Tougher disability benefit assessment may have taken 'serious' toll on mental health

http://www.eurekalert.org/pub_releases/2015-11/b-tdb111215.php

Public Release: 16-Nov-2015
Tougher disability benefit assessment may have taken 'serious' toll on mental health
Higher reassessment rate linked to more suicides, mental ill health, and antidepressant use
BMJ

The introduction of a more stringent test to assess eligibility for disability benefit in England may have taken a "serious" toll on the nation's mental health, concludes research published online in the Journal of Epidemiology & Community Health.

Since 2010 the test, known as the Work Capability Assessment (WCA), has been used to assess the eligibility of claimants of the main out of work disability benefit, in a bid to get more people back into the workplace and help curb the government's rising welfare bill.

But areas with the greatest use of the WCA to assess existing claimants have seen the sharpest rises in reported suicides, mental health issues, and antidepressant prescribing, the findings show, prompting the researchers to question the wisdom of introducing this policy.

Doctors and disability rights organisations have voiced fears that use of the tough new criteria to measure incapacity to work is undermining the mental health of claimants.

•••••

Between 2010 and 2013, more than one million (1.03) people claiming disability benefit were reassessed using the WCA. A higher proportion of people living in areas of deprivation were reassessed.

The analysis showed that in those areas with higher rates of reassessment, there was a corresponding increase in suicides, mental health issues, and antidepressant prescribing.

After taking account of the impact of baseline deprivation, economic trends, and long term trends in mental health, the researchers calculated that, there were around six extra suicides, 2700 more cases of mental ill health, and an extra 7020 prescriptions for individual antidepressants for every 10,000 people reassessed during this period.

This adds up to a total of 590 additional suicides, 279,000 extra cases of mental ill health and 725,000 more prescriptions for antidepressants across the country as a whole that were associated with the reassessment policy between 2010 and 2013..

This is an observational study, so no firm conclusions can be drawn about cause and effect. None the less, the researchers point out that they were at pains to adjust for other potentially influential factors, and that the observed increases in mental ill health followed--rather than preceded--the reassessment process.

•••••