New research has indicated that the work capability assessment – used by the government to decide whether a claimant should receive incapacity or disability benefits – may be causing mental illness among its patients.
The finding that the process is potentially harming its recipients has raised “major ethical issues” for all those involved, according to the report’s authors.
The research by Oxford University and Liverpool University shows that more than two-thirds of claimants who took the fake ‘medical’ test between 2010 and 2013 – 7,020 out of every 10,000 – received prescriptions for anti-depressant drugs afterwards.
There were 2,700 cases of mental ill-health and – most damning of all, six suicides per 10,000 assessments. If these were all separate cases, that would leave just 274 people who, after the assessment, were only suffering with the illnesses they took into it.
All the results were calculated after taking account of the impact of baseline deprivation, economic trends, and long-term trends in mental health.
More than a million people were reassessed for benefit using the WCA between 2010 and 2013 – in fact, using the figures from the study, around 1,306,670 people faced the assessment.
This means 590 of those people aren’t around anymore – they committed suicide and are dead.
If that doesn’t seem many, it should be remembered that suicide reached a 13-year high in 2013, according to the Office for National Statistics.
Of the others, 279,000 were diagnosed with mental ill-health and 725,000 were prescribed anti-depressants.
This is equivalent to 5 per cent of the total number of suicides, 11 per cent of prevalent cases of self-reported mental health problems and 0.5 per cent of the total number of antidepressant items prescribed in England. And yes, all of these phenomena increased between 2010 and 2013.
The research also found that people who were reassessed were more likely to live in deprived areas – and the areas with the greatest number of people taking the WCA medical test had seen the sharpest rises in suicides, mental health issues and anti-depressant prescribing.
There is so much in the report that raises serious concern about the entire work capability assessment process. For example, it states: “Health professionals are involved in carrying out a large number of these assessments every year with a further one million assessments planned for 2015. Given that doctors and other health professional have professional and statutory duties to protect and promote the health of patients and the public, our evidence that this process is potentially harming the recipients of these assessments raises major ethical issues for those involved.
“Regulators and other bodies representing health professionals should advocate for the benefits and harms of alternative disability assessment policies to be established though a well-designed trial.”
The report states: “These test results suggest that the observed association between the reassessment process and mental health outcomes in the working-age population is not due to unobserved confounding” – in other words, the researchers believed they had ruled out the possibility of other, unseen, elements contributing to the results.
It adds: “We found that the level of reassessment in the previous time period predicted future increases in suicides, self-reported mental health problems and antidepressant prescribing.”
The experts concluded: “The programme of reassessing people on disability benefits using the Work Capability Assessment … may have had serious adverse consequences for mental health in England, which could outweigh any benefits that arise from moving people off disability benefits.”
They wrote: “We found that those local areas where a greater proportion of the population were exposed to the reassessment process experienced a greater increase in three adverse mental health outcomes—suicides, self-reported mental health problems and antidepressant prescribing.
“These associations were independent of baseline conditions in these areas, including baseline prevalence of benefit receipt, long-term time trends in these outcomes, economic trends and other characteristics associated with risk of mental ill-health.”
This is particularly damning: “These increases followed—rather than preceded—the reassessment process.”
You can imagine the DWP spokesperson’s response already, no doubt.
It will say that suicide and mental ill-health are due to multiple causes and should not be associated with a single element of a person’s life. It will also say that this evidence shows correlation, not causation – that is to say that there is no direct causal evidence linking the Conservative Government’s benefit policy with mental illness and suicide.
I say that is not true.
It is only a few days since This Blog revealed that the number of incapacity benefits claimants dying in mid-claim started to fall after the DWP suspended repeat work capability assessments for them in January 2014.
That data was released – reluctantly – in response to a freedom of information request I made almost a year and a half ago, under a threat that the DWP would be prosecuted for contempt of court if it did not comply. To use the government’s own rhetoric: If ministers had nothing to hide, why was this information not provided as soon as it became available?
And we have evidence from coroners, directly linking an increasing number of suicides with the work capability assessment and the DWP’s treatment of benefit claimants afterwards.
Circumstantial evidence, the DWP will say.
And that’s true.
But there are plenty of criminals serving long sentences behind bars because of circumstantial evidence like this.
I expect questions in Parliament. I would like to see a major police investigation into this entire policy area, looking at the cases of everybody who has died after being subjected to a WCA, the way they were treated by DWP representatives (including employees of the private companies that were hired to carry out the tests – Atos, between the dates used by the researchers), the politicians who put in place the policies that have been running between 2010 and the present and their reasons for ignoring the mountain of evidence against those policies, and the people who advocated the current regime in the first place, together with the evidence they used to support their case. Did they have any idea of the consequences?
But my inner pessimist believes all I’ll get are questions in Parliament.
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