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Work and occupational

PIP assessment – are vulnerable people traumatised all over again?

A concern raised in our November edition.

09 October 2018

I attended a Personal Independence Payment (PIP) assessment with my client 'Ella'. Given this was my first time attending one of these assessments, I could offer little reassurance based upon professional experience to Ella of what to expect.

What followed was an extensive fact-finding exercise, where the PIP assessor investigated every intimate nook and cranny of Ella's life. As an observer, I felt frustrated that my client had to answer a flurry of questions that were recorded into a black box for a faceless individual to judge whether Ella was eligible for support.

In particular, Ella was asked to detail her experiences of mental ill health. I could only imagine how sharing these intimate details contributed to her underlying mistrust of professionals, as she had been let down my services in the past for not presenting with 'acute enough' symptoms. I was shocked after Ella had detailed her traumas she had experienced over the last 15 years for the assessor to merely respond with, 'But how are these things impacting you right now, day to day? Otherwise I cannot include this in the report.'

As a practitioner with some foundations in psychotherapy and counselling training, I was shocked at how cold this response from the assessor felt to me. The assessor's fixation with the here and now illustrated to me that they were perhaps not trauma-informed and did not appear equipped to understand that trauma is not a one-off historic isolated event, it can resurface without warning. After the assessor's response Ella burst into tears and stated that she felt suicidal, a communication that she wanted to end her enduring emotional pain. To which the assessor said little more than 'Thanks, we've now completed this section of the report and we can move on'.

As we left the assessment centre I wondered if the situation would have been different had I not been there. Would my client have been expected to return home in this vulnerable state without any aftercare or follow-up support? I wondered whether my presence as a support worker had unconsciously permitted the assessor to ask more difficult questions with the expectation that I would pick up the pieces afterwards. Or worse, would the assessor have asked the same questions irrelevant of whether Ella had support, simply to comply with the modernist bureaucratic demands of the PIP policy which reflects a wider shift towards a managed-care approach to welfare.

In closing, I wonder could there be a better way to establish eligibility and need without the re-traumatising process of asking vulnerable people to share their story in an alien environment? Perhaps instead PIP assessors could liaise with professionals already working with clients for their current assessment? I feel this would be preferable, rather than asking vulnerable people to travel to obscure assessment centres which incur both financial and emotional costs.

Furthermore, what support should be on offer for those who are re-traumatised by this assessment experience? Luckily my client had a dedicated support worker but not everyone shares this circumstance.

Whilst the future remains unclear for Ella, I am drawn to a quote by Maya Angelou, which resonates with me around this experience: 'I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.'

Jonathan Hutchinson
London