Tag: Suicide

National Audit Office to investigate DWP suicide monitoring of social security claimants

SUICIDE_PREVENTION

The National Audit Office is to demand information from Department for Work and Pensions (DWP) on a ‘serious and important’ issue after ministers refuse to provide figures on how many people claiming social security have taken their own lives. The watchdog is to investigate the government’s monitoring of suicides among welfare claimants amid longstanding concerns about links between welfare reforms and declining mental health.

The National Audit Office (NAO) said it would call on the DWP to reveal what information it held on the suicides, after ministers refused to provide an MP with figures on the number of people in the welfare system who had taken their own lives.

In a letter seen by The Independent, the watchdog said it was “clearly a very important and serious” topic and that it would consider trying to collate the information itself if the government could not provide it. 

It comes as charities raise concerns about links between welfare reforms and declining mental health among claimants, with an increasing number of self-inflicted deaths being associated with financial difficulties stemming from cuts to support. 

A number of studies have established links specifically between universal credit and an increased risk of suicide, with experts blaming the “complicated, dysfunctional and punitive” nature of the new benefit and the frequency at which it pushes people into hardship, debt and rent arrears.

In December 2017, for example, concern was also raised when an analysis of NHS data showed that attempted suicides among out-of-work disability support had more than doubled since the introduction of work capability assessments in 2008.

The survey revealed that 43 per cent of Employment and Support Allowance (ESA) claimants – and as high as 47 per cent of female ESA claimants – had attempted suicide in their lifetimes, compared with 7 per cent of the general population.

In response to the figures, Dr Jay Watts, a consultant clinical psychologist and member of the campaigning Alliance for Counselling and Psychotherapy, said at the time: “These results are staggering. It is difficult to overemphasise how large a jump in rates of attempted suicide this is. I cannot think of a greater jump in rates in any population. 

“If the Government has any real interest in suicide prevention, benefits reform must be the immediate priority. The UN has condemned the government’s treatment of disabled people as contrary to their human rights.

“The shame, guilt, anxiety and paranoia the current system provokes is a national scandal, that should be headline news. Making the workless feel worthless, and under-serving of support, has provoked a mental health emergency.”

A study by leading academics of claimants and support staff in Gateshead and Newcastle found the new benefit to be a “complicated, dysfunctional and punitive” system that forces people into debt and rent arrears and “simply doesn’t work” s claimed by the government.

The research, among the first to focus on the experiences of claimants in a universal credit full service area, also said it was making people increasingly anxious and depressed and worsening existing health problems. Catherine Donovan, deputy leader of Gateshead Council, said: “This report confirms the significant hardship we have seen people and families in Gateshead endure for some time now.

“Austerity is not over. The roll out of universal credit means people are having to choose between eating and heating. It is appalling that people in this study talked about feeling so low, they had considered suicide.

“They talked about the shame and stigma of using food banks. With Christmas coming, the impact on communities and families will be extremely hard. I’m calling on government to scrap universal credit as a matter of urgency.”

At the time the research was published, a DWP spokesperson said: “This survey of 33 claimants doesn’t match the broader experience of more than 9,000 people receiving universal credit in Gateshead, who are taking advantage of its flexibility and personalised support to find work.”

That is atrocious gaslighting. 

There are also serious concerns and individual case of premature mortality, within a short time of someone being deemed ‘fit for work’, as well as the increase in numbers of people having suicidal thoughts and taking their own life, raised by many disability campaigners since the implementation of welfare ‘reforms’.

The United Nations concluded in a formal inquiry that the welfare ‘reforms’ have ‘systematically and gravely’ violated the human rights of ill and disabled people. 

Government ministers, however, simply denied that this is so, and have accused us of “scaremongering” denying any “causal link” between their punitive policies and distress and harm of citizens. Yet studies have established a clear correlation. Without further investigation, the government have no grounds to dismiss the possibility of a causal link. 

Campaigners have said that it was “unacceptable” that the DWP does not appear to record suicides among people claiming social security support and that it was “vital” for it to start doing so in order to assess the impact of changes to the welfare system.

Kamran Mallick, from Disability Rights UK, said: “This is a crucial issue which demands a thorough review. The welfare benefits system is confusing and challenging to navigate at the best of times.

“The causes of suicide are complex and multi-layered. But there’s no doubt that few disabled people find the benefits system welcoming and supportive, and for some it induces high levels of mental and emotional distress.”

Deborah Coles, director of charity Inquest, said: “That people have been so desperate to take their own lives as a result of the punitive and cruel benefits system is a serious concern that requires much greater scrutiny.”

Frank Field MP, chair of the Work and Pensions Committee, who requested the data from ministers in a written question, said in his subsequent letter to the NAO: “I struggle to believe that, given the time it must take to put together evidence for inquests, attend court hearings, and internally review the decisions, that there is no record of such. 

“It shocks me even more that the DWP is apparently unconcerned with the most drastic efforts of its policies and conducts no internal monitoring of the tragedies in which it is complicit.”

Field told The Independent he was “pleased” to hear that the NAO was now looking into the issue, adding: “This for the first time will give us some concrete facts on the link between the current welfare system and suicide rates among claimants.”

In one suicide case, published in April in Derbyshire Live, a man who took his own life after running out of money for his electricity meter reportedly left a suicide note sarcastically “thanking” universal credit bosses.

In another, an inquest ruled last month that the mental health of a disabled man who took his life after his benefits were cut was “severely and adversely” affected after the DWP declared him fit for work, as reported by the newspaper.

Ayaz Manji, senior policy and campaigns officer at Mind, said: “Suicides are not inevitable, they can be prevented, and the DWP is responsible for making make sure its processes and policies are safe for those of us at our most unwell, and not causing serious harm.

“We still hear every week from people with mental health problems who have struggled to cope with the impact of sanctions, repeated and unnecessary fit-for-work assessments, and other changes to their benefits. 

“It’s important that the DWP is held to account when independent investigations cite problems with benefits as a factor in someone taking their life. We cannot continue to wait until someone else takes their own lives before change happens.

Sara Willcocks, head of communications at charity Turn2us, said: “It is disappointing that the DWP does not already know how many of its claimants have committed suicide. We believe it is vital that the department records this data so it can draw correlations between changes to the welfare benefits system and increases or decreases in suicide.”

A DWP spokesperson said: “The death of a claimant is always a tragedy and whilst this is not an inquiry, we will engage with the NAO on this important topic.”

However, an inquiry is long overdue.

