[gpt3]Summarize this content to 100 words:
- Rhiannon Mihranian Osborne, foundation doctor
Over the past six months, I’ve worked in primary care, emergency care, and paediatrics. Every day I see people in mental distress—from depression to psychosis to post traumatic stress disorder.
Recently, the UK Labour government doubled down on inaccurate, stigmatising, and offensive narratives around mental health. In the Spring Statement, the government announced more than £5 billion cuts in benefits support—a move that will push thousands of people into poverty.1 The government used two primary narratives to support its approach. Firstly, that mental health conditions are overdiagnosed and that people are unjustifiably claiming sickness benefits on this basis. Secondly, that the way to improve the lives of people living with physical and mental health conditions is to cut state support and “encourage” them back into employment.
We tend to think of ill health, especially mental health, as an individual issue. This couldn’t be further from the truth. Many aspects of poor mental health are driven or worsened by a deeply inequitable society. It’s easier (and politically convenient) to bemoan the fact that more people are on long term sickness benefits and blame the individuals, rather than analyse why this is the case.
Everywhere I work I see the same patterns every day: young people with autism or attention deficit hyperactivity disorder on long waiting lists for support, refugees experiencing post traumatic stress disorder from living in conflict and crises, people with addictions who have been evicted and made homeless, survivors of abuse spending years in and out of psychiatric units, single parents who are struggling on meagre child support payments and are depressed, and younger people who are anxious and terrified about the impact of the climate crisis on their future. For many people, mental distress is an understandable and proportionate response to their living conditions.
Liz Kendall, secretary of state for work and pensions, has said that some people are out of work due to “self-diagnosed” mental health problems—in particular targeting her comments towards younger people.2 This minimises the social and political determinants of health. For example, 62% of younger people say that the cost of housing affects their mental health.3 Younger people in the lowest income bracket are 4.5 times more likely to experience severe mental health problems than those in the highest.4 Wes Streeting, secretary of state for health and social care, recently suggested that mental health problems might be overdiagnosed, ignoring rising inequality, underfunding of mental healthcare, and the decimation of community and public services.5 Mad Youth Organise, a group of younger people with lived experience of the mental health system, have created a manifesto that highlighs how issues such as displacement, poverty, transphobia, social media, privatisation of services, environmental pollution, and systemic racism are driving youth mental distress.6
Rather than tackle the inequalities that are driving the rise in mental and physical disabilities in the population, the government is targeting the health of disabled people, and making personal independence payments (PIP) harder to get. I have supported patients through the process of obtaining PIP, and I know that it is already a dehumanising and stressful process. Nearly half of all people in poverty either have a disability or live with someone who does, and yet the government is making key financial support harder to get.7 The new scoring requirement is especially likely to impact PIP claimants with mental health conditions. Alongside making PIP even less accessible, they are making it harder to get health support outside of PIP, by targeting the universal credit health top-ups for people who are signed off sick from work.
The government has used the same justification for these cuts—that they are helping to get people “back to work.” This argument does not hold. PIP payments have always been independent of work status. The government hasn’t announced any plans to decrease ableist discrimination in workplaces or education. Pushing disabled people into poverty and refusing to support people while they are off sick will not enable people back into work, but it will make them sicker and force more people to give up work to become carers.
More importantly, the logic behind this rhetoric is a symptom of a deeply sick society—one that views people only as valuable if they serve the economy. People shouldn’t be forced to work when unwell, and some people will never be able to work. They are full members of our society regardless. Why is it that disabled people who need benefits or PIP support are presented as a “burden” to society, while billionaires and giant corporations who avoid paying tax, and contribute to the nation’s poor health with their products or actions, are celebrated as innovators? The government claims that they need these cuts to save £5 billion a year, but a 2% wealth tax on assets worth more than £10 million would raise £24 billion per year.8 The UK’s richest people have only become richer since the pandemic, while the majority of the population have found that the cost of living has reduced their expendable income, or pushed them into poverty.
The government’s argument ignores the fact that work itself is often a source of sickness. The UK workplace is rife with racial and gender discrimination, insecure contracts, exploitation, pressure, and underpaid work.9 Although meaningful activities (not limited to work) can improve mental health, we live under an economic system that focuses on profit instead of wellbeing. In this context, work is often a source of mental distress and disability, not the cure for it. The belief in a “work cure” for mental illness originated in Victorian times and reflects a capitalist tendency to define health itself as the ability to work.10
It is moments like this where a political, collective, and justice focused understanding of health among health workers, patients and the public is essential. As health workers, we must follow the lead of patient groups (such as Disabled People Against Cuts, Crips Against Cuts, and Mad Youth Organise) to fight alongside communities to prevent these disastrous policies.
Footnotes
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Competing interests: None declared.
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Provenance and peer review: Not commissioned, not externally peer reviewed.
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