Disabled mum took fatal overdose after she was refused PIP

Susan Roberts was found dead because of a morphine overdose (Photo: Philip Coburn)

A disabled mum, Susan Roberts, was found dead at home following an overdose of morphine. Susan died just metres away from a heartbreaking 11-page letter she had written to the Department for Work and Pensions (DWP), detailing her suffering following being told she wasn’t eligible for Personal Independence Payment (PIP). 

Susan, a grandmother of eight, had survived four heart attacks. She died £4,000 in debt, after taking a fatal overdose within hours of being informed that her claim for PIP was unsuccessful. She had previously claimed Disability Living Allowance (DLA) and had been given an indefinite award, as her medical conditions were considered highly unlikely to get better.

The letter from the Department for Work and Pensions (Photo: Philip Coburn)

Susan was asked to apply for PIP by the DWP following the proposed closure of her DLA claim. Many people who have previously been eligible for DLA have found that they lose their support once they are reassessed for PIP. The government introduced PIP to replace DLA and to cut costs in 2013, as a part of their welfare “reform” programme, which inflicted cuts on the poorest citizens. The Conservatives claim that PIP “targets those most in need”. However, many people with the highest level of needs have been turned down for PIP after having indefinite or lifetime awards of DLA.

Susan’s tragic death also highlights that despite their claims, the government are not succeeding in “targeting the most vulnerable people”

Before taking a fatal dose of morphine, Susan had placed the paperwork from the DWP, which informed her that she had been turned down for PIP following mandatory review, a Do Not Resuscitate note and her unsent letter, on her dresser.

Susan was shocked when she was informed that she did not even qualify for an award of PIP at the lower rate. 

She began her heartbreaking letter: “Dear sirs, first of all, I request that you read this through carefully – this is my life after all.”

She said: “I am in a considerable state of depression after receiving your decision about my claim for PIP.”

Describing her health, she said: “My gall bladder needs to be removed because of multiple stones, weight loss, vomiting, excruciating pain – but specialists won’t operate because of my heart condition.”

She then describes the impact of suffering from ME, and explains that she can only manage to do tasks for just two or three hours a day. 

Susan had a stent fitted after her heart attacks and spent most of her time bedbound, largely due to also having ME.

An operation to remove part of her bowel meant she needed help to go to the toilet. She also needed help with her personal care, such as showering and with shopping, as she struggled to walk. But in late 2015, the Conservatives scrapped DLA and replaced it with PIP. Anyone 65 or older on April 8, 2013 still got DLA.

Susan’s daughter, Hayley Storrow, said: “It’s so sad. If she was born a week earlier she may have still been alive today.”

Susan’s PIP assessor had somehow erroneously decided that she could wash and bathe unaided, go to the loo and walk over 200 metres. Shockingly, this type of “error” and gross inaccuracy is very commonplace in the reports produced when disabled people are assessed for their lifeline support. In fact, earlier this year, the Labour party, the Green party and the Liberal Democrats called for the government to act on claims of widespread dishonesty by the medical professionals paid to compile benefits assessment reports, following a two-month investigation by Disability News Service.

Susan added in her letter that she would be virtually housebound without her Motability vehicle and her concluding comment is: “Thank you for reading this, with the greatest respect.”

She lost her Motability car last April because of the DWP’s decision not to award her PIP. Susan had sent a heartbreaking text to her daughter, Hayley, saying: “I’m never going to be able to see you again because they are taking the car.”

Susan is among thousands of disabled people who have lost their specialist Motability vehicles and wheelchairs because of cruel Conservative cuts and the restrictions to the eligibility criteria of PIP, and many more are likely to be affected. 

The PIP is supposed to help with the additional costs of being disabled, and in supporting disabled people in maintaining their independence and dignity, but many people are being denied the benefit because they are not assessed properly, and because the eligibility criteria have been made increasingly restrictive.

This means people previously eligible for the mobility component of DLA lose their cars and wheelchairs once they have been reassessed for the new PIP, if they don’t qualify for the mobility component. For many disabled people, this is a massive blow which impacts on their ability to remain independent, take part in their communities or get and keep a job. PIP is not means tested, so disabled people in work may claim it to help with additional support and extra costs. Many people losing their Motability vehicle will no longer be able to work.

