Two years on and positive change is happening but can integration truly support people if social security in not part of the process?
Integration, by definition from the Cambridge Dictionary, means “to combine two or more things in order to be effective”.
As we enter the two-year anniversary of integration across health and social care here in Scotland, can we honestly say that it has been successful in doing the above? My answer would be that change is happening, albeit in my area it is incredibly slow and patchy. However there is one area that MUST be taken into consideration that so far hasn’t – but is having a massive impact on both health and social care across not only Scotland but the UK as a whole.
This is the area of “benefits”, or so called “social security”.
As someone who has recently had to access both health and social care services to help me to recover from a prolonged episode of illness, I can honestly say that the support I received was second to none. NHS Lanarkshire, in particular my GP and Clydesdale Psychological Therapies Team, provided me with person centred care, in the right place and at the right time. They worked effectively with each other to ensure that I received what I needed to help me. The Local Authority provided me with support to sort out a complicated financial situation after marriage separation. I also accessed amazing support and opportunities via the third sector in my area. What I will say is there is still very much a sense of the third sector not quite being seen as an equal partner – but that’s nothing new and hopefully will improve in time.
However, all of the support that I received and the incredible amount of hard work I have personally put into my own recovery has been continually jeopardised by the current social security assessment process. I am not exaggerating when I say it was one of the most inhumane and degrading experiences I have ever experienced, ironic given it is a system that is supposed to be there to support people at their time of need.
It is a system that forces you to focus on your illness and your deficits. This alone is psychologically very painful when you are in the grasp of mental illness. Your illness already tells you that you are a waste of space and that this world would be better off without you – and the social security system at present reinforces that message. Prove to us that you are ill – and prove to us that you are worthy of support. To sit in an assessment and be asked by a complete stranger incredibly intimate questions including “why have you not killed yourself” is traumatising.
It is a system that punishes you for self managing, for trying to effectively manage your illness and regain some meaning and purpose in life. It does not allow time for this recovery to happen – it instead assumes that if you can wash your hair, sit without rocking, set an alarm clock and spell ‘world’ backwards – then you are fit for work. Both my GP and Psychologist have been an excellent support to me, composing letters of support as evidence that I am currently not well enough to work. But I know that this is happening every day to people across Scotland – and their medical evidence is being completely disregarded and they are being judged purely on an assessment. The pressure that this is putting on everyone is massive.
So, I would recommend that if we take ourselves back to the definition at the top – that that in Scotland we need to add the social security system into the mix because it’s undoing a lot of good work that is happening in health and social care.
Donna’s Opinion is part of the ALLIANCE’s ‘We Need To Talk About Integration’ anthology which is available at the link below.