Tag: Depression

Depression and time out

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With Alex Cunningham, Debbie Abrahams and my good friend Gail Ward at the Disability Equality Roadshow a couple of years ago. 

I don’t often talk about myself in my posts. I write about government policies, their socioeconomic consequences, their often devastating impacts on fellow citizens and critical, evidenced exploration of the ideological narratives that underpin them. In particular I write about welfare policies.  

I began campaigning and writing critically about the implications of the Coalition’s controversial Welfare Reform Bill in 2012, prior to it passing into law. It was clear that poor, unemployed and disabled citizens were being politically targeted with cuts of unprecedented intensity to their lifeline income. Social security was calculated originally to provide for essentials only. The cuts, strict conditionality, work fare and sanctions have left many citizens without enough money to cover basic survival needs such as food, fuel and shelter.

I messaged every single peer in 2012 to tell them why the welfare reform bil must not happen, and although many agreed, Cameron pushed this controversial bill through parliament, using the ‘financial privilege of the Commons to override criticism and challenge.

The punitive, regressive welfare reforms transformed social security from being a publicly funded social safety net into a ‘hostile environment’ concerned with administrating work discipline. It struck me that the policy details are very authoritarian and reflect certain traditional Conservative prejudices concerning the characteristics of the poorest citizens. These prejudices have been embodied in extremely discriminatory and oppressive policies. 

These coercive policies are offensive to basic ethical principles, undermine democracy and the fundamental universality of basic human rights, by making them conditional for the poorest citizens with the greatest need for protection from political abuse. Austerity was an ideological choice among several more humane ones. Austerity is a central feature of neoliberalism.

Having gone through the controversial Work Capability Assessment in 2011, when I had to give up my social work because I was too ill to continue in my post, followed by the distressing appeal process, some of my first pieces of work were aimed at providing support for other people going through the same process. I used information that an Atos whistleblower provided to help others navigate the fundamentally unfair assessment for Employment and Support Allowance (ESA), which is based on a biased process, weighted specifically towards finding justification for ending a claim for support and finding disabled or ill people ‘fit for work’.  

My own experience of the Work Capability Assessment was so terrible that I couldn’t face claiming PIP for 6 years. I finally did last year, with support from my local council, who had also provided some adaptations and aids in my home because of the growing extent of my disability. The experience of the PIP assessment was as terrible as I had anticipated.

I also co-run a group on Facebook to support other people going through ESA and PIP claims, assessments, mandatory reviews and appeals. Many of the people we support are experiencing profound psychological distress, anxiety and so many are having suicidal thoughts. Lots of people contact us for psychological and emotional support, and sometimes it feels very overwhelming to see such widescale and profound distress and harm that people are experiencing because of cruel government policies.

Many concerns have been raised regarding the reliability of the assessment in practice, the harmful effects of wrong decisions on vulnerable citizens and even its value-for-money. I submitted evidence to a United Nations’ inquiry from 2012 onwards, which concluded in 2016 that the government’s welfare policies have systematically violated the human rights of disabled people.  

My main aim is to share information, evidence, analysis and insight and to raise awareness of the unjust impacts of neoliberal welfare policies as widely as possible with citizens, politicians, professionals, academics and allied organisations. This has included speaking at conferences about the consequences of neoliberalism and the welfare reforms, meeting regularly with opposition welfare ministers (Conservative ministers have consistently refused to engage); contributing to the design of opposition welfare policies where I can, in addition to writing blogs.  

I’ve been asked a few times to do interviews on TV, and I try to get out to protests but often I’m simply not well enough to do so. My illness – lupus – affects all of my joints, tendons, periodically causing inflammation and pain, affecting my mobility. It also affects my nerves, blood cells, lungs, brain, my gut and my ability to fight infection. I catch a cold and end up with pneumonia.