Susan had asked for a review of the DWP decision following her first appeal. On 18 May last year, a letter arrived at her warden-assisted flat to tell her that the PIP award had been turned down yet again.

She was found dead the following morning and despite the letter and papers left out on the dresser, remarkably, a coroner said in October that she “had not taken her own life as there was no suicide note”, ruling it was a “drugs-related death”.

However, her daughter, Hayley, said: “I believe her unsent letter was her suicide note.”

It’s highly unlikely that an accidental overdose would have somehow prompted Susan to include a Do Not Resuscitate note with her letter and the bundle of DWP paperwork, too.

Do Not Resuscitate (DNR) orders are basically notes kept in a patient’s file that they do not want to be resuscitated should their heart stop. The medical establishment views DNR orders as the patient’s choice, though they do request that those considering DNR orders to discuss it with their family members. DNR orders may be requested by patients for a variety of reasons, all of them designed to keep the patient from suffering further. However, DNR laws do not take into account the situation of mentally ill patients framing a DNR order as a preparation for suicide.

The fact that Susan left the DNR note out with her letter and bundle of DWP documents indicates that her overdose was not accidental.

The Coroner’s verdict

By the end of 2015 it had emerged that the UK had experienced the largest annual spike in mortality rates for nearly 50 years.

Much media coverage seems to avoid reporting suicide as a response to structural conditions, and instead tends to emphasise suicide as an outcome of “mental illness” – as an individual act, rather than a problem that is influenced by socioeconomic and political conditions. The government has attempted to reconfigure wider social and economic problems as psychological problems, which has pushed highly politicised individual clinical and state therapeutic interventions – embodied in a rise of the mass provision of cognitive behavioural therapy and mandatory “attitude adjustment” classes for welfare recipients in the UK. This approach reflects political ideology and prejudices, rather than tackling the bigger issues of social inequality, poverty, lack of opportunity and an extremely punitive welfare regime. All of which are largely shaped by government policies.

Earlier this year, the Samaritans pubished their report Dying from Inequality, which clearly recognised rising socioeconomic inequality with a higher risk of suicide. The charity called on the government to direct support to those with unstable employment, insecure housing, low income or in areas of socioeconomic deprivation.

Mary Hassell, the senior coroner for inner North London, wrote directly to the DWP in 2015, stating that the suicide of Michael O’Sullivan, a disabled man who hanged himself, had been a direct result of being ruled “fit to work.

The coroner’s verdict of Michael O’Sullivan’s suicide is widely seen as ground-breaking by disability rights campaigners and groups like Disabled People Against Cuts (DPAC) because the DWP, the media and charities usually frame suicide as “complex” with no single cause, which means suicide has rarely been directly linked to the austerity programme, nor have government policies more generally been seen as directly responsible for suicides. 

Suicide is a significant social problem. Over 800,000 people commit suicide every year. Many of these can be quite properly understood as “economic suicides” because they take place against a backdrop of structural adjustment policies and rampant neoliberal market-led reforms. A counter discourse to the government tendency of psychologising socioeconomic conditions, making them the responsibility of individuals, rather than government and wider society, is of course crucial.

Technically, a coroner makes a finding of fact at the end of an Inquest. The coroner cannot attribute blame to any individual and cannot imply a criminal or civil liability, by law. The Coroner must use the evidence heard to decide who the deceased person was, where they died, when they died, and what the cause of their death was. Commonly, the “finding of fact” is referred to as a verdict or conclusion. A conclusion of suicide is decided where the evidence indicates a person has voluntarily acted to destroy his or her life in an intentional way. Inquest verdicts of Suicide (and Unlawful Killing) must be decided “beyond reasonable doubt”. Other causes of death may be decided on “a balance of probability”.

However, there is evidence to suggest that suicides are being under-reported because of the change in Coroner’s statutory regulations and guidelines, in 2013. Interestingly, contrary to the current trend in health and safety inquests, the Ministry of Justice guidance tells coroners that, wherever possible, short-form conclusions should be delivered, rather than the more detailed narrative conclusion.

