J is for Jobs and the journey to a career.

 There’s so much pressure and importance placed on what someone does for a living. It’s one of the first things we ask someone we don’t know very well, “What do you do?”. It’s also something we constantly use to compare ourselves to other people with and try and find out where we fit socially. People are constantly trying to better themselves, move higher and do as much work as possible to make themselves seem busy and important. It’s this attitude and social expectation that seems to be causing mental health issues in the workplace.

  The Health and Safety Executive found that in 2014/2015, 9.9 million work days were lost due to work related stress, depression or anxiety. This equates to roughly 23 days per case1. This doesn’t surprise me when I think of how many people I know who are trying to work harder, do more and take less time for themselves, sacrificing that crucial self-help and relaxation time.

  Then you’ve got the other side of the situation, unemployment. Back before I got diagnosed, I had just finished my Masters and I had been offered a fully funded PhD. To say that this was a great opportunity is an understatement. Unfortunately for me, at the same time my mental health started to decline rapidly. I had to make the decision to not follow through with the great opportunity given to me and stay at home and focus on trying to get better.

  A couple of months of unemployment and I realised, whilst it was good I was taking time to de-stress and go to my psychiatrist and doctor appointments, I was running out of money fast. I had no money to treat myself when I was feeling down. No money to socialise and go out with friends or family. No money to travel to these necessary appointments or buy food. If I spent anything, I felt guilty because I was spending money that I simply couldn’t afford. It started to cause me stress and anxiety and put me in a vicious cycle that I felt that I had to get out of.

  That’s when I started looking for easy part-time jobs that meant I would have an income whilst getting plenty of rest days in between the work days. I was lucky that my mental health was at a state that allowed me to do this as I am aware of so many people around me that it wasn’t an option for at the time. It worked for a couple of years, I could take the time to go to appointments without booking days off work, call in sick at the last minute without it being detrimental to my career and so on.

  Now I find myself in a state of mind where I feel I can handle a full time job, maybe even start a career. I feel that I have enough self-help and coping strategies to take on the world of full-time work. I’ve dabbled with part time jobs that are within the field I want to go in to, and have a good academic background (if I do say so myself), but there is now a new problem. The huge time gap in my CV between now and when I graduated. It’s been three years and I haven’t managed to hold down a full-time job in that time.

  I hate the idea of lying about my mental health. I am a very strong advocate to tell people, let the world know and not shy away from it. But that only works when I’m the one with the power behind the statement. Me telling my friend that I have problems, personally empowers me and makes me feel I’ve achieved something and got it out there. In an interview or job situation, the power belongs to the interviewer or boss. If they decide that mental health is bad for business, they can fire me, or just downgrade the work that I am doing. The power is lost and so is my confidence to tell the truth.

  The only thing that gives me back confidence about finding a job, potentially telling an employer the truth, or having a gap in my CV is the Two Ticks scheme. This scheme is used throughout Great Britain to encourage positivity about disabled people. When a job is advertised and mentions it follows the Two Ticks scheme, it means that they are committed to the following:

  • To interview all disabled applicants who meet the minimum criteria for a job vacancy and to consider them on their abilities

  • To discuss with disabled employees, at any time but at least once a year, what you can both do to make sure they can develop and use their abilities

  • To make every effort when employees become disabled to make sure they stay in employment

  • To take action to ensure that all employees develop the appropriate level of disability awareness needed to make these commitments work

  • To review these commitments every year and assess what has been achieved, plan ways to improve on them and let employees and Jobcentre Plus know about progress and future plans2

Under the Equality Act 2010, mental health is considered a disability.

The Equality Act says you have a disability if you have a physical or mental impairment that has a substantial, adverse, and long term effect on your normal day-to-day activities.”

  You are still covered by the Act even if you are taking medication or going to talking therapies and now consider yourself stable enough to work, or have had a mental health episode in the past. The Act looks at how your mental health would be without the treatment or medication and ensures you don’t get penalised for any previous mental health episodes3.

  Therefore, the Two Ticks scheme applies to you if you have, or have had, mental health problems. If you have the qualifications and meet the criteria of the job specification, you should get a guaranteed interview.

  I’ve only just started applying for jobs that have not yet reached their cut off dates, so have no idea how effective this Two Ticks scheme is, but it has given me a lot more confidence about applying for jobs that would help me start a career. I have made sure to look for jobs that follow the scheme and always make sure to state that I have a disability. I felt a little uneasy at first, because when I feel fine and can function normally, stating I’m disabled feels like I’m cheating the system. But then I think back to all those days lost to depression, to the torment inside my head, to all the time lost to fighting something no-one else can see of feel. I realise that this scheme is a positive thing, here to to help people who have lost that time to something so horrible. For that, I am grateful.

References

  1. PDF: Work related Stress, Anxiety and Depression Statistics in Great Britain 2015, by the Health and Safety Executive.

  2. https://www.gov.uk/recruitment-disabled-people/encouraging-applications

  3. http://www.mind.org.uk/information-support/legal-rights/disability-discrimination/disability/#.Vo5uwfmdDIU

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Should a diagnosed mental health problem qualify you for free prescriptions?