How many people with chronic illness and disability have simply died because they can’t meet their most fundamental survival needs in light of austerity cuts?

What kind of government shows no concern or remorse that its policies are destroying some citizens’ lives?

And continually denies that this is happening?

This prompts another question;  the risk of suicide among support-dependent disabled people is now foreseeable. Does the government intentionally disregard us as economically “surplus to requirements” and ultimately disposable? When the evidence points so clearly to the relationship between austerity cuts, which have disproportionately been targeted at the poorest and most fragile citizens, and suicide, it’s hard to reason otherwise. Especially when the government shows nothing but supreme indifference to those of us raising these serious concerns.

The link between social security cuts and suicide cannot and must not be denied or ignored any longer.

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If you’re feeling suicidal, you can contact your GP, call 999, go to A&E, call the Samaritans on 116 123, or email them at jo@samaritans.org


 

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Twin brothers found hanging from tree in tragic suicide pact after benefits were cut

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Vulnerable twin brothers were found hanging from a tree in Greater Manchester within months of their social security support being axed by the Department for Work and Pensions (DWP), the Manchester Evening News reportsNeil and Paul Micklewright were found by someone walking their dog in Urmston on 31 July 2018.

Suicide notes were found in the brothers’ pockets, and similar longer notes were found “neatly laid out” on a table in their home. Police coroners officer David Wood told an inquest that when officers searched the brothers’ flat they found financial documents had been arranged in folders, the fridge and freezer had been emptied and defrosted, the fish tank had been emptied and cleaned, their clothes had been packed away in plastic bags, electrical appliances had been switched off, the batteries were removed from the smoke alarms and the beds had been stripped.

The two brothers, who are said to have “relied on each other most of the time”, were reported to have received £40,000 inheritance following the death of their mother which resulted in their benefits being stopped. However, it is also reported that neither brother had more than a few pounds in their bank accounts at the time of their deaths. Their sister Julie Gillaspy told an inquest that the twins were “too proud” to go back to claim social security and were suffering financial hardship in the months leading up to their death.

The inquest into the 52-year-old twins’ deaths heard that they were “gentle, kind and generous”, and had lived with their parents their entire lives.

 Gillaspy described the two men as “introverted,”  adding: “They were very close, sometimes to the exclusion of others.” She said that she had “struggled to understand” why her brothers took their own lives. 

The two suicide notes found in the pockets of the brothers and the two found left n their home were described by a coroner as “essentially identical”, and offered no real clue as to the reasons behind the apparent suicide pact, other than to say that they had “had enough”. 

But it was clear that the twins were vulnerable. “I think they struggled socially and I think it all just got on top of them”, Gillaspy said.

“They were very proud people who perhaps weren’t dealt the best hand in life.”

A post-mortem examination gave both brothers’ cause of death as hanging.

Wells said the brothers’ suicide pact “appeared to be a well-planned event”, he added: “All suicides are tragic but the death of two brothers in these circumstances is particularly tragic.”

Researchers and sociologists have identified several causes for rises in the rate of suicide in the United Kingdom; these include recent recessions, unemployment, austerity measures and loneliness. Research undertaken by Samaritans suggested that mental-health issues of middle-aged men and loss of masculine pride and identity are also major factors behind the high rate of suicide.

It is very difficult to establish a single cause of suicide, the reasons are often very complex. One of the thoughts that struck me when I wrote this is how inaccessible our social security system has become, especially for vulnerable people. One of the reasons for this is related to the stigma that has been attached to claiming support, which has happened at least in part because of utterly irresponsible political and media scapegoating narratives, as well as the government’s programme of punitive welfare policies. This made me very angry and also, terribly saddened, because those people who need support the most are being catastrophically let down by a dehumanising system.

There is no narrative from the inquest, as far as I know, that explains why the twin brothers had scarcely any money in their accounts to get by, given the reported circumstances of their inheritance. 

The Samaritans and other charities and campaign groups have called for a prioritisation of resources towards services aimed at suicide reduction and prevention. 

My own view is that unless we ensure people can meet their basic living needs as a society – such as ensuring that social security is accessible and covers the costs to secure food, fuel and shelter – citizens’ psychosocial needs will always be less of a priority, while they are struggling to survive. Abraham Maslow’s iconic hierarchy of human needs explains how psychological and social wellbeing is very much dependent on our physical wellbeing, and meeting survival needs. 

It is difficult to report on suicide. I try my best to do so responsibly and sensitively, while ensuring that the wider public are kept informed. It is important not to brush over the complex realities of suicide and its devastating impact on those left behind, and to also remain mindful of how an article is written, which may have potential consequences for others, including people who are vulnerable, or who identify with the persons who have died.

I know that researching and writing about suicide affects my own state of mind.

If you have been affected by this article, or if are experiencing distress and anxiety and don’t know who to talk to, the Samaritans (116 123) operate a 24-hour service available every day of the year. If you prefer to write down how you’re feeling, or if you’re worried about using the phone, or being overheard, you can email Samaritans at jo@samaritans.org

The Sanctuary (0300 003 7029 ) helps people who are struggling to cope – experiencing depression, anxiety, panic attacks or in crisis. You can call them between 8pm and 6am every night.

 


My work is unfunded and I don’t make any money from it. This is a pay as you like site. If you wish you can support me by making a one-off donation or a monthly contribution. This will help me continue to research and write independent, insightful and informative articles, and to continue to provide support others who are affected by the welfare ‘reforms’. 

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A man ended his life when his ESA award was stopped, because he couldn’t find work

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Damien Lawler, who had a generous nature and a heart of gold. (Image: Karen Lawler)

Last year on 19 July, Karen Lawler found her son Damien, aged 34, dead at his flat in Newtown Court, Hull.

Damien killed himself after struggling to find work and his social security support – Employment and Support Allowance (ESA) was due to be stopped. Known as ‘Damo’ to his family, he was found dead in his flateast Hull, flat with a suicide note in his hand.

In the note, he wrote that he felt like a “hindrance” and “couldn’t carry on anymore” after having no success for the numerous job applications he had made. He also wrote that his ESA was due to be cancelled, and he was so terrified about being put on Jobseeker’s Allowance he was experiencing “stupid” panic attacks.

He wrote: “I’m sorry for all the pain and heartache I’m leaving behind. I love you with all my heart but I can’t carry on anymore.”

Damien’s mother, Karen Lawler, spoke of her heartache and described her son as someone “with a heart of gold”.  She said: “He never had much money but he would always give his last penny or his last cigarette to a homeless person on the street. He always had a care for the homeless.” 