Furthermore, open conclusions are discouraged, to be used only as a “last resort”. Concerns have been raised about the government’s new short-form conclusions and some organisations, including the Royal College of Psychiatrists, have asked the government to give due consideration to changing the standard of proof required for suicide verdicts. The 2013 reforms also enable the government to suspend an independent inquest into any death in favour of an inquiry, which under the Inquiries Act 2005 can be now be held in secret. 

The House of Commons Health Committee Suicide prevention: interim report Fourth Report of Session 2016–17 says: “Our evidence suggests the need for a more rapid provisional notification of suicide at the time when a suspected death by suicide occurs. We recommend that the Government take action to improve consistency between coroners and to make routine the use of provisional notifications of suicide. Furthermore, we recommend that the standard of proof for conclusions of death by suicide should be changed to the balance of probabilities rather than beyond reasonable doubt.” 

Rule 43 of the Coroners Rules (1984) states that if the Coroner is of the opinion that a death could have been prevented if different action had been taken by a particular person or organisation, he/she may make a recommendation for change. Also, the scope of the coroner’s investigation must be widened to include an investigation of the broad circumstances of the death, including events leading up to the death in question, where this wider investigation is necessary to ensure compliance with Article 2 of the European Convention on Human Rights (right to life). The positive duty to protect life implies a duty to investigate unnatural deaths, including but not confined to deaths in which state agents may be implicated.

Hayley has accused the government of having blood on their hands. She said: “People are living in poverty or considering suicide because of these benefits changes. My Mum won’t be the last to die.”

A DWP spokeswoman said: “Our thoughts are with Mrs Roberts’ family but there is no evidence to suggest any link between her death and her benefit claim.”

There is no evidence to suggest it isn’t, either, without further investigation, which so far, the government have refused to do. There is an established correlation between disability benefit assessments and increased mental health problems, distress and exacerbations of physical illness symptoms, too. While correlation isn’t necessarily the same thing as causation, it quite often implies a causal link, which may only be ruled out following further investigation, rather than political denial.

The DWP has quietly carried out investigations into 60 cases where benefit claimants are said to have taken their own lives. Labour MP Diana Johnson said the figures cast doubt on claims that there is no link between suicide and welfare re-assessments, with the DWP carrying out the internal reviews over the last five years. 

Johnson said: “Ministers have repeatedly claimed there to be no link between suicide and welfare re-assessment whenever figures have come to light.

“This parliamentary answer to me blows this claim out of the water.

“If there was no link, there wouldn’t have been 60 reviews of suicides in the past five years.

“I am appalled that these figures have remained unpublished for so long.”

A written parliamentary question from the Hull North MP revealed that the DWP carried out 15 internal reviews into suicides or alleged suicides of so-called DWP “clients” in 2012/13 alone.

“Families who’ve been left in the dark need to know everything the DWP knows about these cases,” Johnson said.

“Most importantly, we need a welfare system that supports, rather than victimises, the poorest and most vulnerable in our society.”

Susan’s daughter, Hayley said: “When my brother went to mum’s flat after she died, he found 37p in her purse. Even with DLA she was living day to day, scraping by. She was found dead with the PIP refusal letter placed strategically on a dresser.

“She was a poorly woman and this ­decision tipped her over the edge – she was in a desperate situation. I feel if it wasn’t for PIP and the Tory Government, my mum would still be alive. 

“They failed her like they have failed thousands.”

Susan wrote the 11-page letter criticising the decision and outlining her circumstances but as the DWP turned down her initial appeal within six days, she did not have time to send it. 

Hayley said: “I just want Theresa May to know that her rules and regime are killing the most vulnerable people in society.

“With the election coming up, it is so vital that things change.

“I feel any vote for the Tories is going to lead to more deaths.”

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If you are experiencing distress and feel suicidal, please don’t suffer in silence. The Samaritans have launched a free telephone national helpline number, 116 123. 

People who are going through a difficult time can access the service round the clock, every single day of the year.

This number is free to call from both landlines and mobiles, including pay-as-you-go mobiles. You do not need to have any credit or call allowance on your plan to call 116 123.

 

Related

Government guidelines for PIP assessment: a political redefinition of the word ‘objective’

Government subverts judicial process and abandons promise on mental health ‘parity of esteem’ to strip people of PIP entitlement

New discriminatory regulations for PIP come into effect today

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