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APPENDIX I State benefits

D'Ombraine Hewitt, Roz Karnac Books ePub

Britain's social security system has been described as the best in the world, but it can seem complicated when someone wants to find out their entitlements. Benefits may be means tested, others depend on the amount of National Insurance (NI) contributions made. At the time of writing, the following benefits are available, but as the entitlement rules and benefits will change, in order not to miss out it is important to check the eligibility criteria.

Statutory Sick Pay (SSP)

This is a taxable payment made to employees by their employers for up to twenty-eight weeks in any period of sickness which lasts four or more days. SSP does not depend on NI contributions. A person can be employed either full- or part-time, but he or she must earn at least the lower earnings limit, currently 84 a week. Unemployed and self-employed people are not eligible for SSP, but may be able to claim incapacity benefit instead.

Incapacity Benefit (IB)

Previously known as Sickness Benefit and Invalidity Benefit, IB is for people who cannot work because of illness or disability and who have not reached retirement age (sixty for women and sixty-five for men). Usually it is related to NI contributions and requires regular medical certificates (sick notes) from a doctor that state that the person is still unable to work. But this does not apply if the person was incapable of work before age twenty or, in some cases, twenty-five, and they claim in time. In that case the person claims “IB in youth”. For people aged sixty or over, IB has been replaced by pension credit.

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CHAPTER SIX: Employment— paid and voluntary

D'Ombraine Hewitt, Roz Karnac Books ePub

Eighty-five per cent of people with a long-term mental illness are unemployed (Mental Health Foundation, 2002) and in the UK they have the highest unemployment rate of any group of people with a disability. A national Healthcare Commission survey (2006) found that only half the people who requested help from their community mental health services in finding a job received it.

Yet work can be a valuable coping mechanism for people, and provide a sense of purpose and value (Mental Health Foundation, 2000b) and returning to work after an absence due to illness may be a confirmation to someone that they have recovered.

In Graham's experience, work also often helps people's recovery.

I needed a reason to get out of the house and not sit in a corner all day and listen to the constant voices. I needed a reason to move on and work gave me that reason. It was just a minor admin role, but it helped me recover.

Graham coordinates a mental health users’ employment service. He believes that the mental health field can be an ideal setting for people to use their personal experience to help others and encourage them to take a positive attitude towards their mental health.

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CHAPTER FOUR: Sources of support

D'Ombraine Hewitt, Roz Karnac Books ePub

Support is the cornerstone of recovery from severe mental health problems. If someone has been diagnosed with schizophrenia, NHS support will be provided by a multi-disciplinary team, known as the community mental health team (CMHT), although the first person people tend to contact with concerns about their mental health is a general practitioner (GP). Usually, it is by appointment at the surgery, though a doctor will sometimes make a home visit if the person has been a patient for some time. If GPs think that someone has a serious mental health problem they will refer him or her for a psychiatric assessment. This may take between two and three weeks. However, a home visit from a psychiatrist, or one of the mental health team, can be arranged within a day or two if a GP considers a person's symptoms require urgent attention.

When someone is diagnosed with schizophrenia their GP will be kept informed of their treatment by the person's psychiatrist. In addition to providing repeat prescriptions of medication, the GP will continue to take care of the person's general health. The leaflet “Getting the most from your GP practice” gives information on how people can receive help for their physical and mental health. It is available from GP surgeries and can be downloaded from the Rethink website: www.rethink.org/publications

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CHAPTER EIGHT: Counselling and psychotherapy

D'Ombraine Hewitt, Roz Karnac Books ePub

Access to “talking treatments” frequently tops the list of priorities of people with mental health problems (Rankin, JL.2005). But it seems that sometimes GPs or psychiatrists are reluctant to refer someone for counselling or therapy. This may reflect the shortage of counsellors working in the NHS. It is not unusual to wait six months, or even longer for an appointment. (Though if someone's care plan includes counselling, Rethink believes it can be worth writing to the hospital trust, which may be able to speed up the process.) Alternatively, the apparent reluctance may reflect concern that the patient sees counselling as an alternative to medication, or possibly as a “cure”. Some health professionals also consider counselling inappropriate, or even dangerous, for people with schizophrenia.

Considerable research indicates that psychodynamic “insight” therapies, especially psychoanalytical therapy, which comprises intensive (two to three times a week) deep psychological exploration, can be experienced as traumatic and worsens people's symptoms. This was the finding of a review of the negative effects of psychotherapy (Drake &Sederer, 1986). The researchers also reported that people having these therapies with experienced practitioners were more likely to leave therapy, needed longer periods of hospitalization, and subsequently functioned less well.

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CHAPTER FIVE: Health and well-being

D'Ombraine Hewitt, Roz Karnac Books ePub

People with a diagnosis of schizophrenia are more than averagely unhealthy. Their symptoms and the effects of medication often result in a tendency to exercise little, eat unhealthily and smoke heavily, meaning that many individuals are unfit and vulnerable to physical illness (Connolly &Kelly, 2005). One study (Harris, 1988) indicates that they are more prone to infec-tions, heart disease, Type II diabetes (adult onset) and female breast cancer.

There is also evidence (Torrey, 2006, p. 115) that some people with schizophrenia have a higher than usual pain threshold. They are not so likely, therefore, to seek medical advice until a particular illness has reached a less easily treatable stage, or to get treatment for problems such as backache or asthma, which can undermine their morale and even lead to depression.

A possible first step for someone to improve their health is to have a medical check-up with their GP, who can also give dietary advice and support in tackling unhealthy habits such as excessive drinking and smoking, and ways to manage stress.

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