Tag Archives: anti-depressant

Yes, Iain Duncan Smith – Vox Political HAS accused you of ‘outrageous action’. PROVE US WRONG

Iain Duncan Smith can’t prove us wrong. He deliberately refuses to collect the statistics that would confirm his claims – or ours.

Instead, he has claimed that This Blog (and presumably others) has accused him of “outrageous action”, without providing a scrap of evidence against the allegation.

This Writer is delighted that the Gentleman Ranker has tried to defend himself. I am currently working on a book covering this subject and his words may provide an excellent introduction.

The man we like to call RTU (Return To Unit – a Forces description of someone who trained to be an officer but was a washout) was responding to a request for information from Frank Field, chairman of the Commons work and pensions committee.

Mr Field had asked what data the DWP collects on the deaths of benefit claimants, in an attempt to find out whether there is any link between the work capability assessment (WCA) – carried out on claimants of Employment and Support Allowance and the Personal Independent Payment – and suicide, self-harm and mental ill-health.

The issue had been raised in research by Oxford University and Liverpool University entitled First Do No Harm.

This Blog reported on that document’s findings here – and you would be well-advised to refresh your memory of that article before you see the Secretary-in-a-State’s comments.

You should also read Vox Political‘s follow-up article in which a response from the Department for Work and Pensions – attempting to deny the research findings – is comprehensively disproved.

Iain Duncan Smith started writing his letter without a leg to stand on. Here it is – read it for yourself and see if you have any sympathy for his attitude.

Note that he admits the DWP has a “duty of care” to benefit claimants. It has taken years to get him to admit this and it will be very important if – for example – corporate manslaughter charges arise in the future.

Where he says the report’s authors admitted there was no evidence of a “causal link” between the WCA and suicide, he is of course being disingenuous. Iain Duncan Smith would not be satisfied with any evidence other than coroners’ findings that all 590 suicides mentioned by the report were attributed by the perpetrators to the work capability assessment. That was never going to happen.

But the report did examine other causes and eliminated them. While it states there is no direct evidence of a causal link between the WCA and suicide, the deaths certainly aren’t linked to any other cause.

Note also, Duncan Smith’s claim that the lack of a causal link was not reported in the media is not true.

The comment that there is no evidence the people with mental health problems underwent a WCA is covered in This Blog’s follow-up article, but for clarity I’ll repeat it here:

“Jonathan Portes of the National Institute for Economic and Social Research (NIESR) told This Writer that… the DWP’s response ‘reflects a basic misunderstanding of how you do this sort of analysis! Looking at WCA cases would be precisely wrong. You need to be able to control for selection – to do that here, [you] need to look at [the] whole population.

“’Let’s try [an] example. Does Coke make you fat? You can’t just look at people who drink coke & ask if they’re fatter, but if in areas where Coke [is]cheap, [and] people [are] on average fatter, *controlling for everything else*, that does tell you something.’

“So, in order to ensure that the correct cause is ascribed to any particular effect, those who carried out the study had to examine the health of the population as a whole, and eliminate elements that could relate to everybody, rather than just those who took the work capability assessment. They needed to rule out “unobserved confounding” – unseen elements contributing to the results.”

And that is precisely what they did.

Duncan Smith’s assertion that being sent back to work can “promote and protect health, and also reverse the harmful effects of long-term unemployment or prolonged sickness absence” is only accurate if the person doing the work is healthy enough for it – and, by definition, may not be applied to those whose mental ill-health has driven them to suicide.

Inaccurate WCA findings that claimants are “fit for work” or may be “fit for work” within a year of their assessment also mean that many ESA claimants will be sent back into the job market before they are healthy enough. In these cases, there can only be one result: Being sent back to work will make their health worse.

Of course it will; there is a reason they stopped working and claimed ESA in the first place. If that reason still applies, then sending them back to work can only have one result.

Anyone wanting to suggest that a large number of ESA claimants are committing fraud in order to avoid work should remind themselves of the facts: While a TUC survey has shown people think 27 per cent of the ‘welfare’ budget is claimed fraudulently, the government’s own figure is just 0.7 per cent. For ESA claimants it reduces even further, to 0.4 per cent. That’s one person out of 250, rather than roughly one in four – a big difference, especially when one considers the effect on their health of sending an ill person back to work prematurely, as Iain Duncan Smith appears to be advocating.

