society as a whole is being told by newspapers and politicians that sick and disabled people are undeserving scroungers. The support that was once in place within society, both in spirit and in practice, is being rapidly dismantled. Disabled people are more likely to face interrogation and abuse than support and understanding.
  • People with disability are increasingly experiencing feelings of isolation, desperation, and the sense there is no where to turn to for help. The government is not listening, the general public is widely misinformed and hostile towards disabled people. Meanwhile, the DWP (Department for Work and Pensions) — who administers disability benefit and, in so doing, authorises the social “passport” that gives ones disability social legitimacy — is not just rewriting the definition of disability but undermining the credibility of all benefit claimants.

Uncertainty

  • The Conservative-led Government is cutting services so fast and so deep that it is impossible to plan for the future and know how to understand and accommodate the proposed changes in the Welfare Reform Bill. We can’t calculate their effect on our lives, we are uncertain about whether we will ‘be okay’. 
  • When the government first published its intention to “reform” Disability Living Allowance (read “abolish”) and replace it with PIP (Personal Independence Payment), its intention was clear: reduce the number of claimants by 20%; ignore the fact that fraud and departmental error adds up to a mere 0.5%. So while we could be sure that the government intended to reduce the eligibility requirements we were uncertain, and remain uncertain, exactly how eligibility will be established and how we will be judged. (“Uncertainty is compounded by lack of information”).
  • Disabled people are asking themselves “when will this reform effect me?”, “how badly will these cuts effect me?”, “How can I possibly cope with more stress and uncertainty?” (Disabled readers please contribute to this list in the comments section below). 
  • With uncertainty about how government cuts will effect the support and services, planning for the future becomes impossible.

Relationships with doctors

  • On the one hand doctors are given more responsibility by the government (managing their budgets) and on the other hand are told that their medical opinion no longer has the authority or reliability with which to base a decision for benefits (instead an independent company is employed). Where patients need reassurance and support more than ever, doctors are being worn down and disenfranchised.
  • In the same way a person with a medically unexplained condition seeks acknowledgement of their experience from their doctor, a disabled person now arrives in the same position: equally anxious, potentially suicidal, and uncertain about the social legitimacy of their medical condition. What both groups now share is an emotionally fraught situation:
  • The patient is wanting the doctor to authorise their experience of disability with words that can be universally understood: by the nosy neighbour, the government agency, the employer, the family, and the patient themselves who is suddenly feeling much less confident about explaining their condition to themselves and others.
  • The doctor is wanting to make the situation better but is powerless to do so and struggling to accept their limitations because they went into the profession to ‘fix’ problems and ‘make people better’.

Lack of credibility and legitimacy

  • I think this is the no. 1 biggest issue facing people with Medically Unexplained Illness, and now the whole population of sick and disabled people. When you don’t get better, people want to know why. When your health limits your ability to function, people want to know why. But people with health problems “just want permission to be ill”. Permission to have a bad day without being labelled a faker. Permission to have a good day without being labelled a scrounger.
  • The software designed for ATOS Healthcare Work Capability Assessments has been described as reminiscent of UNUM Insurance “disability denial software” because we are facing a check-box system determining the legitimacy of a persons medical condition and, in the face of extra cash per failed claim, an incentive to contradict the informed opinion of a GP or specialist. Meanwhile, the media, politicians, and even the DWP are publishing misleading information about the credibility of sick and disabled benefits claimants.

Influence on the ‘self’ and social identity

  • Although the sick and disabled recognise the authenticity of their symptoms, as verified by their doctors and their daily experience, they can’t help questioning themselves when they have a good day. Many may find themselves asking “Do I deserve disability benefit?”, “I feel better than I did yesterday, am I a scrounger because I am finding it easier to move today?”.
  • In fact I think the impact on a persons sense of self, personal wellbeing, and social identity is huge. If you are effected by any of these issues I would appreciate it if you would comment on this in the comments section below.

Searching for explanations/justice

  • Although some people can accept that reform may be needed, it's still important to them that they see changes that reflect the experience of disabled people and their needs. The government have scared disabled people and their friends. They are asking:
  • “How will eligibility be decided?”
  • “How will you protect the wellbeing of disabled people throughout the process of reforms?”
  • “How can you commit to cutting 20% of claimants on the assumption that half a million people don’t ‘deserve’ or ‘need’ to access the funding, care and support they require to function and live ‘normally’, despite their disability?”