I often have low platelet counts – autoimmune thrombocytopenia, which is a bleeding disorder. That seriously limits what I can do, sometimes. I’ve also developed a sensitivity to flickering lights, which causes partial seizures and other problems. That’s problematic because it restricts where I can go – shopping areas for example, are often a nightmare and my clubbing days are long over. I’ve always been an outgoing person, but over recent years, my increasing physical vulnerability has left me a little agoraphobic, too. But I do my best. I’m a person that seems to prefer working ‘behind the scenes’ – ideas and scripts. I once worked for the BBC many years ago as a script writer. I was given some acting roles for some of the comedy sketches I had written. I hated the acting, but loved the creative side of my work. It’s not that I couldn’t act – apparently I could and kept getting asked to do it – but I don’t like that kind of being on stage thing, it makes me very uncomfortable. 

Another part of my illness is neurological, and that means I have cognitive problems and depression. Lupus can also sometimes lead to psychosis. All of this said, simply being chronicallly and seriously ill can cause depression because of the constant need to adapt to progressive and ever-expanding symptoms.

Over the last 2 weeks I’ve written several particularly nightmarish articles about nightmarish policies, policy proposals and serial acts more generally of a nightmarish and utterly indifferent, unresponsive government. 

I’m currently in utter despair about the state of the UK and the fact that we have an extremely authoritarian government chiseling away at democracy and our fundamental human rights. The writing and the support work I do can sometimes feel relentless and overwhelming, and those of us supporting others don’t have a professional debrief session. We should probably address that and work together supporting each other a little more. But most of us probably seldom get time to stop and think about it.

I’m going to have to take some time out to deal with serious depression and exhaustion. In the meantime, would you please share my articles, because as depressing as they are, people in the UK need to know the way the wind is blowing.

I also want to say thank you for everyone who has supported my work over the past few difficult years, and those who have very frequently shared it. Also, thank you for all of the feedback you have given, which has kept me going.

I will be back as soon as I’m feeling more myself.

Thank you,
Sue x

dis-eq-roadshowGail Ward and me working with Debbie Abrahams and others


Here are my last few articles:

Welfare sanctions are killing people with chronic illnesses such as type 1 diabetes

Why private landlords are calling for ‘major overhaul’ of Universal Credit, many refuse to let properties to ‘high risk’ universal credit claimants

The Centre for Social Justice say Brexit is ‘an opportunity’ to introduce private insurance schemes to replace contribution-based social security

The government’s shameful lack of progress on disability rights in the UK – new report update and submission to the UNCRPD Committee

Concerns about the impact of Brexit on the human rights of disabled people in update report to UNCRPD

Damian Hinds rebuked for misusing statistics and being conservative with the truth

Government plans to use your phone and online data to police your lifestyle and predict ‘threats’ to your health

Government changes to Mental Capacity Act threatens human rights of vulnerable citizens

British Medical Association proposals deemed passive ‘euthanasia by stealth’ for disabled people with degenerative illnesses

Research finds ‘inaccuracies and distortions’ in media coverage of antisemitism and the Labour Party

Meet Liam and Michelle. It’s time to listen to the voices of homeless people about the fatal flaws of Universal Credit

Disability campaigners & organisations meet with Labour ministers to discuss devastating impacts of government’s draconian disability policies

I had a spot on message from my friend Hubert, who sometimes shares his excellet posts on this site.

He says this: “This is the long term outcome of Tory Policies: the systematic destruction of people for no real reason. In the words of Jarvis Cocker, fuck the morals does it make any money. In her blog, Kitty Jones asks for Readers to share her writings. Not just this blog but all of her blogs.

As a Writer and Researcher, Kitty Jones is providing analytical, researched articles that are frequently expose stories a year before the mainstream media. These are articles that outrage and upset and depress because they are not pandering to the egos of narrow partisan interests. They are setting out the truth, the facts, the consequences of policies.

Which is depressing. Because Government Policy for almost a decade has been grinding destruction. The destruction of sharing between people who think about consequences. The destruction of sharing between people who care about others. The destruction of sharing of aspirations, utopias and ideals. The grinding destruction of the society that they do not believe in.

The core of changing that is sharing this. Sharing the ideas and research that can transform the world. Becaust the truth is, Government Policy is to create a hostile environment to everybody who is not “one of us”. Yet, some people, like Kitty Jones manage to carry on doing and researching and writing. Sharing her work is just one way to stop that hostile environment from spreading.