And then there is this:

160211IDSnote-outrageousaction

The handwriting is appalling so This Writer will try to translate: “NB: There are some out there in the media and social media who have used raw figures to accuse the govt of outrageous [sic] action. I would hope that the committee would not seek to follow suit. I note that having introduced the ESA and the WCA, the Labour Party now seeks to attack it as though they had nothing to do with it. Surely the committee should seek to recognise the good intent of those engaged in this difficult area.”

Those engaged in this area have no good intent whatsoever – let’s get that clear from the start. Their intentions are well-covered in previous articles on This Blog, which I will forward to Frank Field and his committee.

As for “some out there in the media and social media who… accuse the government of outrageous action” – I think he means me.

How nice to have official recognition and how clever of him to describe his own behaviour accurately.

Outrageous action? That’s exactly right.

Iain Duncan Smith’s department practises ‘chequebook euthanasia’ – WCA assessors use psychological ‘nudge’ techniques to push the mentally-ill towards suicide in order to reduce the “burden” on society caused by these “useless eaters”.

Even Frank Field – chairman of the work and pensions committee who contacted Iain Duncan Smith over the Oxford University and Liverpool University allegations – has raised concerns about this behaviour:

zTerminal

It is outrageous.

Even more outrageous is the fact that Iain Duncan Smith is trying to deny it.

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Government knew about rise in mental illness long before this week’s study – but won’t talk about it

[Image: Black Triangle Campaign]

[Image: Black Triangle Campaign]


Yesterday (Wednesday), This Writer learned two new things about the new university study that has found 590 people committed suicide between 2010-13 after taking work capability assessments (actually, one was a reminder of something I’d forgotten):

The study found that, for every 10,000 people undergoing a work capability assessment for sickness or disability benefits in those years, 7,020 were prescribed anti-depressant drugs afterwards, 2,700 reported to their GPs with mental health issues, and six committed suicide.

The reminder came from a Vox Political commenter and was that the DWP already knew there had been a huge increase in the number of benefit claimants with mental health disorders.

According to the Express, of all places: “In 2010 just 221,000 with mental disorders were in receipt of out of work benefits. But official statistics show the figure leapt to 861,000 last year [2013] – a rise of 289 per cent.

“Those with conditions like bipolar disorder, severe depression, obsessive compulsive disorder and schizophrenia now account for 46 per cent of those paid Employment and Support Allowance.”

So the increase of 279,000 people with mental health problems, added to the 221,000 who were on benefit in 2010, gives us half a million people – easily within the 861,000 total for ESA alone.

So figures that were published by the DWP itself totally support the new study.

The second new thing was that the Conservative Government doesn’t seem to want to talk about it.

Debbie Abrahams, shadow minister for the disabled, tried to ask an urgent question about the new study in the House of Commons on Tuesday (November 17) but was refused permission. So she made a point of order, asking the Speaker, John Bercow, how she could get the work and pensions secretary, Iain Duncan Smith, to make an early statement on the subject.

Again, she was rebuffed – Bercow told her to table a written question and “if she remains unhappy with the answers—or, as she sees it, the lack of answers—she can try again to deploy the mechanism of an urgent question”.

There might be a justification for not answering if the study had only revealed the extent of mental illnesses, which was known.

But there is the matter of the 590 suicides. Is the work capability assessment driving people to their deaths?

People killing themselves as a direct result of the work capability assessment – as the study indicates – is a serious issue, especially for a government that is still – increasingly desperately – clinging to claims that it is not possible to show that the WCA causes people to die, in any way.

And nobody at the DWP wants to talk about it.

Thomas More once stated: “The maxim is ‘Qui tacet consentit’: the maxim of the law is ‘Silence gives consent’. If therefore you wish to construe what my silence betokened, you must construe that I consented.”

Let’s have that question again: Is the work capability assessment driving people to their deaths?

The DWP is silent.

Silence gives consent.