“He had a wicked sense of humour and a heart of gold. He would do anything for anybody.”

Lawler, who found her son after letting herself into his home on July 19, 2018, said her son had been suffering depression for a number of years, and said more needed to be done to support people with mental health issues.  She said: “Damo was just so tired and exhausted with it all.

“There was not enough support for him.

“There’s just nothing there. He’s not the only one. The recent cases with males in Hull is going sky high because they can’t cope anymore.”

An inquest on Tuesday heard Ms Lawler took her son to his GP in November 2013 after he deliberately self-harmed, using a Stanley knife to cut off his toe nails. He was prescribed with anti-depressants but his mental health difficulties took a turn for the worse in 2017.

During a visit to his GP in January 2018, Damien revealed he had thoughts of self-harm and suicide. He was advised to return to the surgery for further consultation, but he did not follow through with the appointments.

Many people who are ill and struggling find it very difficult to keep appointments, especially when they face difficulties accessing acute services for help. Many need immediate help to follow from the first appointment, because by that time, they are in crisis. But all too often, people in terrible distress, with suicide ideation, are being told they must attend yet another appointment.

This system sets up a bureaucratic wall, placing an all too often insurmountable barrier between citizens in the greatest need – those least ability to cope with navigating the wall – and the services and support they need to access. 

We must also question the decision to end Damien’s ESA award, when he was so clearly ill and unfit for work. We must challenge a system that leaves people feeling as if they are some kind of ‘burden’ simply because they are ill.  

“There needs to be something there if they do not turn up for any appointments,” said Ms Lawler.  “They cannot just discharge someone. They need to try and find out why they have not come to the appointment. Maybe contacting a next of kin or something.

She added: “I don’t know what the answer is and I don’t suppose there is an easy answer but something needs to be changed. Something has got to change in Hull, it really has.”

I agree. Something has to change. The social security and health care systems no longer function to meet fundamental human needs. Instead they have been redesigned to provide as little support as possible at the lowest costs, while a host of private companies make profits at citizens’ expense. 

The Coroner, James Hargan, returned a verdict of suicide.

If you need help

Please, please talk to someone.

Samaritans (116 123)
 samaritans.org operates a 24-hour service available every day of the year. If you prefer to write down how you’re feeling, or if you’re worried about being overheard on the phone, you can email Samaritans at jo@samaritans.org , write to Freepost RSRB-KKBY-CYJK, PO Box 9090, STIRLING, FK8 2SA and visit http://www.samaritans.org  find your nearest branch.

CALM (0800 58 58 58) thecalmzone.net has a helpline is for men who are down or have hit a wall for any reason, who need to talk or find information and support. They’re open 5pm to midnight, 365 days a year.

Childline (0800 1111 ) runs a helpline for children and young people in the UK. Calls are free and the number won’t show up on your phone bill. 

PAPYRUS (0800 068 41 41) is a voluntary organisation supporting teenagers and young adults who are feeling suicidal. 

Depression Alliance is a charity for people with depression. It doesn’t have a helpline, but offers a wide range of useful resources and links to other relevant information depressionalliance.org 

Students Against Depression is a website for students who are depressed, have a low mood or are having suicidal thoughts. Bullying UK is a website for both children and adults affected by bullying studentsagainstdepression.org

You can also contact me on this site any time, too. I’m a good and experienced listener. I can also signpost people to organisations that can help.

 



I don’t make any money from my work. I have a very limited income. But you can help if you like, by making a donation to help me continue to research and write informative, insightful and independent articles, and to provide support to others affected by the Conservative’s welfare ‘reforms’. The smallest amount is much appreciated – thank you.

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Fear of losing disability support led a vulnerable man to a horrific suicide

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The government have persistently denied that there is a “causal link” between their welfare “reforms” (a Conservative euphemism for savage cuts) and an increase in suicides, premature deaths, psychological distress and severe hardship. However, a number of researchers and many campaigners have demonstrated a clear correlation that the government have so far refused to investigate further. Correlation quite often implies a causal relationship, and as such, requires further research.

Each case that has been presented to the government as evidence that their policies are causing severe harm has been dismissed as “anecdotal”.

Dr Simon Duffy, Director of the Centre for Welfare Reform said: “It is not enough to just stop introducing new policies to attack the rights and lives of disabled people and the poorest in society. These policies have been in place for six years and many are designed to increase poverty year on year. The Government should apologise for the harm it has caused since 2010, calculate the full impact of cuts that targeted the most disadvantaged and begin a full programme of reparations.”

This is the third harrowing article I have written this week about the devastating impact of the Conservatives’ punitive welfare policies on some of our most vulnerable citizens. I wish with all my heart that this is the last such article.

However, we have a government that has casually and systematically transgressed the human rights of disabled people, and then casually denied that they have done so. 

There will continue to be a need of witnesses like myself and other campaigners until the political denial stops.

Last month, an inquest in Ipswich heard how Peter, a disabled man, struggling to cope with mental health problems, committed suicide by setting himself on fire because of fear that he would lose his lifeline support, following his compulsory re-assessment for Personal Independence Payment (PIP).

The government introduced the controversial PIP to replace Disability Living Allowance (DLA) in order to save costs and to “target those most in need” in 2013.  

Peter Sherwood set fire to himself in front of horrified onlookers in Lowestoft town centre on September 4, 2015.  The retired builder died in Broomfield Hospital, Chelmsford, which has a specialist burns unit, on September 8, 2015, following the horrific incident in Lowestoft town centre four days before.

Peter had received a letter from the Department for Work and Pensions, informing him that his DLA was ending and that he needed to reapply for PIP.

He suffered with a recurrent depressive disorder and psychosis. Peter had attempted to take his own life on a number of occasions previously. He also had a condition called tardive dyskinesia, which caused involuntary movements to his mouth and is a known side-effect of anti-psychotic medications.

Giving evidence at the inquest, Lucinda Stapleton, care coordinator from the Waveney Recovery Team, said this had affected Peter’s self-confidence as he was worried people were laughing and staring at him when he left the house.

In a statement read during the hearing, Mr Sherwood’s niece, Sarah Wilby, said: “I knew he was feeling a bit low the last time I saw him, which was two weeks before he died. He held me close on the sofa and told me he loved me.

“He was a loving person and had a great sense of humour.

He was angry at many things in life, but could put a good front on.

“I loved him very much and miss him dreadfully.”

Ms Wilby said she was shocked at the drastic way her uncle took his own life.

