Chapter 1: Introduction

CPAG

1. What does this Handbook include

Learning difficulties, learning disabilities and neurocognitive disorders

This Handbook is a comprehensive guide to social security benefits for people who have a mental health problem or who are struggling with their mental health. It is aimed at advisers helping someone with a mental health problem to apply for benefits. It may also be helpful for carers, families and other professionals such as social workers and housing officers.

This book provides advice and guidance for different stages of benefit claims and problems you might encounter during the process. People with lived experience of mental health problems and the benefits system have shared their insights and experience to inform this Handbook.

Benefit topics included

Part 2 of this Handbook focuses on the benefits that someone with a mental health problem is most likely to claim. These are:

•employment and support allowance (ESA – see Chapter 4);

•universal credit (UC – see Chapter 5);

•pension credit (PC – see Chapter 6);

•housing benefit (HB – see Chapter 7);

•personal independence payment (PIP – see Chapter 8);

•adult disability payment (ADP – see Chapter 9);

•disability living allowance (DLA – see Chapter 10);

•child disability payment (CDP – see Chapter 11);

•attendance allowance (AA – see Chapter 12).

Part 3 covers the evidence you need to support your claim (see Chapter 13) and the assessments for UC, PIP and ESA (see Chapter 14). Chapter 15 contains information on the rules about work and benefits and Chapter 16 covers what happens if you are in education or you go into hospital, a care home or prison. If you need to challenge a decision, see Chapter 17. Chapter 18 covers the extra support you should be offered when applying for benefits or carrying out actions to do with your benefits and what happens if you cannot manage your benefits.

Benefit topics not included

Learning difficulties, learning disabilities and neurocognitive disorders

This Handbook does not cover:

•income support or income-based jobseeker’s allowance;

•tax credits;

•most contributory benefits, including contribution-based jobseeker’s allowance;

•severe disablement allowance and incapacity benefit;

•industrial injuries benefits;

•armed forces independence payment;

•statutory sick pay;

•statutory maternity, paternity, adoption and other parental pay;

•carer benefits;

•maternity allowance;

•bereavement benefits;

•pensions (but see Chapter 6 on pension credit);

•child benefit and guardian’s allowance;

•immigration and residence rules;

•benefit overpayments and deductions; or

•fraud and penalties.

For more information on these topics, see CPAG’s Welfare Benefits and Tax Credits Handbook. Citizens Advice also has information on many of these benefits and rules (see ).

Learning difficulties, learning disabilities and neurocognitive disorders

This Handbook does not cover learning difficulties and learning disabilities, including ADHD, autism and dyslexia. People with these conditions often experience mental health problems, so the information about mental health may be useful in these situations. For more information on benefits for people with learning difficulties and learning disabilities, visit the Scope website.1

This Handbook also does not cover neurocognitive disorders, such as dementia. The Brain Charity can provide support with applying for benefits if you have a neurocognitive disorder.2

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About Mind

Mind empowers people to understand their mental health and the choices available to them. It campaigns on a range of issues that could affect anybody with a mental health problem. This includes health services, legislation, protection of legal rights and employment.

Mind supports people to understand their choices through:

•Infoline, which offers confidential help for the price of a local call;

•Legal Line, which provides information on mental health-related law to the public, service users, family members, carers, mental health professionals and mental health advocates;

•providing online information;

•a network of more than 130 local Minds across England and Wales that offer specialised support and care based on the needs of the communities they support.

You can find out more at

About CPAG

Child Poverty Action Group (CPAG) works on behalf of the more than one in four children in the UK growing up in poverty. It works to understand what causes poverty, the impact it has on children’s lives, and how it can be prevented and solved.

CPAG collects evidence from families and advisers, and campaigns for achievable and long term solutions to child poverty. It supports frontline advice workers by providing expert information and advice through:

•books and AskCPAG, an online information platform, to help advisers navigate the social security system;

•a comprehensive range of training courses about benefits and related topics;

•a telephone advice line for advisers (see Appendix 2);

•legal action to challenge unjust decisions.

You can find out more at .

2. What are mental health problems

Mental health problems are when the way you think, feel or act becomes difficult to cope with and has a big impact on your day-to-day life. They can last for a short period or a long time and can happen to anyone. This Handbook focuses on symptoms and experiences of mental health problems rather than specific diagnoses.

Mental health problems and disability

Under the Equality Act 2010, a mental health problem is considered a disability if it has a significant and long term effect on your ability to carry out normal day-to-day activities.1ss6 and 15 EA 2010 This means that any mental health problem can be considered a disability in a legal sense if it affects you enough, even if you do not think of yourself as having a disability.

While the Equality Act 2010 gives a clear definition of a disability,2s15 EA 2010 different health-related benefits have different criteria for what they consider enough of an impairment to meet eligibility rules.

