startnewlife Mendee CIC · London

PIP for PTSD and severe depression

Updated: 3 May 2026
In short

39% of all PIP awards are for mental health: PTSD, severe depression, anxiety, agoraphobia, the after-effects of torture. The main routes for refugees are Activity 9 (engaging socially), Activity 11 (planning journeys), and Activities 1/4/6 (basic self-care). The landmark case MH v SSWP [2016] UKUT 531 established "overwhelming psychological distress" as grounds for 12 points under Activity 11. The Helen Bamber Foundation and Freedom from Torture help survivors prepare evidence.

39%
of PIP awards
mental health
Act 9+11
Main routes
for PTSD/agoraphobia
MH 2016
Landmark
UKUT 531
0
Past Presence
refugees exempt from day 1
💚 Mental health PIP — the largest category, not the most stigmatised
In 2024, 39% of all PIP awards were for mental and behavioural disorders (DWP data). This is not "weakness" or "laziness". It is a measurable functional impact of a condition on daily life. Refugees living with PTSD after war, persecution or torture are disproportionately represented in this category. King's College London and the Maudsley NIHR Biomedical Research Centre have documented that PIP mental health claims are the fastest-growing group.

4 main activities for PTSD/depression

If you are not sure where to start, describe the functional impact through these 4 areas.

DAILY LIVING · ACTIVITY 9 · up to 8 points
Engaging with other people face-to-face
The most relevant for PTSD and social anxiety. The threshold for 4 points is "needs social support from others". For 8 points it is "engagement with others is precluded due to overwhelming distress".
What to describe (if it applies):
• "I cannot be in a room with an unfamiliar man — at the GP appointment I left within 30 seconds when I saw the doctor was a man"
• "When the support worker comes round, I sit and shake, I cannot speak"
• "I only leave the house with my daughter, without her I have a panic attack"
• "At the WCA assessment I could not answer questions for 20 minutes"
MOBILITY · ACTIVITY 11 · up to 12 points
Planning and following journeys
Critical for agoraphobia, panic disorder and severe PTSD. The threshold for 4 points is "cannot follow a route in an unfamiliar place without assistance". For 10 points it is "cannot follow a route in a familiar place without assistance". For 12 points it is "cannot undertake a journey because of overwhelming psychological distress" (after the landmark case MH v SSWP [2016] UKUT 531).
What to describe:
• "I cannot use public transport — I have panic attacks on buses ever since the bombing"
• "If the GP appointment time changes by even an hour, I have a panic attack and cannot leave the house all day"
• "My daughter goes with me to all appointments — I cannot manage without her"
• "From home to the shop is 200 metres — it takes me 30 minutes because I have to stop when triggers come up"
DAILY LIVING · ACTIVITIES 1, 4, 6 · up to 8 points each
Preparing food / Washing / Dressing
Depression often disrupts basic self-care. If, because of severe depression, you cannot start and finish daily tasks, the descriptor applies. "Prompting" (you need a reminder from others) — 2 points. "Supervision" — 2 points. "Help" — 4 points.
What to describe:
• "I do not wash up for 3-4 days at a time — I have no energy, my daughter does it for me"
• "I do not wash for 4-5 days — the social worker reminds me every morning"
• "I only cook in the microwave — the hob triggers PTSD from a fire during a bombing"
• "I wear the same clothes for weeks — I do not have the energy to choose what to wear"
DAILY LIVING · ACTIVITY 3 · up to 8 points
Managing therapy or monitoring a health condition
If you take psychiatric medications, that is already a basic screening point. If you need "supervision, prompting or assistance" to take them on time — points. If your condition needs frequent monitoring (for example, recurring thoughts of self-harm) — points.
What to describe:
• "I take sertraline 200mg + mirtazapine — I forget to take them, my daughter gives them to me every morning"
• "I see an IAPT psychotherapist once a week — without reminders I miss it"
• "I have a crisis plan — I call the Samaritans when I have suicidal thoughts, last time was 14 April 2026"

Case law — what to cite at MR and Tribunal

These decisions form the legal framework for mental health PIP. Use them in Mandatory Reconsideration and tribunal submissions.