To conclude, a sinister shift has occurred in the fabric of our society, spurred on by political propaganda. It is no longer enough to have a medical diagnosis or receive disability benefit. The existence of disability is under dispute. If you are effected by any of these issues, I welcome your comments below and would especially love it if you expanded on any of the points I have made above.

13 comments:

  1. Excellent article that expands beautifully on what I was attempting to portray in my blog. I am a Dr of Psychology and so know the pattern of behaviour I am currently going through, I question every thing about myself in relation to my medical condition, I want my GP/consultant to tell me how serious this condition is so that I may justify to myself my right to fight to keep my disability benefits. The other half of me is still fighting the knowledge that I am indeed disabled, what an awful label and what a depressing vision I hold for my future. The two sides are at war, throw into this mix the anger at having to feel this way, the anger at having to 'feel disabled' and the anger at no longer being considered 'worthy' of anything resembling a normal life and you have a very dangerous and indeed sad situation facing me and many many others like me.

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  2. Thank you for your comment Penny, and for inspiring/reminding me to write this in the first place!

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  3. I have just read an article about Hidden in Plain Sight which "the most detailed study yet into abuse faced by disabled people". As resentment and abuse towards disabled people grows in response to the propaganda surrounding the Welfare Reform Bill it is easy to forget that it isn't new. The intensity of it feels new. But the reality of chronic illness and disability has always been largely hidden from society as a whole. So maybe the support and acknowledgement we have been receiving through DLA, Carers Allowance, Incapacity Benefit, etc... maybe these have been just a thin veneer hiding the fact that the general public remain largely ignorant of what it means to have an illness of disability that isn't going to get better. What do you think?

    The article: http://www.equalanddiverse.co.uk/im-spat-at-every-day/

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  4. Hi, I read your post and I think it is very true. I think it is especially true where people have mental health problems and the Harrington report highlighted this but not very much seems to have been done about it.

    One if the things that I want to see is only mental health nurses are able to assess people with mental health problems. Under current conditions Atos will not employ them. Atos has said that the DWP have stipulated this as part of their contract and it was not their decision.

    The NMC (Nursing and Midwifery Council) are also not protecting the public and I believe they should be facing some very tough questions by our journalists regarding why they feel it is acceptable for mental health nurses to be excluded from assessing peoples mental health for access to support to help them cope on a day to day basis.

    Unum are adamant that they have had no input to the WCA (Work Capability Assessment) also. You can check out their statements on Ask Unum.

    Private Eye seem to the only "mainstream" media that are getting in about the nitty gritty of this and all though it is better than nothing it is way far off of the standards of reporting that one should expect on such a serious subject.

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  5. I agree wholeheartedly about the way those with fluctuating conditions question themselves and their entitlement. If I've managed to pace myself and nothing unexpected has been sprung on me I haven't budgeted spoons for, I convince myself, even after 18 years of illness, that I might find someone willing to employ me once ATOS inevitably find me fit for work. The trouble is that in reality the amount of activity I can realistically set myself is pitifully low.

    Most people I see in everyday life don't know I'm ill as I'm new to the area. In recent years I've noticed so much casual dismissal of 'scroungers' in everyday small talk that I don't want them to think that way about me when they don't know me. They wonder why I've taken to my bed exhausted after a week of visiting seriously ill relatives in hospital when all I've done is sit in chairs and cars. Not even driving, since I've been rattling with strong painkillers. I'm sure they'd raise their eyebrows if they realised that for years I've been eligible for Incapacity Benefit. And, you know, I kind of don't blame them. Friends and relatives who actually know about me and my condition don't believe my only means of support will be taken away.

    In the public mind, there are 3 kinds of disabled claimant. People they know who are 'deserving', people they think are not, because they've seen them going to buy a newspaper, and the whole mass of others who, in the popular mind, mostly belong in the latter camp.

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    1. Thank you for your post, it really adds weight to the points I made.

