Daily living component activity 9 descriptor D (8 points)
Cannot engage socially with other people due to such engagement causing either:
(i). overwhelming psychological distress to the individual; or
(ii). the individual to exhibit behaviour which would result in a substantial risk of harm to the individual or another person
Who it’s most likely to apply to
Daily living component activity 9 descriptor D is most likely to apply to an individual whose needs relate to mental health and/or cognitive conditions.
Overwhelming psychological distress
‘Overwhelming psychological distress’ (OPD) means distress related to a mental health condition or intellectual or cognitive condition resulting in a state in which the symptoms are so severe that the individual cannot engage with other people without being overwhelmed.
The threshold is a very high one – an individual who, without prompting, would be left feeling anxious, worried or emotional does not meet it.
Overwhelming psychological distress (OPD) may occur in conditions such as:
- generalised anxiety disorder
- panic disorder
- dementia or
- agoraphobia
The risk referred to in descriptor 9 D (ii) is one that is still likely to occur with, or cannot be overcome by social support.
Prompting and social support
You should consider whether prompting and/or social support is likely to overcome an individual’s limitations.
Daily living component activity 9 descriptor D would usually be appropriate if the individual experiences (i) or (ii) in spite of prompting and/or support.
Example: an individual with paranoid schizophrenia who satisfies daily living component activity 9 descriptor D
Mike has paranoid schizophrenia and has a letter from his psychiatrist to support his diagnosis.
Supporting information
The letter outlines that Mike experiences paranoid episodes that lead him to believe that people want to hurt him and he often acts on these fears.
Application form
In his ADP application, completed by his community psychiatric nurse (CPN), it explains that Mike has been arrested a number of times for assault because he has thought people in the street were trying to hurt him and so has attacked them.
His CPN has taken him into the community to try and reassure and protect him. However, his paranoid thoughts were overwhelming and he caused damage to a shop window when he tried to attack someone that he thought was trying to hurt him.
Mike’s symptoms mean that he presents a risk to those that he might engage with. He cannot engage with others in a safe or acceptable manner.
Case manager’s decision
The case manager determines that Mike satisfies daily living component activity 9 descriptor D because his behaviour may result in a serious risk to his or others’ safety.