She added: “He seemed to want to make some kind of a statement, but I don’t know what.”

During the inquest Ms Wilby said that Peter was claiming Disability Living Allowance but not long before his death he received a letter informing him he needed to reapply for Personal Independence Payment, which she believes contributed to his low mood at that time.

She said: “I personally think quite an underlying cause of his anger was the change in benefits.

“Knowing Peter as we did that would have had a huge impact on him.”

Paul Anderson, a community support worker for the Norfolk and Suffolk Foundation Trust, said Peter had claimed that the Government was trying to take money off him.

The Coroner, Peter Dean, read statements from witnesses, who described seeing Peter spraying something on the pavement starting with the letter ‘h’ with an aerosol can.

The inquest heard passer-by William Groves asked Peter if he was a street artist, to which he replied “no, I’m a suicide artist”.

Peter then poured liquid over his head and set himself on fire using a lighter.

Members of the public tried to douse the flames by first throwing their jackets onto Peter, and then using a fire extinguisher from a nearby shop.

Police at the scene reported that Peter had muttered the word “humanity” to them a couple of times following the incident.

On September 4, 2015, Peter was visited at home by the community mental health team and he had expressed plans to end his life.

An urgent appointment was made for Peter to see a psychiatrist the following week, but it was tragically too late.

Norfolk and Suffolk NHS Foundation Trust has since updated its criteria of when patients should be referred to the 24-hour crisis team, following its routine investigation into Peter’s death.

The medical cause of death was given as 75% non-survivable full thickness burns, and mental health concerns.

The coroner’s conclusion was suicide.

If you are experiencing distress and feel suicidal, please don’t suffer in silence. The Samaritans have launched a free telephone national helpline number, 116 123. 

People who are going through a difficult time can access the service round the clock, every single day of the year.

This number is free to call from both landlines and mobiles, including pay-as-you-go mobiles. You do not need to have any credit or call allowance on your plan to call 116 123.

 

Related

Government guidelines for PIP assessment: a political redefinition of the word ‘objective’

New discriminatory regulations for PIP come into effect today

Disabled mum took fatal overdose after she was refused PIP

Vote Labour to uphold the rights of disabled people – our letter to the Guardian


 

I don’t make any money from my work. I am disabled because of illness and have a very limited income. 

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

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Vote Labour to uphold the rights of disabled people – our letter to the Guardian

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The following letter was published in the Guardian today, written and signed by a group of academics, professionals, campaigners and grassroots activists who work together cooperatively.

We collaborate to fulfil our mutual aims of achieving a progressive, civilised, just and safe society for all. We hope to do this by ensuring that the society we are a part of is democratic and fully inclusive: we want a civilised society that observes and meets its human rights obligations on behalf of all social groups. This isn’t happening currently. (See: UN’s highly critical report confirms UK government has systematically violated the human rights of disabled people).

As an independent researcher, writer, campaigner, and as a disabled person, I am very proud to be included among them. 

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Many disabled people see Labour’s policies as a lifeline, say the 30 signatories to this letter. 

For chronically ill and disabled people, recent years have been a disaster. The UN recently found “reliable evidence that the threshold of grave or systematic violations of the rights of persons with disabilities has been met” (Report, 8 November 2016).

We have been forced through a work capability assessment that the government’s own expert adviser described as “inhumane”, and which in 2015 was found to be associated with an additional 599 suicides.

Many needing help are now forced through another persecutory assessment – the personal independence payment – designed to reduce the numbers qualifying for help by half a million.

Social care has been so savagely cut that some young disabled must wear incontinence pads for lack of toileting assistance. People can’t take any more of this.

Many disabled people are not party-political, but see Labour’s policies for disabled people as a lifeline – envisioning a society where people are treated as human beings deserving of respect, equality and a decent life. Please, don’t endorse recent human-rights abuses; endorse the human rights of disabled people by registering, and by voting Labour on 8 June.

Paul Atkinson Jungian psychotherapist
Stef Benstead Spartacus Network
Peter Beresford Co-chair, Shaping Our Lives
Gary Bourlet Founder, People First Movement in England
Dr Emma Bridger Research fellow in psychology
Professor Woody Caan Journal of Public Mental Health
Dr Kelly Camilleri Registered clinical psychologist
Merry Cross
Dr David Drew Labour Parliamentary candidate for Stroud
Nick Duffell Psychohistorian
Dr Simon Duffy Centre for Welfare Reform
Dr Dina Glouberman Skyros Holistic Holidays
Catherine Hale Chronic Illness Inclusion Project
AC Howard DWPexamination.org – For The UK’s Disabled Community
Chris Johnstone General practitioner
Sue Jones Psychologists Against Austerity, researcher and writer, campaigner
Jayne Linney Disability activist
Alec McFadden TUC Salford
Helen McGauley Trainee clinical psychologist, Lancaster University
Beatrice Millar Person-centred counsellor/psychotherapist
Rev Paul Nicolson Taxpayers Against Poverty
Gavin Robinson Alliance for Counselling and Psychotherapy
Professor Andrew Samuels University of Essex
Nicola Saunders Psychotherapist
Martyn Sibley Disability blogger
Mike Sivier Vox Political
Professor Ernesto Spinelli
Mo Stewart Independent researcher, disability studies
Gail Ward
Dr Jay Watts Queen Mary, University of London
Dr Claudia GillbergSenior Research Associate in Education; Fellow at Centre for Welfare Reform and Disability Rights Activist

Dr Richard House Alliance for Counselling and Psychotherapy

 

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters


I don’t make any money from my work. I am disabled because of illness and have a very limited income. The budget didn’t do me any favours at all.

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

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Woman sanctioned after miscarriage was left in poverty and suicidal

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A woman was left with just £24 each week of her social security to live on after suffering a miscarriage and being sanctioned. She has told the Daily Record how she considered suicide after being left with barely anything to buy food and pay bills.

Lyndsey Turnbull told of her ordeal as the Scottish Government formally launched their new welfare-to-work programmes.

Lyndsey from Midlothian, said: “I wanted to get into work but the whole thing seemed geared up to punish those who wanted to get off benefits.”

She was on approximately £140 a fortnight Employment and Support Allowance when she missed an appointment after having a miscarriage around nine weeks into a pregnancy.

She said: “I was in a bad place and couldn’t talk to anyone about it.”

Lyndsey was sanctioned because was too distressed to disclose the reason for missing the appointment, which is absolutely understandable. However, the punitive sanctions framework does not accommodate people’s circumstances and situations when they may be very vulnerable.