      About "3 kinds of disabled claimant..." In time, I hope to write more on this blog about the three illness narratives. In one you get better, in the second you don't get better but you learn something from your experience and 'grow as a person' this is seen as being "successfully ill" and you are seen as a "deserving" patient.

      In the third, there is no clear beginning, middle or end, and it is a narrative that brings people face to face with their own vulnerability, the idea that sometimes we don't get better, sometimes we don't get the information or support we need, sometimes things don't even make sense. It's easier to reject this uncomfortable truth and blame this patient group as malingerers, as "undeserving". But they're not. If chronic illness were more widely understood, disabled people and people with unexplained illness would be much better off.

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  6. I find myself constantly reading blogs like yours and scouring the online news sources for and stories or articles about the wrb, pip, disability, etc etc. My family say I should stop obsessing and wait and see what will happen. Besides, they know about my health and know I'm not faking so I have nothing to worry about. But they are wrong. I'm currently waiting for the cut in my housing benefit, signalled some months ago, to come into effect. I wait each day for the brown envelope to drop through the door 'inviting' me to take the wca. I currently get low rate care and low rate mobility, I am sure that will disapear when pip is introduced. I am afraid all the time. Even when I am asleep. I feel as though I have to constantly justify myself, my income, my expenditure, the reality of bipolar disorder and the constantly painful arthritus in my spine. I would love to work. Poverty and fear were not the life style choice I wanted. I feel guilty. Guilty that I am not disabled enough. That I should be able to cope better. I wish I never had to leave the house again.

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    1. You are not alone. There are a lot of people who are afraid. Your description is very familiar to me. Do you have a twitter account? There is a lot of sharing and discussion that goes on amongst people who are worried about welfare reform. With twitter you will be able to stay on top of the news and what people are saying, and make friends with people like you.

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  7. i have sort of got a diagnosis of cfs/me but they can't give me a definitive diagnosis because my main symptom is vertigo although i do have many of the other symptoms as well. when i am sitting down doing very little i also question myself and if i've managed to pace myself so that my symptoms are not too bad i wonder what kind of job i could do, but experience tells me that as soon as i up my activity levels, even a little, the symptoms become so much worse. i went through a period when my symptoms were quite stable for a while and i applied for and got a job collecting the census. however i never managed to start the job because after 1 afternoons training i spent most of the next day in bed. i decided to ignore that fact and later that week i went out 2 nights running, although all i did was sit down. following that my health took a nose dive from which i haven't recovered. i'm scared because every time i have a relapse my health never gets back to where it was before. due to the under occupancy rules regarding housing benefit and social housing i face losing my home after 2013 or if i'm lucky enough to get 1 of the very few 1 bed properties i face the prospect of trying to pack up my house on my own, a task that is way beyond me as i can't even cook myself a meal, and yet i do still question myself and worry that i may be 1 of the 'scroungers' that the tory driven press would have you believe are everywhere.

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    1. Thank you for sharing. What you say about worrying you are one of those scroungers, even though you're not, is exactly why I have drawn a parallel between the Unexplained Illness Experience and what all disabled people are facing now.

      With Unexplained Illness, the lack of information and support makes patients fear that they are a fraud, and putting on their illness. It's very similar: both groups are full of doubt and develop a low opinion of themselves when their experience is not acknowledged or legitimised by society.

      How we fit or don't fit into society's idea of health and disability does matter.

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  8. Well hopefully we can get the medical profession to recognise MUS as a disease. At least having a clear diagnosis of MUS from a doctor would alleviate the symptoms of not having a label.

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    1. MUS is not recognised as a disease, but it is widely recognised as the word for a syndrome that has no known cause.

      Unfortunately MUS can mean different things to different doctors and patients. Not to mention the public! To someone who has never heard of MUS it's too easy to interpret "Medically Unexplained Symptoms" to mean "no medically recognised symptoms". For this reason I have never heard the term MUS welcomed by patients.

      MUS is a term used by doctors, and it can act as quite a dead end, leaving the patient with no information with which to navigate their illness, day to day. On the plus side, it gives them something to google and in time that will lead them to this blog!

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  9. Thank you so much everybody for your comments and for sharing your reactions and experiences. I really appreciate it.

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