Does anybody remember the research by Oxford University and Liverpool University that showed the Work Capability Assessment, used by the Conservative Government to determine a sickness benefit claimant’s fitness for work, may be causing or worsening mental illness?
It was in a paper entitled First, do no harm’: are disability assessments associated with adverse trends in mental health? A longitudinal ecological study, published on November 16, 2015.
This Site reported at the time: “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.
“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.”
The report itself reported the following, damning conclusions:
“Given that doctors and other health professionals 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.”
The DWP provided its usual disparagement of any adverse research in short order: “The authors themselves caution that no conclusions can be drawn about cause and effect. It is concerning that they provide no evidence that the people with mental health problems highlighted in the report even underwent a Work Capability Assessment.” That would be because the DWP never provide such information.
Now look at the the analysis of the WCA provided by the British Psychological Society, the British Association of Counselling and Psychotherapy, the British Psychoanalytic Council, the British Association for Behavioural and Cognitive Psychotherapies and the UK Council for Psychotherapy in a joint response to a recent government’s consultation:
“We do not believe that the WCA assesses work fairly or effectively. Determining ‘fitness for work’ for people with mental health conditions and disabilities is not only difficult, but it may also have adverse consequences on an individual’s understanding of themselves, their attitudes, behaviour and psychological wellbeing.
“Moreover, a significant body of published psychological literature highlights that inappropriately labelling individuals as ‘unfit for work’ or “fit for work” can have significant and far reaching consequences on psychological wellbeing, impacting on self-esteem, self-image, self-belief and self-worth (Steele, 1997); as well as the ability (Rydell et al., 2009) or motivation of the individual to engage in the process (and specifically with the source of the perceived threat – Major et al., 1998).
“By focusing on “fitness for work” or limited capacity for work, the system has the potential for detrimental impacts on the beliefs of many potentially employable people, as well as those who are seriously unwell.
“The Government has missed an opportunity to effectively use psychological theory and practice within the benefits system, which has left it open to results that lack validity, efficacy, fairness and compassion for people’s mental health and wellbeing.”
Is it my imagination, or do these comments fit together – perfectly – with the findings of the Oxford/Liverpool Universities’ study?
And does this not suggest, not only that the DWP devote the most serious attention to the psychologists’ comments, but that an investigation should be launched into the causes of the 590 suicides mentioned in the original report, with a possible view to prosecution?
Something to think about, perhaps.
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