MH v SSWP [2016] UKUT 531 (AAC)
Overwhelming psychological distress + journeys (landmark)
If psychological distress is so overwhelming that a person cannot undertake a journey, this gives 12 points under Activity 11 (descriptor 1f). The DWP tried to get around this decision through a Conservative regulation in 2017. RF v SSWP [2017] EWHC 3375 ruled that regulation unlawful — the High Court restored the MH rule. Use this in any tribunal involving PTSD or agoraphobia.
SSWP v MM [2019] UKSC 34
Supreme Court — "social support" is broader than "prompting"
The Supreme Court confirmed that "social support" in Activity 9 includes not only the presence of a person during the engagement, but also preparation before the meeting (for example, support with managing anxiety before an appointment). This broadens descriptor 9c (4 points) for people living with severe social anxiety.
RJ KS DJ v SSWP [2017] UKUT 105 (AAC)
"Engaging" means reciprocity, not just physical presence
"Engaging in social contact" means "reciprocity, give and take, initiation and response". Simply being present at a doctor's appointment or an assessment does NOT prove engagement. If you sit in silence, do not respond and do not initiate, you are not engaged.
AH and AK v SSWP [2022] UKUT 50 (AAC)
Descriptor 1f vs 1e in mobility — for those who never leave the house
If you do not leave the house at all because of overwhelming psychological distress, descriptor 1f (12 points) applies, not 1e (10 points). A decision-maker cannot "downgrade" to 10 points on the basis that you "could in theory try with someone's help". A useful precedent for tribunals.
KW v SSWP [2024] UKUT
Recent decision on mental health credibility
A tribunal must not dismiss a mental health claim based on the claimant's appearance at the assessment ("looked confident", "did not cry"). Mental health is not always visible. Decisions should be based on medical evidence and history, not just the assessor's impression.

Evidence hierarchy — from strongest to weakest

The higher up the list, the stronger the argument. Ideally you would have several.

1 · Psychiatrist letter with diagnosis + severity + functional impact
The strongest. Through an NHS Community Mental Health Team or a private psychiatrist. It should describe the diagnosis, severity, and how it affects daily functioning.
2 · Helen Bamber Foundation / Freedom from Torture report
Specialist expertise on torture survivors. These reports often turn a Fit-for-Work decision into an enhanced rate award. Free for eligible refugees. Helen Bamber (London), Freedom from Torture (UK-wide).
3 · IAPT / NHS therapist letter
NHS Talking Therapies — usually CBT or EMDR. The therapist can write a letter describing severity and progress (or lack of it).
4 · GP letter with diagnosis + medications + history
GP fit notes for UC are usually not enough on their own — ask the GP for a supporting letter (£20-£100, optional). It should set out the diagnosis, medications and limitations.
5 · Hospital admission records / A&E visits
Especially psychiatric admissions, Section 2/3 detentions, and A&E suicidal crisis visits. Objective evidence of severity.
6 · Self-report supported by a support worker
The weakest. A social worker, charity case worker, family member or friend can write a witness statement. Use this when professional evidence is limited.

Refugee-specific scenarios — typical patterns

Each scenario shows a typical PIP points configuration. Not a replacement for an individual assessment, but a starting point.

🇷🇺 Survivors of FSB / Belarusian KGB / Russia-Ukraine war (torture)
Main routes: Activity 9 (avoiding men in uniform / authority figures), often Activity 11 (PTSD triggers in the street, panic on transport), often Activity 1, 4, 6 (depression interferes with basic self-care). The Helen Bamber Foundation is the most relevant charity for this profile.
🏳️‍🌈 LGBTQ+ refugees with persecution-related PTSD + internalised stigma
Activity 9 and Activity 13/14 (LCWRA — initiating action and coping with change) commonly apply. Often complex depression, a sense of "not belonging", fear of being identified. RefuAid and Stonewall have specialist support workers.
🇺🇦 Mothers from Ukraine on the Ukraine Scheme — husband fighting / killed
Severe complicated grief, depression, acute anxiety. Often Activity 1, 3, 4, 6 (basic self-care interrupted by grief), Activity 9 (isolation). Substantial Risk under Schedule 9 para 4 for LCWRA. The Ukrainian Institute and the British Red Cross offer specific support.
⛰️ Chechen / North Caucasus claimants — long-standing complex PTSD
Trauma is often from the 1990s-2000s wars and ongoing persecution. Long-standing complex PTSD often involves dissociation, Activity 9, Activity 11, Activity 16 (LCWRA — uncontrollable behaviour episodes). Caucasus-specific community support is available through charities.
🌾 Central Asian (UZ, TJ, KG) trafficked workers
Modern slavery survivors (Seasonal Worker Scheme abuse, agriculture, hospitality). A combination of exploitation trauma, isolation and financial coercion. Activity 12 (LCWRA — awareness of hazard), Substantial Risk. NRM (National Referral Mechanism) status can speed up access to services.
⚠️ Describing trauma without re-traumatising yourself
For many refugees it is hard to write or talk about torture, violence and loss. That is understandable. A few tactics:
  • Write in the third person if the first person is too hard: "This person was subjected to..." instead of "I was subjected to...". This is often easier emotionally.
  • Describe the EVENTS briefly (dates, places, type of harm), and the IMPACT in detail (how it affects day-to-day functioning now).
  • Take breaks. Write for 30 minutes a day, not in one sitting.
  • Bring in a support person — a friend, family member or social worker — to help structure things.
  • If you have a Helen Bamber / Freedom from Torture report, they will do most of the work for you. These reports are written specifically for immigration and benefits processes.
  • Do not write for "effect" — precise concrete examples with frequency and duration are stronger than emotional descriptions.
  • If your condition gets worse while filling things in, put it down. Use an extension request (1 month + extension if there is a good reason).

