Disabled activists say government-funded research, which concludes that the programme to reassess people on incapacity benefit through the work capability assessment (WCA) was linked to 590 suicides in just three years, is both “damning” and “timely”.
Campaigners, doctors and psychiatrists have been warning for several years of strong anecdotal evidence that the programme to reassess hundreds of thousands of old-style incapacity benefit (IB) claimants was causing significant harm and distress, particularly to people with mental health conditions.
But now public health experts from the Universities of Liverpool and Oxford have shown in a study that, for every 10,000 IB claimants who were reassessed in England between 2010 and 2013, there were an additional six suicides, 2,700 cases of self-reported mental health problems, and an increase of more than 7,000 in the number of anti-depressants prescribed.
The most significant increases took place in the most deprived local authority areas of England.
Across England as a whole, the reassessment process from 2010 to 2013 was “associated with” an extra 590 suicides, 279,000 additional cases of self-reported mental health problems, and the prescribing of a further 725,000 anti-depressants.
The idea for the research came originally from disabled activist Rick Burgess (pictured), who later co-founded the grassroots campaign group New Approach, and wanted “recognised and respected epidemiologists” to carry out “an academically-rigorous study” into the number of deaths caused by the WCA, with the results to be reported before the 2015 election.
Together with three other leading campaigners – artist-activist Liz Crow* and New Approach co-founders Jane Bence and Nick Dilworth – Burgess began discussing the idea early last year with David Stuckler, professor of political economy and sociology at Oxford and one of the new study’s co-authors.
Stuckler concluded at the time that such research was not possible because the necessary data had not been released by the government.
Burgess pointed out that the research had been “started by disabled people with no funding”, but he said it was “brilliant” it had been completed, and that he felt “grimly vindicated” by evidence which would, “in any functioning democracy”, cause a government to be removed by a vote of no confidence.
He said: “It does show welfare reform is causing excess deaths, which is what we have always said, and it has been reported in most media, so the idea to have a rigorous, reputable study done was worth it for campaigners, even though it is not exhaustive and there is much data still to be wrestled out of the hands of this very secretive government.”
Linda Burnip, co-founder of Disabled People Against Cuts (DPAC), said: “This research simply confirms what we’ve all known for a long time, but is very timely both in relation to the ongoing UN inquiry into the grave and systematic violation of disabled people’s human rights and to DPAC’s campaigning priorities for 2016.
“The main focus of this campaigning will be an end to people being wrongly pushed to their deaths by the current benefit system inflicted on them by [work and pensions secretary] Iain Duncan Smith.”
Mark Harrison, chief executive of Equal Lives, said the research was “very timely and damning of a brutal system which is damaging people’s mental health”.
He said it was clear the government was intent on cutting public spending and dismantling public services “whatever the human consequences”.
He said: “To them, people who commit suicide or whose mental health conditions deteriorate as a result of their policies are merely collateral damage in their austerity war.
“I am sure the government will ignore the evidence in this report as it does with all the facts and statistics which show their policies are damaging the life chances and killing poor and disabled people.”
He added: “This poses a real challenge for the leaders of the disability rights movement and disabled people’s organisations in how to respond to politicians and civil servants who are not listening and aren’t interested in disabled people’s lives and human rights.”
John McArdle, co-founder of Black Triangle, said: “This is yet another damning body of evidence that makes it clear that the UK government is guilty of implementing policies and systems that are leading directly to the deaths of hundreds, if not thousands, of chronically ill and/or disabled people.
“It remains the case that there exists no safety protocol built into the DWP-Maximus [the US company which carries out the tests] disability assessment regime.
“Vital medical evidence is neither sought by, nor provided to, the DWP and we are firmly of the view that this is a deliberate policy.
“The Westminster government knows fine well that were such vital evidence to be provided, far fewer people would be found fit for work and so the Tories’ overarching goal of destroying our social security safety net as part of George Osborne’s ‘long-term economic plan’ would fail to meet its target.
“Lives lost are accepted as being collateral damage in achieving this aim. These deaths have irrefutably arisen as a direct consequence of the implementation of an official policy that is ‘intentionally or knowingly reckless with a depraved disregard for life’.
“The Westminster government is therefore unquestionably guilty of democide.”
Michelle Maher, of the WOWcampaign and petition, said the research “joins a long list of evidence given to the government on the horrific impact of medical assessments”.
She said: “I am still concerned that the government will claim they are listening and change the WCA, making it worse, under the heading of helping sick and disabled people into work because work is good for us.
“The numerous reports into foodbanks have been ignored or justified in appalling ways, with Tory members celebrating their existence.
“I fear the same will be said of the WCA and reports of the language the DWP and Iain Duncan Smith are using would indicate a direction of change that will be far worse.”
The study’s authors say their findings also demonstrate the need for a cumulative assessment of the impact of austerity measures on disabled people, as demanded by the WOWcampaign.
The study was published online in the Journal of Epidemiology and Community Health, and carried out by researchers from the University of Liverpool’s Institute of Psychology, Health and Society, and from the University of Oxford, and funded by the National Institute for Health Research, which itself is funded by the Department of Health.
Ben Barr, the study’s lead author and senior clinical lecturer in applied public health research at the University of Liverpool, said: “The programme of reassessing people on disability benefits using the WCA was independently associated with an increase in suicides, self-reported mental health problems and antidepressant prescribing.
“This policy may have had serious adverse consequences for mental health in England, which could outweigh any benefits that arise from moving people off disability benefits.”
But DWP dismissed the report’s findings.
A DWP spokesman said: “This report is wholly misleading, and the authors themselves caution that no conclusions can be drawn about cause and effect.
“In addition, it is concerning that they provide no evidence that the people with mental health problems highlighted in the report even underwent a work capability assessment.”
He pointed to the five independent reviews of the WCA – the first three carried out by Professor Malcolm Harrington – and “significant improvements to the process” made by DWP since 2010, including to how the WCA is used to assess people with mental health conditions.
He also said the percentage of people with mental health conditions who receive the highest level of support after being assessed for eligibility for employment and support allowance through the WCA has “more than tripled since 2010”.
Barr said DWP’s response was “disappointing”, and that none of the other factors researchers had looked at as possible causes, such as cuts to local government services or a fall in wages, could explain the rise in suicides and the deterioration in mental health.
And he said the increases only happened among age groups most affected by the WCA, while the rise in mental health problems “tended to occur shortly after the increase in people undergoing the WCA in each area”.
Barr also called on DWP to publish any data it has on claimants’ mental health before, during and after the assessment.
He said: “Unfortunately, the DWP implemented the policy without a controlled trial or any plans to evaluate its impact on mental health.
“Given that data is not currently available on the specific individuals who underwent the WCA and there is no trial evidence, the next best approach to investigate the potential effects on mental health is the one we applied in our study, using appropriate statistical methods to control for alternative explanations for these trends.
“Our findings should at the very least raise serious concerns for the DWP that the potential negative impacts of the WCA need to be investigated further.”
Sue Bott, deputy chief executive of Disability Rights UK, added: “It is shameful for the DWP to dismiss in such an offhand manner a serious academic study showing a worrying rise in suicides and mental health issues connected to the WCA.
“This evidence, added to the growing weight of evidence from tribunals and concerns from coroners, should surely lead to a complete rethink on the WCA, which by any measure is not fit for purpose.”
*Crow’s own piece of work, We Are Figures, grew out of the discussions with Stuckler, but because of the difficulty of identifying how many austerity-related deaths there had been, she focused on the human cost of austerity