Having to face a stern and unsupportive bureaucrat, whose role is to discipline and punish people who cannot comply with rigid welfare conditionality, to discuss deeply personal and distressing circumstances – and such a traumatic event as miscarriage – is the very last thing anyone needs. 

She added: “I went down to £24. I had no food, nothing to pay bills. It was awful.

“I really thought suicide might be the only option – and I wondered how many people would be just like me.”

Fortunately, Lyndsey eventually found someone to talk to at welfare service group Working Links, who helped her to get a second sanction reduced.

She later found a job at a petrol station and she said the new system’s voluntary focus will make it easier for people to get off benefits.

Lyndsey courageously contributed to a group meeting with Scottish National Party (SNP) Employability Minister Jamie Hepburn, to explain the problems she faced with the UK Department for Work and Pension sanctions regime.

Holyrood has no control over major benefits policy. However the new Scottish programmes will be voluntary – with no financial penalties attached – in a bid to get better results.

In other words, they will be genuinely supportive, rather than punitive and mandatory.

Around 4,800 people with disabilities and health conditions will get some help into work, the Daily Record reports.

Employment support is one of the first powers devolved through the Scotland Act 2016, made possible by the Vow of more powers before the independence vote.

Work First Scotland will help 3300 disabled people while Work Able Scotland will focus on 1500 people with long-term health conditions.

The Record revealed last year that the SNP would block any bid by Westminster to impose a sanctions system on the new programmes.

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Batul Hassan, 49, who also met Hepburn yesterday, was made redundant after 11 years at a local authority and was helped into work by Remploy.

She has dyslexia, dyspraxia and hearing problems and said her previous employer struggled to understand her needs.

Batul, from Edinburgh, added: “The new system has the potential to be a good thing.

“Two contracts mean people can move at the right pace, not lumped together.”

Hepburn said: “The devolved services will have fairness, dignity and respect at their core.

“We believe people will see them as an opportunity to gain new skills through supportive training and coaching.”

The Conservatives have clearly changed the meaning of words such as “fairness”, “support” and “respect”, in order to persuade the public that their punitive policies are somehow acceptable, and to deny the negative consequences they have on people who need the most support.

They are not acceptable.

 


 

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Dying from inequality: socioeconomic disadvantage and suicidal behaviour – report from Samaritans

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As Samaritans release a report ahead of Wednesday’s Budget linking inequality with a higher risk of suicide, the charity is calling on the government, businesses, industry and sector leaders to be aware of the risks of suicide and to direct support to those with unstable employment, insecure housing, low income or in areas of socioeconomic deprivation.

The report, Dying from Inequality, produced in conjunction with leading researchers and academics, is far-reaching and highlights clear areas of risk to communities and individuals, including the closure and downsizing of businesses, those in manual, low-skilled employment, those facing unmanageable debt and those with poor housing conditions.

In today’s press release, Samaritans’ CEO Ruth Sutherland says, “Suicide is an inequality issue that we have known about for some time, this report says that’s not right, it’s not fair and it’s got to change. Most importantly this report sets out, for the first time, what needs to happen to save lives. Addressing inequality would remove the barriers to help and support where they are needed most and reduce the need for that support in the first place. Government, public services, employers, service providers, communities, family and friends all have a role in making sure help is relevant and accessible when it matters most.

“Everyone can feel overwhelmed at times in their life. People at risk of suicide may have employers, or they may seek help at job centres, or go to their GP. They may come into contact with national and local government agencies, perhaps on a daily basis. So, in the light of this report we are asking key people and organisations from across society, for example those working in housing, in businesses, medical staff, job centre managers, to all take action to make sure their service, their organisation, their community is doing all it can to promote mental health and prevent the tragedy of suicide. 

Samaritans has already started addressing the inequalities driving people to suicide, by making its helpline number free to call, by calling on Government for more frontline staff to be trained in suicide prevention in England and by campaigning for local authorities to have effective suicide prevention plans in place. Now, in response to the findings of this report, the next steps will involve instigating working groups, in different sectors, bringing together businesses and charities who can influence in the areas highlighted, in order to tackle this issue in a collaborative, systematic and effective way to ensure that fewer people die by suicide.”

Sutherland continues: “Each suicide statistic is a person. The employee on a zero hour’s contract is somebody’s parent or child. A person at risk of losing their home may be a sibling or a friend. And each one of them will leave others devastated, and potentially more disadvantaged too, if they take their own life. This is a call for us as individuals to care more and for organisations that can make a difference, to do so.”

She went on to say: “Living in poverty shouldn’t mean losing your life. Going through difficult times like losing your job or being in debt shouldn’t mean not wanting to live. But that is what’s happening in the UK and Ireland today. Suicide is killing the most disadvantaged and vulnerable people, devastating families and communities.”

Some key points from the report summary:

There is no single reason why people take their own lives. Suicide is a complex and multi-faceted behaviour, resulting from a wide range of psychological, social, economic and cultural risk factors which interact and increase an individual’s level of risk.

Socioeconomic disadvantage is a key risk factor for suicidal behaviour.

Socioeconomic disadvantage or living in an area of socioeconomic deprivation increases the risk of suicidal behaviour.

The research evidence was considered at three levels: societal, community and individual: 

Societal: political, economic and social policies related to, for example, economic change, employment, social support and the labour market; stigmatised attitudes towards people on the basis of their socioeconomic standing or their suicidal behaviour.

Community: the local economic, social, cultural and physical environment, including, for example, geographical location, job opportunities, service availability and accessibility, and home ownership.

Individual: demographic characteristics, such as gender and age; socioeconomic position, including occupational social class and type of employment; mental health; and health-related behaviours.

Suicide risk increases during periods of economic recession, particularly when recessions are associated with a steep rise in unemployment, and this risk remains high when crises end, especially for individuals whose economic circumstances do not improve. Countries with higher levels of per capita spending on active labour market programmes, and which have more generous unemployment benefits, experience lower recession-related rises in suicides.

During the most recent recession (2008-09), there was a 0.54% increase in suicides for every 1% increase in indebtedness across 20 EU countries, including the UK and Ireland. Social and employment protection for the most vulnerable in society, and labour market programmes to help unemployed people find work, can reduce suicidal behaviour by reducing both the real and perceived risks of job insecurity and by increasing protective factors, such as social contact. In order to be effective, however, programmes must be meaningful to participants and felt to be non-stigmatising.