For example, to qualify for personal independence payment (see Chapter 8), you must have a ‘mental or physical condition’ which results in difficulties doing certain everyday tasks or getting around, and you must have had (and expect to have) these difficulties for a sufficient length of time.

There are different qualifying conditions for disability living allowance for children (see Chapter 10) and attendance allowance for those over pension age (see Chapter 12).

In this Handbook, ‘disability’ refers to any health conditions and characteristics that are relevant to the benefit being covered.

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Severe mental illness

‘Severe mental illness’ (SMI) is a term that may be used by the NHS, GPs or local councils, often in reporting and data collection. It refers to some types of mental health problems which are considered to cause significant problems with your day-to-day life and activities and which require ongoing management, even when you are feeling well.1Public Health England, Severe mental illness (SMI) and physical health inequalities: briefing, available at It is most commonly used to describe bipolar disorder and schizophrenia.

Your mental health problem can still be severe even if it is not considered an SMI.2See It should not be necessary for you to state whether your mental health problem is an SMI in benefit applications unless you feel it is relevant.

1 Public Health England, Severe mental illness (SMI) and physical health inequalities: briefing, available at »

2 See »

3. Language used in this Handbook

Diagnosis

This Handbook uses the term ‘mental health problems’ because it covers a wide range of experiences. This term may not feel appropriate for you and it is OK to use other terms when talking about your experiences. If you are supporting someone with a mental health problem, it is important to use the language they are comfortable with.

Diagnosis

Mental health diagnoses can be very complicated. Not everyone with a mental health problem has a formal diagnosis, and those with a diagnosis might not agree with it. Diagnoses can also change over time.1 It is important to remember that you do not need a diagnosis to be eligible for benefits, and that no specific diagnosis automatically entitles you to benefits. Benefit entitlements are based on your circumstances and how a particular health problem affects you.

This Handbook focuses on symptoms and experiences of mental health problems rather than specific diagnoses.

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Diagnosis texts

Some mental health problems are classified differently across medical texts. For example, schizoaffective disorder has different diagnostic criteria in the DSM 51American Psychiatric Publishing, Diagnostic and Statistical Manual of Mental Disorders, 5th edition, ed. 2013. and ICD-11.2 The DSM 5 is the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association in 2013. The ICD 11 is the 11th edition of the World Health Organisation International Classification of Diseases published in 2019. Both are trusted medical sources, but they have differing criteria. Some people’s symptoms may appear to fit a diagnostic label given in these texts, but they may feel that the diagnosis is not appropriate for them.

Criteria and diagnoses can also change over time. Different editions of the DSM and ICD reflect changes in understanding of mental health and society. For example, homosexuality was listed as a mental disorder in the first and second editions of the DSM, but was removed in 1973.3 Therefore, while these texts can be useful, they also reflect the social and medical bias of the times in which they were written.

1 American Psychiatric Publishing, Diagnostic and Statistical Manual of Mental Disorders, 5th edition, ed. 2013. »

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Controversial diagnoses

Some diagnoses are controversial for the people diagnosed with them and medical professionals. This includes diagnoses like personality disorders.1

You may encounter more prejudice and misconceptions because of these diagnoses. This is covered in Chapter 2.

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Diagnosis and treatment

Your diagnosis can affect your access to treatments. Some treatments are harder to access unless you have a certain diagnosis. For example, dialectical behaviour therapy is a type of therapy offered to some people with borderline personality disorder.1 In some places, you may not be able to access this treatment through the NHS if you do not have a diagnosis.2

Sometimes a diagnosis on its own is not enough to access treatments. For example, some people are denied certain treatments for eating disorders if they are not below a certain body mass index (BMI),3, para 13 even though you you can have an eating disorder at any BMI.

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Diagnosis and young people

Diagnosis for people under the age of 18 can be complicated. They may find it harder to get a diagnosis or their diagnoses may change as they age. Some diagnoses, such as personality disorder diagnoses, are not normally given to people under the age of 18.1

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Outdated terminology

Some people working in the benefit system still use outdated terms for certain mental health problems. If you are supporting someone to claim a benefit, make sure you are using the correct terms and correct others when they use the wrong terms. However, do not correct the person you are supporting if they choose to call their condition by its outdated name.

For example, ‘dissociative identity disorder’ is the correct term for what used to be called ‘multiple personality disorder’.1 ‘Bipolar disorder’ is the correct term for what used to be called ‘manic depression’,2 but the term ‘mania’ is still a valid term for some bipolar disorder symptoms. See here for more information on symptoms.3

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Different perspectives on mental health

Not everyone sees mental health problems the same way, both in themselves and in others. The way we think about mental health depends on a lot of different factors, including:1

•our experiences in childhood and as adults;

•our cultural background;

•our religion or faith;

•where we work or what we have studied;

•the opinions of people around us.