Please go to the blog and read. Then cut and paste the url from the address bar of your browser and share one of Kitty Jones’s articles. Please. Thank you.”

He added “Because you actually are making a difference. So it does look grim, but we still have visions like yours. 🙂”

 

I don’t make any money from my work. I write because it’s something I can do. We each do what we can, when we can and in our own way. 

If you like you can help by making a donation to help me continue to research and write informative, insightful and independent articles, and to continue to provide support to others. The smallest amount is much appreciated – thank you. 

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Research finds strong correlation between Work Capability Assessment and suicide

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In England between 2010 and 2013, just over one million recipients of the main out-of-work disability benefit, Employment Support Allowance (ESA) had their eligibility reassessed using a new stringent functional (as opposed to medical) checklist – the Work Capability Assessment.

Doctors, disability rights organisations, mental health chaities and individual campaigners, such as myself, have raised concerns that this has had an adverse effect on the mental health of claimants, but there have been no population level studies exploring the health effects of this or similar policies, until now.

Research, conducted by B Barr, D Taylor-Robinson, D Stuckler, R Loopstra, A Reeves, and M Whitehead, has established a link between the Work Capability Assessment (WCA) and suicide. The research, published in the Journal of Epidemiology and Community Health (which is peer-reviewed,) and carried out by social scientists from a variety of backgrounds, from the universities of Oxford and Liverpool, scrutinised the rates of mental health issues and suicide in different local authorities in England.

The study found that the authorities with a greater number of people undergoing WCAs also have more people reporting mental health problems, more people being prescribed antidepressants, and more people taking their own lives. The research found that every 10,000 assessments led to around six suicides.

For comparison in terms of statistical significance, isotretinoin, an acne medication which was notoriously linked to suicides, is associated with around four extra deaths per 10,000 treatments.

The researchers estimate that for every 10,000 people reassessed, you would expect to see an additional six suicides (95% confidence interval (CI) 2 to 9), an extra 2,700 reports of mental health problems (95% CI 548 to 4,840) and 7,020 extra antidepressants prescriptions (95% CI 3,930 to 10,100). By convention, 95% certainty is considered high enough for researchers to draw conclusions that can be generalised from samples to populations.

There have been more than 1 million assessments since the WCA was introduced, which suggests that there may be more than 600 people who have taken their own lives who would otherwise have not. The researchers say: “Our study provides evidence that the policy in England of reassessing the eligibility of benefit recipients using the WCA may have unintended but serious consequences for population mental health.”

There have been earlier claims and evidence that the Department for Work and Pension’s (DWP) reforms have led to deaths. However, the DWP has persistently refused to release data which would make it possible to assess whether the death rate for people found fit for work is higher than would be expected.

Both the assessment and appeals process itself, which is widely reported to be stressful, and the financial hardship that occurs when people are denied disability benefits, could result in negative health effects. There is good evidence that loss of income, particularly for people already on low incomes, increases the risk of common mental health problems.

People undergoing a WCA are likely to be particularly vulnerable to the adverse mental health consequences of this policy because a very high proportion have a pre-existing mental health problem. Furthermore, those with physical chronic illness are more prone to mental health problems such as reactive depression, and sometimes, forms of depression that are associated with the illness itself.

The research included efforts to rule out other possible causes of suicide – to eliminate potential confounding variables and bias – for example, there is no similar effect found in people over 65, who are not subject to the WCA – and so the results suggest that the link between the WCA and suicide is not due to “confounding” factors, but is most likely causal.

The Department for Work and Pensions has rejected the study’s findings. A spokesperson said in a statement: “This report is wholly misleading, and the authors themselves caution that no conclusions can be drawn about cause and effect.” 

However, the DWP have no grounds for their own claim whatsoever. Whilst correlation isn’t quite the same thing as cause and effect, it often strongly hints at a causal link, and as such, warrants further investigation. It certainly ought to raise concern from the DWP and ministers, regarding the negative impact of policy on many of the UK’s most vulnerable citizens.