There is a strong association between area-level deprivation and suicidal behaviour: as area-level deprivation increases, so does suicidal behaviour. Suicide rates are two to three times higher in the most deprived neighbourhoods compared to the most affluent.

Admissions to hospital following self-harm are two times higher in the most deprived neighbourhoods compared to the most affluent. Multiple and large employer closures resulting in unemployment can increase stress in a local community, break down social connections and increase feelings of hopelessness and depression, all of which are recognised risk factors for suicidal behaviour.  

While the economic situation and policy approaches vary across the nations in which Samaritans operates, the link between socioeconomic disadvantage and increased risk of suicide is evident in all these nations. It is therefore essential that we understand why this link exists. We all need to address this inequality issue which is resulting in the tragic loss of lives.

Features of socioeconomic disadvantage include low income, unmanageable debt, poor housing conditions, lack of educational qualifications, unemployment and living in a socioeconomically deprived area. Individual Individuals experiencing socioeconomic disadvantage and adverse experiences, such as unemployment and unmanageable debt, are at increased risk of suicidal behaviour, particularly during periods of economic recession.

The risk of suicidal behaviour is increased among those experiencing job insecurity and downsizing or those engaged in non-traditional work situations, such as part-time, irregular and short-term contracts with various employers. The experience of being declared bankrupt, losing one’s home or not being able to repay debts to family and friends is not only stressful but can also feel humiliating. This can lead to an increased risk of suicidal behaviour.

The risk of suicidal behaviour increases when an individual faces negative life events, such as adversity, relationship breakdown, social isolation, or experiences stigma, emotional distress or poor mental health.

Socioeconomically disadvantaged individuals are more likely to experience ongoing stress and negative life events, thus increasing their risk of suicidal behaviour. In the UK, socioeconomically disadvantaged individuals are less likely to seek help for mental health problems than the more affluent, and are less likely to be referred to specialist mental health services following self-harm by GPs located in deprived areas.

Different welfare states have been shown to have different effects on social and health inequalities. High quality public service provision leads to a more cohesive society than policies based on means-testing which may generate social divisions. Given the link between inequalities and suicidal behaviour, labour market policy design can help improve wellbeing and reduce the risk of suicide.

Employment

Evidence on the association between working conditions, debt and suicide suggests that increased, involuntary part-time work, job insecurity and workplace downsizing are important risk factors for suicidal behaviour. It is not only unemployed people who are at increased risk. Employees who keep their jobs during a workplace downsizing may experience job insecurity and negative relationships with their peers, as well as stress from an increased workload. People who are self-employed can also be affected if demand for their business decreases. 

Unemployment benefits

Generous unemployment benefits and other types of social protection can reduce the risk of suicidal behaviour. Suicide rates tend to increase in countries which implement significant budget cuts, which was evident during the 2008-09 recession in some EU countries (Karanikolos et al., 2013). Unemployment benefits compensate for some of the income loss experienced from involuntary unemployment. Depending on the level of benefits, they should help ease financial worries that may lead to suicidal behaviour. However, means-tested benefits may actually contribute to suicidal behaviour, if recipients feel stigmatised, leading to feelings of shame, worthlessness, a loss of status, and a deterioration of mental health.

Employment protection

Strong employment protection should reduce real and perceived risks around job insecurity and unemployment, resulting in a positive impact on mental health. In contrast, weak employment protection is likely to increase real and perceived insecurity, and could lead to precarious forms of employment, such as temporary or zero-hours contracts, with adverse effects on mental health.

Inexperienced workers with low skills are particularly vulnerable in such contexts, since they are most likely to be on contracts which are less well protected and more precarious. The risk of mental health problems is increased among those engaged in non-traditional work situations, such as part-time, irregular and short-term contracts with various employers, especially where there is little or no choice, as well as for those experiencing job insecurity and downsizing. Suicidal behaviour can be reduced amongst the most vulnerable in society through social and employment protection and labour market programmes. This will reduce the real and perceived risks of job insecurity and reduce stigma of unemployment.

Recommendations:

Individuals, communities and wider society can all play a part in reducing the risk of suicidal behaviour. Governments need to take a lead by placing a stronger emphasis on suicide prevention as an inequality issue.

National suicide prevention strategies need to target efforts towards the most vulnerable people and places, in order to reduce geographical inequalities in suicide. Effective cross-governmental approaches are required, with mental health services improved and protected.

Suicide prevention needs to be a government priority in welfare, education, housing and employment policies. Workplaces should have in place a suicide prevention plan, and provide better psychological support to all employees, especially those experiencing job insecurity or those affected by downsizing.

Poverty and debt need to be destigmatised so that individuals feel valued and able to access support without fear of being judged. Every local area should have a suicide prevention plan in place. This should include the development and maintenance of services that provide support to individuals experiencing socioeconomic disadvantage.

Staff and volunteers in services accessed by socioeconomically disadvantaged individuals or groups should receive specialist training in recognising, understanding and responding to individuals who are in distress and may be suicidal (even if they do not say they are feeling suicidal). People bereaved or affected by suicidal behaviour, and therefore at higher risk of suicide themselves, should be offered tailored psychological, practical and financial support particularly in disadvantaged communities.

It is well understood that adverse individual or family circumstances, such as relationship breakdown, unemployment or debt, can result in a higher risk of suicidal behaviour (Gunnell & Chang 2016). What is less well known is the potential impact of the place where people live (neighbourhood, city, region) on the likelihood of suicidal behaviour.

The public health evidence is clear: as area-level deprivation increases, so does suicidal behaviour. For both men and women, those living in the most deprived neighbourhoods are more likely to engage in suicidal behaviour; and every increase in area-level affluence results in a reduction in the risk of suicidal behaviour.

The health of people in a neighbourhood, town, region or country is the product of the demographic, behavioural, socioeconomic and other characteristics of the people who live there. Compositional factors that are likely to increase the risk of suicidal behaviour in areas of socioeconomic deprivation include (O’Reilly et al., 2008; Lorant et al., 2005): experiencing multiple negative life events, such as poor health, unemployment, poor living conditions feeling powerless, stigmatised, disrespected, social disconnectedness, such as social isolation, poor social support other features of social exclusion, such as poverty, and poor educational attainment.

People living in the most deprived areas are more likely to engage in suicidal behaviour. Suicide rates are two to three times higher in the most deprived neighbourhoods compared to the most affluent, and rates of hospitalised self-harm are also twice as high. Neighbourhoods that are the most deprived have worse health than those that are less deprived and this association follows a gradient: for each increase in deprivation, there is a decrease in health. Additional support for those living in deprived areas is needed to reduce geographical inequalities in health and the risk of suicidal behaviour.