These perspectives can affect someone’s mental health and the support they seek, including their ability to:

•recognise that they might have a mental health problem;

•talk to others about their experience;

•seek treatment that suits their perspective;

•describe how they are feeling to others;

•support others who have a mental health problem.

For example, people from different generations may talk about and understand mental health differently to each other. Each generation has grown up with different terms and social ideas about mental health, and not everyone is able to identify their experiences using the same words. This might also make it difficult to talk about your mental health, for example, with family members from different generations. Some of us might not feel comfortable discussing or seeking help for our mental health, especially if other people from our generation do not often do this.

Being aware of and understanding about these perspectives can help you better understand your needs and others’ needs when it comes to mental health.

It is important to remember that no matter what someone’s perspective is, no one deserves to be made to feel guilty or wrong for having mental health problems. They are not something that you cause yourself and they do not mean that you are a bad person.

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4. The different types of benefit

There are different types of benefit that you might be entitled to when you have a mental health problem. Which benefits you can claim depends on your circumstances – eg, the effects of your condition on your day-to-day life, your support needs, your ability to get out and about, your income, your savings and your work history.

Getting financial support can make a big difference when you are managing a mental health problem, either in the long or short term. Claiming benefits not only gives you a regular source of income but can also open up many other types of support, like help with energy costs or free school meals. The amount of benefit you get might not cover all your costs, but getting benefits can still make a significant difference to your life.

What advisers say: claiming benefits

‘Sometimes, there can be stigma around claiming benefits. Remember that benefits are awarded in recognition of the extra costs of having a health condition or disability and if you are eligible for a benefit you deserve to claim it. It is understandable to feel unsure about these things, particularly if people around you are negative about benefits and mental health, but there is nothing wrong with claiming help you are legally entitled to.’

Means-tested benefits

‘Means-tested’ or ‘income-related’ benefits may be available if you have a low (or no) income. Your entitlement is affected by most other types of income and by the amount of savings you have. Your national insurance (NI) contribution record does not matter. The means-tested benefits covered in this Handbook are income-related employment and support allowance (ESA – see Chapter 4), universal credit (UC – see Chapter 5), pension credit (PC – see Chapter 6) and housing benefit (HB – see Chapter 7).

Contributory benefits

To qualify for this type of benefit, you must have paid enough NI contributions.

This Handbook only covers one kind of contributory benefit, contributory ESA (see Chapter 4). This is the benefit you are most likely to claim if you have paid enough NI contributions and are now unable to work due to a mental health problem. CPAG’s Welfare Benefits and Tax Credits Handbook covers other kinds of contributory benefits and pensions. Citizens Advice has more information on other types of benefits on its website (see ).

Disability benefits (non-means-tested and non-contributory)

These benefits are to help with the extra costs of having a long-term health problem or disability. They are non-means-tested and non-contributory, which means that your NI record, income and savings are not taken into account. You can claim them alongside the other benefits listed above.

The disability benefits covered in this Handbook are personal independence payment (PIP – see Chapter 8), adult disability payment (ADP – see Chapter 9), disability living allowance (DLA – see Chapter 10), child disability payment (CDP – see Chapter 11) and attendance allowance (AA – see Chapter 12).

Other types of benefit

There are other types of benefit that might be relevant to you if you or somebody you care for has a mental health problem. For example, you might be eligible for a benefit paid by your employer (eg, statutory sick pay) or for carer’s allowance. These benefits are not contributory or means-tested but they do have eligibility rules relating to your work history and earnings. They are not covered in this Handbook but you can find more information about them in CPAG’s Welfare Benefits and Tax Credits Handbook.

Financial help beyond benefits

As well as benefits, there are many other sources of financial help which depend on your location and circumstances – eg, council tax reduction schemes and local welfare assistance schemes.

For help with managing debts, see CPAG’s Debt Advice Handbook.

5. How to use this Handbook

This Handbook is divided into two main types of information.

•Chapters deal with various topics covering mental health and relevant benefits. Contents are given at the beginning of each chapter to help you find the information you need. Each chapter has endnote references which give the sources of information so that you can use them as an authority for your actions. Where an abbreviation is used in the endnotes, the full reference is given in Appendix 4. If you are challenging a benefit decision, you may want to refer to the law.

•Appendices contain supplementary material and information.

There are references to other CPAG handbooks which provide more detail on specific topics, such as benefits and debt. Where detailed information is required, such as eligibility criteria for particular benefits, consult the specialist handbook.

Abbreviations are used in the text to save space. The abbreviated term is explained in full the first time it is used in a section, and here there is a list of all the abbreviations used. There is also a glossary of terms used in this book in Appendix 1.

The information applies to England, Wales and Scotland.

Updates

The online version of this Handbook is updated throughout the year to reflect changes in legislation and new caselaw.

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