One thing I hadn’t realised until recently was that if you lived in Wales, Scotland or Northern Ireland, you get free prescriptions on the NHS. This got me thinking, which turned into researching, which turned into annoyance, which turned into blogging. Although I was jealous of the fact that, if I lived in another country directly linked under the same government I’d get free medication, I knew that that was another topic for another time. What got me was what I found when I searched for who, if anybody, was applicable for free prescriptions within England, this was the list:

  • Treatment for cancer; note this includes treatment for the effects of cancer, or treatment for the effects of a current or previous cancer treatment.
  • A permanent fistula requiring dressing.
  • Forms of hypoadrenalism such as Addison’s disease.
  • Diabetes insipidus and other forms of hypopituitarism.
  • Diabetes mellitus, except where treatment is by diet alone.
  • Hypoparathyroidism.
  • Myxoedema (underactive thyroid) where thyroid hormone replacement is necessary.
  • Myasthenia gravis.
  • Epilepsy requiring continuous anticonvulsive medication.
  • A continuing physical disability which means you cannot go out without help from another person (1)

Surely they can’t be serious? They have ten different categories and yet mental health doesn’t even get a look in. The last point could have been stretched to cover it seeing as mental illness can be debilitating, but then they whacked the “P” word in there.

I can hear the critics already saying that the people on the list above would most likely die without the medication provided but I feel this is a very narrow minded and misguided view that comes with a hint of stigma attached to it. There is still a very noticeable gap between the age at which someone with severe mental health problems die and those without. One study by Rethink mental illness found that those with serious mental health issues can die as much as 20 years earlier than the general population. The study then goes on to show that it’s not just death that we should focus on. Mental health can lead to a number of other physical problems. They stated that people with mental
illness are three times more likely to develop diabetes and twice as likely to die from heart disease (2) as well as developing side effects from the medication and addictions such as cigarettes, all of which decrease your life expectancy. We can already see the irony in the fact that mental health doesn’t qualify for the freebies even though they are three times more likely to develop an illness that does. Then there’s the other ironic side to the coin where people with poor physical health are at higher risk of experiencing common mental health problems (3). So you may have a physical problem that is covered by the categories above BUT if you then experience mental health problems linked to this, you have to pay.

To get out of the never ending cycle of mental health leading into physical and vice versa, I started looking into when mental illness was considered a disability. Luckily the lovely people at Mind had already done the research for me. I was looking at the definition and terms of disability in conjunction with the Equality Act, 2010. This act is essentially “116 separate pieces of legislation into one single Act. Combined, they make up a new Act that provides a legal framework to protect the rights of individuals and advance equality of opportunity for all.” (4). 

Under the Act the term disability covers a much broader area. It states that if you have an impairment that is either physical OR mental and this has a substantial, adverse and long term effect on you normal day-to-day activities, you are considered to have a disability (5). This is a good start. It’s included mental health. To define, substantial effect means your mental health problem has more than a small effect on your everyday life. This means thinking about:

  • how long it takes you to do something, compared a person who does not have your mental health problem
  • the way you do things compared with someone who does not have your mental health problem
  • the total effect that your mental health problem has on your ability to do daily activities (such as doing cooking, cleaning, doing the shopping, using a computer, using public transport).

Adverse effect means your mental health problem makes things more difficult for you and long term effect means you have a mental health problem that has lasted at least 12 months, likely to last 12 months or is likely to happen repeatedly.

  It also states that even though you may be currently stable or taking medication, the Act looks at what your behavior would be like WITHOUT the medication. Therefore, the law is looking at how your condition affects you when you’re not getting treatment or medication (5) and covers you even if you are.

  So, if this Act can state that everyone with ongoing mental health problems can be classified as disabled, whether they have ongoing bad mental health or just sporadic episodes, then why can’t they then be considered for free prescriptions?  Why can’t that last bullet point have the very restrictive word physical taken out of it to include those with underlying mental illness that requires medication every day. If those with a mental illness can be considered disabled in one area of the law then I’m sure it can be transferred to another. Even if this is a bit of a flimsy argument, combine this with the fact that those with poor mental health have a high chance of also developing poor physical health should be argument enough. I’m constantly hearing how the NHS should be looking into prevention of illness instead of the cure as it saves money in the long run. The medication doesn’t prevent the mental illness itself, and there is no cure, but it will help prevent a torrent of other things.

 Should a diagnosed mental health problem qualify you for free prescriptions? The short answer is yes.

 

 

(1) http://www.nhs.uk/nhsengland/Healthcosts/pages/Prescriptioncosts.aspx

(2) http://www.rethink.org/media/810988/Rethink%20Mental%20Illness%20-%20Lethal%20Discrimination.pdf

(3) http://www.mentalhealth.org.uk/content/assets/PDF/publications/fundamental_facts_2007.pdf?view=Standard

(4) http://www.equalityhumanrights.com/legal-and-policy/key-legislatures/equality-act-2010/what-is-the-equality-act

(5) http://www.mind.org.uk/information-support/new-legal-publications/disability-discrimination-the-mind-guide/what-is-a-disability/