Experiences of childhood adversity, negative life events, and the cumulative effects of stress are associated with feelings of entrapment and hopelessness and increase the risk of suicidal behaviour, especially among those who are socioeconomically disadvantaged.

Stressful life events and childhood adversity

Exposure to negative life events, particularly those involving loss, such as bereavement or a relationship breakdown, heightens the risk of suicidal behaviour. Socioeconomically disadvantaged individuals are more likely to experience such negative life events, and therefore more likely to engage in suicidal behaviour. Experiencing childhood adversity increases the likelihood that individuals will become socioeconomically disadvantaged in later life.

For example, unemployment is more likely among those who have adverse childhood experiences, particularly men who have experienced childhood sexual abuse. Stress response and allostatic load Ongoing exposure to stress and adversity may gradually reduce an individual’s biological stress regulation resources, leading to a cumulative physiological toll known as “allostatic load” (Seeman et al., 2010).

Socioeconomic disadvantage itself is a stressor linked to increased allostatic load, but it may also influence allostatic load indirectly by increasing the likelihood of individuals experiencing childhood adversity and other stressful life events. Increased allostatic load brought about by the chronic and acute stresses associated with socioeconomic disadvantage may contribute to suicidal behaviour.

Socioeconomic disadvantage, from a psychological perspective, makes a major contribution to the occurrence of suicidal behaviour.

 

You can read the full summary report here

The full version of the report will be available on 10th March

 


 

I don’t make any money from my work. I am disabled because of illness and have a very limited income. But you can help by making a donation to help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you. 

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Young woman who committed suicide was called ‘a f****** waste of space’ by mental health worker

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Suicidal Hannah Groves did not get the support and care she needed

The  Mirror reports: “In the UK the number of ­women taking their own lives has grown steadily since 2011. Mental health issues make up 23 per cent of those with health problems making contact with the NHS. But mental health provision has received only 13 per cent of the overall funding. Since 2011 the number of beds for mental health patients has fallen by 8 per cent.”

Last year female suicides hit a ten year high.  In 2015 – 2016, only 55% of mental health trusts reported increases to budgets since 2012, when “parity of esteem” with physical health was promised by the government.

Last year, a leaked report by a government taskforce painted a bleak picture of England’s mental health services, revealing that the number of people killing themselves was soaring, three-quarters of those with psychiatric conditions were not being helped, and sick children were being sent “almost anywhere in the country” for treatment. Suicide in England is now rising “following many years of decline”, with 4,477 suicides in an average year. There has also been a 10% increase in the number of people sectioned under the Mental Health Act over the past year, suggesting their needs are not being met early enough. In some parts of the country, more than 10% of children seeking help are having appointments with specialists cancelled as a result of staff shortages.

Commenting on the situation last year, Labour’s mental health spokesperson, Luciana Berger, said the figures are a “wake-up call” for ministers.

“Ministers talk about making mental health a priority, but in reality they have presided over service cuts, staff shortages and widespread poor-quality care, with devastating consequences,” she said.

“It is particularly worrying that women’s suicide rates in England are now the highest they have been for a decade. Ministers must identify the reasons behind this drastic increase and take the urgent action needed to tackle it.”

Hannah Groves is one victim of a growing mental health crisis among women, as female suicide rates hit a ten-year high last yearHannah’s desperate mother begged for help in vain more than 100 times over nine days before her daughter killed herself.

Mandy Park’s distraught pleas were not only ignored by a Southern Health Trust mental health worker, they were ridiculed. Hannah was labelled an “attention seeker” and a “f***ing waste of space”.

Hours later Hannah was found dead at home, aged just 20. Hannah had made numerous suicide attempts in the nine days before her death yet was repeatedly ­denied admission to hospital.

Last year, the privatised Southern Health NHS Trust – which runs a series of mental health services across the county and is headquartered in Tatchbury Mount, Calmore – was condemned by the Care Quality Commission after failing to protect patients and investigate the deaths of hundreds of people in its care, following a scathing independent report. The Trust has been the subject of independent government reviews since it was revealed it failed to investigate the unexpected deaths of hundreds of its patients between 2011 and 2015. See also: Southern Health NHS Trust, a Drowning and a Call for Better Care Everywhere and Embattled NHS trust boss quits role but will keep salary and benefits in new job and Southern Health criticised for putting ‘patients at risk’.

Hannah was a straight-A student studying French at university, and she had no mental health ­problems until October 2012. Mandy believes she suffered a sudden onset of psychosis, but this was not diagnosed because she was not ­properly assessed.

On the night she got ill, Mandy gave Hannah a lift to her boyfriend’s and later had a ­panicked call from him.She picked up her daughter but on the trip home Hanna ­repeatedly tried to jump from the ­moving car. She also attempted to run into oncoming traffic.

Mandy said: “She was such a sweet, gentle person. But it was like she was possessed.

“Her voice had changed and she was speaking in a monotone.

“She didn’t smoke but she would pace the floor, chain-smoking and ­staring into space. I was terrified of my own girl. She kept saying she felt numb.”

Mandy took Hannah to A&E where the medical staff referred her to the Trust’s mental health crisis team. However, staff from the trust assessed Hannah and decided she did not meet the ­criteria for a bed in Antelope House, in her home town Southampton.

Over the next week she ­repeatedly attempted suicide. Mandy took her to ­hospital, to her GP and even to an out of area mental heath facility, desperately trying to get help.

Police and paramedics regularly attended the family home and she begged mental health workers to intervene, in vain.

Mandy said: “One time she had a scarf round her neck and I had to hold her down. I spent hours on the phone to the mental health team but they would sigh as soon as I told them who I was.

Hannah even got hold of the phone herself and was repeatedly telling them she was going to kill herself but they did nothing.”

Three days before her death, Hannah was taken to A&E once more, but was sent home again by the mental health Trust.

Mandy said: “Hannah fell on the floor in a heap. It was heartbretking. She knew she needed help.”

The evening before Hannah’s death, on October 22, 2012, her boyfriend brought her orange roses and she wrote the words “I’m still alive” on a chalkboard.  Mandy ­recalled she was so hopeful, she said: “I thought I was getting her back.”

The next day Mandy had to call the police after Hannah threatened to kill her family. She was arrested under the Mental Health Act.

Again, staff at Antelope House refused to admit her after a social worker told the police detention officer she was a “f***ing waste of space” an “attention seeker”.

