I have recently been contacted by a client in his late 30s who is HIV +ve. His main symptoms are lethargy, p[oor concentration and a general feeling of being unwell. He says he is unable to cook a main meal as he tends to leave food cooking and forget about it. I feel this would not hold water at an appeal as he could use an alarm. He has recently attempted suicide but has been discharged from hospital with no anti-depressants or support from mental health teams. He presents as being a bit low but of sound mind and he does not admit to feeling depressed or suicidal any more. This would make a case for DLA on supervision grounds difficult. Any advice?

Gill, various mental health lobbying groups such as MACCA,Mind and Rethink to name just 3 examples have loads of good fact sheets relating to DLA. Typical symptoms of depression include " lethargy, poor concentration and a general feeling of being unwell ", again one of the above's fact sheets on male depression might be useful/revealing and help you glean more info from him.

I think you need to get more info from him,which won't be easy because talking about depression and suicidal ideation is not pleasant, this case reminds of past clients, who after being discharged in the same manner, were back in within days or weeks or months.

The fact he has recently attempted suicide is disturbing and does suggest supervision needs, being discharged from hospital with no depressants or follow up care/supervision from mental health teams, is probably more indicative of the failings of Care in the Community or lack of it and sadly more common than people think, than everything in his life being hunky dory.

Which of course is all true but may not help in respect of DLA entitlement. Its not clear from the original post what stage this has actually reached. Has a claim for DLA actually been made? If not, help the client to complete the forms and bang in a claim.

Eligability in cases like this boils down to going back to basics and looking at the eligability conditions. I hate to sound harsh but often one suicide attempt is not enough without more evidence of continuing risk to qualify under supervision requirements. It may also be hard to find supporting evidence if an appeal is neseccary. Suicide A+E admissions always get a Pyche referral which leads (or should lead) to a fairly prompt risk assessment. You need copies of that report if it exists. If it does not exist why not? Did the client refuse? If he did, clearly a section was not deemed necessary. The hospital records are key to this.

Your client is likely to suffer more with infections etc over time. He needs to keep a record of any periods of incapacity. Advise him to ensure that he visits his GP when he is ill (it helps with evidence later on)and, if the current claim is not successful to put in new claims as and when his condition deteriorates and his need for care increases.

With great respect, comrades, may I offer a second opinion on a couple of points made in this thread so far?.

1. I don't believe that this chap should be turned down under the cooking test just because he can use an alarm. The facts seem to suggest that he does put himself at risk through lethargy and poor motivation, so even if he possesses an alarm would he get round to setting it, or respond to it when it goes off? What if he forgets he is supposed to be cooking and goes outside out of earshot?

2. Also not happy about the suggestion that 1 suicide attempt is not enough to show that supervision is required. I have repped at an appeal before in which the tribunal awarded middle rate care component when the Chairman saw evidence that the claimant had attempted suicide on one occasion 10 years previously. I don't think there is any hard and fast rule on this sort of matter. When it comes to an appeal we are in the hands of the Chairperson and if s/he is sympathetic we are in with a shout and if not then we aren't.

I routinely use the mental health route to make a DLA claim for my clients (all of whom are HIV+) and it usually succeeds, in fact more so than when claims are made for symptoms of HIV.(HIV is only a chronic illness as far as the DWP are concerned.) Maybe I'm lucky, but they've never tried the alarm thing as a way round the cooking test, and a doctor's report saying that your client has recently been discharged from hospital after a sucide attempt should be enough. I would urge him to see a counsellor or some sort of mental health professional. Where is your local HIV centre - there should be one hospital in the area that has a special clinic. It would be worthwhile contacting them to see what help they can offer. The consultants that I deal with on a daily basis are very supportive where they believe the person is genuinely at risk or in need and generally welcome it if you write a brief outline of what is required of them as far as the DWP is concerned.

By the way, is he on IS/IB? Is he exempt from the PCA - if he suffers from certain symptoms (such as night sweats) he should be. Let me know if you want more information about this.