Frequently asked questions

I am just "on edge after the war" — surely that is not a PIP issue?

It is exactly a PIP issue. PTSD in survivors of war, persecution, torture or sexual violence is a typical reason for PIP awards. 39% of all PIP awards are for mental health. You do not need a "disability" in the physical sense. The DWP assesses functional impact: can you leave the house, talk to strangers, prepare food, wash, make decisions. If PTSD disrupts these things, you may qualify.

I have no diagnosis from a psychiatrist — can I still apply?

You can, but your chances are higher with a diagnosis. The minimum is a fit note from your GP that mentions a mental health condition. An NHS IAPT therapist (talking therapies) can write a letter describing severity. Ideally, a psychiatrist letter (available through an NHS Community Mental Health Team if your condition is severe). If your GP will not write more than "anxiety", a report from the Helen Bamber Foundation or Freedom from Torture often turns a Fit-for-Work decision into an enhanced rate award.

I am scared to talk about torture or violence with the assessor — what can I do?

You have the right to a support person (friend, advocate, social worker) — ask when booking. You have the right to ask for a female assessor — request one. You can ask for a face-to-face assessment if you are afraid of phone calls. You can request a paper-based assessment if a conversation would be re-traumatising — but make sure to send a psychiatric report to replace the interview. The Helen Bamber Foundation and Freedom from Torture help survivors of torture prepare for assessments specifically.

I was refused — should I tell the assessor "working" things (I go to the shop, I cook)?

Do not lie — it will destroy your credibility. But honestly describe HOW: "I go to the shop once a week with a support worker, without her I cannot leave the house". "I cook food — but only in the microwave, because the hob triggers panic from memories of a fire". The reliability test (safely / to an acceptable standard / repeatedly / in a reasonable time) means that if even one of these is not met, the descriptor applies in your favour.

How long does a tribunal take and what are the chances?

MR (one month after the decision) — success rate is low at around 10-22%. Tribunal — 6-12 months wait, free, you do not need a lawyer (you can bring an advocate). Success rate is 58-67% on paper, higher for an oral hearing. The effective rate is around 80% if you persist (this includes DWP "lapsed" decisions — the DWP withdrawing the decision before the hearing). Free help: Citizens Advice, Z2K, Mind, Rethink, Disability Rights UK, Law Centres.

Sources: Upper Tribunal · MH v SSWP [2016] UKUT 531UK Supreme Court · SSWP v MM [2019] UKSC 34gov.uk · Overwhelming psychological distress (changes from MH judgment)gov.uk · PIP Statistics to Jan 2026 (mental health share)Helen Bamber FoundationFreedom from TortureMind · PIP guide for mental healthRethink Mental Illness · Benefits guide Updated 24 Apr 2026
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⚠️ StartNewLife is an information project — not regulated by the IAA (Immigration Advice Authority). We do not provide immigration advice within the meaning of Section 84 of the Immigration & Asylum Act 1999. All content is general information only and does not replace advice from a regulated lawyer (IAA / SRA / BSB) about your specific case.