Just hours later, Mandy found her daughter’s body. She had left her home for a matter of minutes to call the crisis team, begging for help once again.

Mandy painfully remembers “At the hospital I stood there while they did CPR. Then they said there was nothing more they could do. I fell on the floor, screaming the place down.”

The grieving mother decided to call medical ­negligence solicitor, Nick Fairweather, to fight for justice in her daughter’s memory.

Mandy was heartbroken and ­physically sick when she heard the comments about Hannah, who was a constant danger to herself.

Mandy said: “It beggars belief that ­anyone could treat another human that way.

“Hannah changed overnight from a happy young ­woman to a ­totally different person. She was my world.

“I love and miss her. She had so much to live for and to give. If she’d got the right treatment she’d still be here.”

Last month Mandy, a former ­support worker for deaf children, was awarded £260,000 in an ­out-of-court medical negligence settlement from Southern Health Trust.

The Trust admitted that Mandy had been a “secondary victim” of its ­failings after she developed post-traumatic stress ­disorder and spent six weeks in a ­specialist mental health facility. She has also ­contemplated ­suicide, but felt she could not leave her son Patrick, 21, without a mum.

Mandy said: “Finding Hannah’s body was the worst moment of my life. I have flashbacks every day. It’s like a film on a constant loop.

“The effects of these ­failings have been catastrophic. I’m ­terrified it will happen to someone else’s child.”

The Health Care Professions Council ruled the insults about Hannah were “undoubtedly spoken” but failed to prove the case against a named social ­worker.

Coroner Keith Wiseman ­delivered a narrative verdict at her inquest and ruled the Trust had “not adequately identified” the risks to Hannah.

Mandy said: “Everyone says I did ­everything I could but there are times when the guilt kicks in. I wonder if I should’ve just handcuffed us both to Antelope House.

“It’s 2017 but our attitude to mental health beggars belief – especially from those supposedly trained in this field.”

 She added: “A lot of people do judge, and say, ‘Snap out of it.’ But no one would ever tell you to snap out of it if you had cancer. Something has to change.” 

Julie Dawes, interim chief ­executive of Southern Health said: “I apologise again on behalf of the trust for letting Miss Groves down in 2012 and I send my condolences to her family.”

 

 

If you feel suicidal, need support and someone to speak to, Samaritans operates a 24-hour service available every day of the year. Call 116 123 or email jo@samaritans.org 

 

 


 

I don’t make any money from my work. I am disabled because of illness and have a very limited income. But you can help by making a donation to help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you. 

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Iain Duncan Smith is complaining about valid criticisms of his draconian policies by journalists and social media commentators

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The Work and Pensions Select Committee has just published some letters between Frank Field, the chair, and Iain Duncan Smith, who responded to questions about the correlation between benefit assessments and suicide.

Mr Field had asked what data the Department for Work and Pensions collects on the deaths of benefit claimants.

The issue had been raised in a research report by Oxford University and Liverpool University entitled First Do No Harm, which I also reported on last year.

The letter addressed to Frank Field MP, features a barely legible hand-written footnote warning against listening to those “in the media and on social media” who “accuse the Government of outrageous actions.”

Duncan Smith writes in the footnote:

“There are some out there in the media and social media who have used [raw?] [ons ?- Office for National Statistics?] figures to accuse the govt of outrageous actions.

I would hope that the committee would not seek to follow suit. I [illegible] [note?] that having introduced ESA and the WLA, 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.”

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I would say that this blatant political discrimination constitutes an “outrageous action.” It’s difficult to recognise any “good intent” here, Mr Duncan Smith.

The correlation between the work capability assessment and suicide was established by academic researchers, not by journalists or social media commentators. We simply reported the findings.

Iain Duncan Smith will be accusing the United Nations (UN) of failing to see the government’s “good intent” when the inquiry into “grave and systematic violations” of the rights of disabled people in the UK concludes, next. Despite the fact that we are the first country to face such an inquiry, and given that the UN investigate only when there is evidence of grave and systematic violations of human rights, the prime minister has already dismissed the significance of the inquiry, ludicrously claiming “it may not be all it’s cracked up to be.”

It’s particularly noteworthy that when it comes to government claims, the same methodological rigour that they advocate for others isn’t applied. Indeed, many policies have clearly been directed by ideology and traditional Tory prejudices, rather than valid research and empirical evidence. The fact that no cumulative impact assessment has been carried out with regard to the welfare “reforms” indicates a government that is not interested in accountability, and examining the potential negative outcomes of policy-making. Policies are supposed to be about meeting public needs and not about inflicting Conservative dogma and old prejudices in the form of financial punishment on protected social groups.

As someone with a background in the social sciences, I have written extensive criticism of Iain Duncan Smith’s peculiar brand of epistemological and methodological fascism. He’s not exactly well known for his skill in statistical analysis, having been rebuked more than once for being notoriously conservative with the truth and numbers. Yet he feels compelled to dismiss the accounts of academics, campaigners, empirical evidence and the many qualitative accounts of those adversely impacted by his policies, in his vain attempt to exercise a stranglehold on his own peculiar brand of “truth.”

The goverment often claim that any research revealing negative social consequences arising from their draconian policies, which they don’t like to be made public “doesn’t establish a causal link.”  Recently there has been a persistent, aggressive and flat denial that there is any “causal link” between the increased use of food banks and increasing poverty, between benefit sanctions and extreme hardship and harm, between the work capability assessment and an increase in numbers of deaths and suicides, for example.

The government are referring to a scientific maxim: “Correlation doesn’t imply causality.” 

The tobacco industry made exactly the same claim about the established link between lung cancer and smoking.

It’s true that correlation is not the same as causation.

It’s certainly true that no conclusion may be drawn regarding the existence or the direction of a cause and effect relationship only from the fact that event A and event B are correlated.

Determining whether there is an actual cause and effect relationship requires further investigation.

This is something the government has persistently refused to do. (Here’s a full critique of Conservative methods of “social research”. I sent Mr Duncan Smith a copy, along with some information about proper definitions and measurement of poverty, but he clearly hasn’t read either. Unless he has included those in his arrogant and dismissive horror of “accusations”  criticisms on social media of course)

It is completely inaccurate to say that correlation doesn’t imply causation. It quite often does.

Here’s a final comment from a social media-based campaigner, analytical writer and a qualified social scientist who knows about statistical inference, causality and correlation and suchlike:

Iain Duncan Smith, you’re a blatant numpty.

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You can read the full letter here.

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