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590 suicides: DWP denial is wrong – or an attempt to hide the facts

[Image: www.disabledgo.com]

[Image: www.disabledgo.com]

Nobody should have been surprised by the Department for Work and Pensions’ response to the revelation that suicide and mental illness soared in roughly equal measure to the amount of work capability assessments taking place, between 2010 and 2013.

As predicted on This Blog yesterday evening, a spokesperson said: “The authors themselves caution that no conclusions can be drawn about cause and effect.”

But this is interesting: “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.”

No, they didn’t – but there were several factors affecting this: Firstly, the availability of accurate information, and secondly, whether this was a study that needed to focus exclusively on benefit claimants.

Professor Louis Appleby, a government adviser on suicide and mental health, thinks it was. He tweeted: “True figure for suicide linked to WCA likely to be less than in today’s study: could work out exact number if DWP gave access to individual cases.”

But we don’t have access to individual cases. The DWP has made it abundantly clear that Conservative Government ministers have deliberately chosen not to record medical information such as the cause of a claimant’s death – and in any case (again by deliberate choice), no effort has been made to keep track of claimants whose benefit claim has been halted.

It would, therefore, be pointless to rely on information from the DWP!

But Jonathan Portes of the National Institute for Economic and Social Research (NIESR) told This Writer that, in any case, the DWP’s response “reflects a basic misunderstanding of how you do this sort of analysis! Looking at WCA cases would be precisely wrong. You need to be able to control for selection – to do that here, [you] need to look at [the] whole population.

“Let’s try [an] example. Does Coke make you fat? You can’t just look at people who drink coke & ask if they’re fatter, but if in areas where Coke [is]cheap, [and] people [are] on average fatter, *controlling for everything else*, that does tell you something.”

So, in order to ensure that the correct cause is ascribed to any particular effect, those who carried out the study had to examine the health of the population as a whole, and eliminate elements that could relate to everybody, rather than just those who took the work capability assessment. They needed to rule out “unobserved confounding” – unseen elements contributing to the results.

Is that what happened?

Here’s what the study’s authors had to say: “We found no significant association between the reassessment rate and trends in self-reported mental health problems and suicides in the over 65-year-old population, (ie, people over retirement age and therefore not subject to the WCA reassessment process).

“We also found no association with trends in heart conditions in the working age population, or trends in prescribing of cardiovascular drugs (ie, health conditions that would not plausibly be affected by the WCA reassessment process, in the short term at least).

“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.”

That comment would not have been possible if the study had focused on benefit claimants exclusively, and not the general population.

The study was subjected to further tests, though: “As our main analysis was based on aggregate data, it is possible that changes in composition of these populations could explain the results. To explore this further we analysed individual level data from the Labour Force Survey in a multilevel model, further controlling for a number of individual characteristics including age and sex, labour market status (employed, unemployed and inactive), number of physical chronic illnesses and level of education. This analysis gave very similar results as that based on aggregate data.

“In additional analysis we also controlled for differential trends by the level of rurality in each area and trends in initial assessments for out-of-work disability benefits and found these did not change our results.”

So – in the words of Mr Portes, “controlling for everything else” – the study produced the same increase in antidepressant prescribing, mental illness and suicide, indicating that the significance of these rises was that they coincided with the imposition of the work capability assessment on benefit claimants.

In This Writer’s opinion, the DWP comment was a rather desperate attempt at ass-covering. Ministers had believed they had eliminated any way of relating their flawed, tick-box assessment – which takes no account of medical conditions in establishing whether a person is fit for work, remember – with the deaths or suicides of claimants. Now they have discovered that they were mistaken.

Again we come back to the issue of freedom of information. All the way down the line, the facts about the effects of these tests have been deliberately hidden from the public by a government that is happy to remove our privacy and tell us, “If you’ve nothing to hide, you have nothing to fear.”

What is the Conservative Government afraid we’ll discover?

Perhaps now is the time to demand a full inquiry into the practical results of the work capability assessment regime…

An inquiry to be followed by criminal prosecutions.

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Sickness benefit medical test caused massive increase in mental illness, research shows

sicknote
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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