The association with the WCA and its adverse effects is, after all, more clearly defined than the one between the drug isotretinoin and suicide, and the drug was withdrawn in the US and some European Member States.

In the UK, it is now (as of November last year) prescribed only under strict monitoring conditions, and patients are provided with warnings about the possibility of adverse psychiatric effects. No such warning and monitoring exists regarding the possible adverse psychiatric effects of the WCA. In fact the government have stifled both enquiry into a causal link and discussion of even the possibility there may be such a causal link, despite being presented with much evidence of a strongly indicated correlative association.

Dr Benjamin Barr, one of the researchers from Liverpool University, said that a causal link was likely: “Whilst we cannot prove from our analysis that this is causal, there are various reasons why this is a likely explanation,” he said.

He agreed that a study looking specifically at people who had undergone a WCA would be more precise, but added that the DWP has not released that information.

Dr Barr said: “If the DWP has data on this they should make it openly available to independent analysis.” He added that the DWP has so far chosen not to run a trial of its own into a link between WCAs and suicides.

The researchers 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 the 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. These increases followed – rather than preceded – the reassessment process.

The report concluded that the study results have important implications for policy. The WCA and reassessment policy was introduced without prior evidence of its potential impact or any plans to evaluate its effects. Given that doctors and other health professional have professional and statutory duties to protect and promote the health of patients and the public, this evidence that the process is potentially harming the recipients of these assessments raises serious ethical issues for those involved.

The Royal College of Psychiatrists has also said the research was of “high quality”, adding that it called into question the wisdom of the Government’s reforms.

Last year, coroner Mary Hassell told the DWP she had concluded that the “trigger” for Michael O’Sullivan’s suicide was his fit for work assessment.

“During the course of the inquest, the evidence revealed matters giving rise to concerns. In my opinion, there is a risk that future deaths will occur unless action is taken,” she wrote in the document, known as a Prevention of Future Deaths or regulation 28 report.

At the inquest, Hassell said O’Sullivan had been suffering from long-term anxiety and depression, “but the intense anxiety which triggered his suicide was caused by his recent assessment by the Department for Work and Pensions [benefits agency] as being fit for work and his view of the likely consequences of that”.

The inquest heard that the DWP assessing doctor, a former orthopaedic surgeon, did not factor in the views of any of the three doctors treating O’Sullivan. The coroner said O’Sullivan was never asked about suicidal thoughts, despite writing them down in a DWP questionnaire.

Previously, the loss or reduction of benefits has been cited by coroners as a factor in deaths and suicides of claimants.

The DWP have so far failed to respond coherently, other than with a denial of a “causal” link.

You can read the full research report here.

It’s not the only time that Conservative austerity policies have been implicated in causing harm to citizens. Nor is it the only time that Conservatives have responded with utter indifference to the disproportionately negative impact of their policies on the poorest people. 

A study from Durham University, which looked at over 70 existing research papers, concluded that as a result of unnecessary recession, unemployment, welfare cuts and damaging housing policies, Margaret Thatcher’s legacy includes the unnecessary and unjust premature death of many British citizens, together with a substantial and continuing burden of suffering and loss of wellbeing.

The research shows that there was a massive increase in income inequality under Baroness Thatcher – the richest 0.01 per cent of society had 28 times the mean national average income in 1978 but 70 times the average in 1990, and UK poverty rates went up from 6.7 per cent in 1975 to 12 per cent in 1985. Suicides increased.

Co-author Professor Clare Bambra from the Wolfson Research Institute for Health and Wellbeing at Durham University, commented: “Our paper shows the importance of politics and of the decisions of governments and politicians in driving health inequalities and population health. Advancements in public health will be limited if governments continue to pursue neoliberal economic policies – such as the current welfare state cuts being carried out under the guise of austerity.”

David Cameron’s government has gone much further than Thatcher ever did in cutting essential support and services for protected social groups, such as sick and disabled people, and poorer citizens.

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Pictures courtesy of Robert Livingstone