‘Staggering’ ESA suicide figures prompt calls for inquiry and prosecution of ministers

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“Staggering” new figures show that the proportion of people claiming the main out-of-work disability benefit who have attempted suicide doubled between 2007 and 2014.

The new analysis of NHS statistics, being published for the first time by Disability News Service (DNS), shows that in 2007 – a year before the introduction of the much-criticised work capability assessment (WCA) – 21 per cent of incapacity benefit (IB) claimants told researchers they had attempted suicide at some point in their lives.

The following year, IB began to be replaced by employment and support allowance (ESA), with eligibility tested by the WCA, under the New Labour government.

But by 2014, following four years of social security reforms under the new coalition government, and austerity-related cuts to disability benefits and services – and six years of the WCA – more than 43 per cent of claimants were saying they had attempted suicide.

One leading psychologist described the figures this week as showing “the greatest increase in suicide rates for any population that I can recall in the literature”.

Over the same period, adults questioned for the Adult Psychiatric Morbidity Survey (APMS) who were not claiming IB (in 2007) or ESA (in 2014) remained statistically stable (6.0 per cent in 2007 against 6.7 per cent in 2014).

The figures therefore strongly suggest that government cuts and reforms, and particularly the introduction of the WCA, have had a serious, detrimental – and sometimes fatal – effect on the mental health of a generation of claimants of out-of-work disability benefits.

Two weeks ago, DNS reported on figures from the 2014 APMS which showed that 43.2 per cent of ESA claimants – and as high as 47.1 per cent of female ESA claimants – had attempted suicide at some point in their lives, compared with 6.7 per cent of the general adult population.

Disabled campaigners said then that they feared the 2014 figures demonstrated the impact of years of austerity-related cuts to the NHS, social care and social security budgets, the demonisation of ESA claimants, and the increased use of benefit sanctions.

They also suggested that the figures showed the impact of the WCA, which since its introduction in 2008 has increasingly been associated with relapses, anxiety and distress among those with long-term health conditions, including mental health conditions, and the loss of many lives.

But it was impossible to see how those figures compared with the previous survey, seven years earlier, because the relevant analysis was not carried out for the report on the 2007 figures.

DNS therefore asked Sally McManus, who leads research on the survey* – on behalf of NHS Digital – for the independent social research institute NatCen, to calculate the figures on attempted suicides for those IB claimants who were surveyed in 2007.

Her calculations show a dramatic rise, from 20.9 per cent of IB claimants in 2007 to 43.2 per cent of ESA claimants in 2014.

McManus said that, although the figures did not demonstrate what had caused the rates of attempted suicides to rise so dramatically over the seven years for those on IB/ESA, they did show that the “rates of attempted suicide have clearly increased among people of working age in receipt of a disability-related benefit”.

The age-standardised figures are calculated from data collected through the APMS, which is carried out every seven years for NHS Digital by NatCen and the University of Leicester.

DNS also reports this week (see separate story) that, despite being aware of the startling figures from the 2014 survey, which were published in September 2016, the government has refused to explain why it made no attempt to prioritise ESA claimants as a high-risk group for suicide in its latest suicide prevention strategy, which was published in January 2017.

The strongest evidence until now that there was a link between the WCA and an increase in mental distress came in November 2015, when public health experts from the Universities of Liverpool and Oxford showed in a study that, for every 10,000 IB claimants in England who were reassessed for ESA 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.

In all, 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.

Disabled activists, who have spent years highlighting serious concerns about the impact of the WCA, have told DNS this week that ministers must now be held accountable for the damage they have caused and for repeatedly covering up links between the WCA and suicides.

Denise McKenna, a co-founder of the Mental Health Resistance Network (MHRN), said the figures were “shocking, but they certainly do not come as any surprise”.

She said: “At MHRN, we are frequently having to talk people out of taking their own lives and trying to give people reasons to live.

“We understand these benefit changes are causing people to be suicidal because many of us in the MHRN are themselves feeling suicidal.

“It is all about the WCA. People are terrified of being put in the [ESA] work-related activity group because they are terrified of being pressured into work when they are not ready.”

And because of the increasing focus on employment in mental health services, she said, “the harassment also exists within the Department of Health”.

People with mental health problems, she said, are “bullied, harassed and generally terrorised”.

She added: “That this is happening in 21st century Britain is totally appalling. It will be remembered as a shameful time in British history. And we will not forget it.”

McKenna said there should be a public inquiry into the links between the WCA and suicides, and the associated cover-up of those links, with criminal prosecutions of the government ministers responsible.

She said: “I believe these ministers are personally responsible for these suicidal thoughts and for the actual suicides and there should be charges, there should be legal action against them.”

Paula Peters, a member of the national steering group of Disabled People Against Cuts, said: “The figures show how harmful the WCA is, how it ramps up a claimant’s distress, anxiety and depression.”

She also called for an inquiry into the links between the WCA and suicides, and for a criminal prosecution of ministers – as well as senior civil servants – responsible for ignoring and even covering-up evidence of the links.

She said: “We will not rest until we see them brought to justice and we bring the truth out to the wider public.”

Peters attempted to take her own life in 2011, and was hospitalised for three months, because of “overwhelming distress, fear and anxiety over the WCA”.

She said: “It has definitely had a detrimental impact on my mental health and it has caused my physical health to deteriorate because of the continual stress of the WCA and the continual reassessments.

“You just live with the DWP hanging over you like a big, black cloud, and you live in perpetual fear of them, you’re petrified of them, living in fear of those brown envelopes.”

John McArdle, co-founder of Black Triangle, said: “These latest figures irrefutably confirm what Black Triangle has argued since the inception of our campaign in June 2010, following the death of our friend Paul Reekie who took his own life following a DWP work capability assessment. 

“The WCA assessment regime discriminates against sick and/or disabled people and violates their fundamental human rights – up to and including the very right to life itself.

“The prime minister and the secretary of state can no longer stand at the dispatch box at Westminster and deny the truth of this statement. The evidence can no longer be dismissed.”

He said the government had “implemented policies and systems that have led to the avoidable deaths of disabled people.

“It has done this intentionally and with reckless abandon. It has resisted all calls from every quarter of civil society to implement reforms that would prevent substantial harm and death.

“It is guilty of grave and systematic violations of our fundamental human rights. It is guilty of creating – and maintaining – a human catastrophe for disabled people.”

Dr Jay Watts, a consultant clinical psychologist and member of the campaigning Alliance for Counselling and Psychotherapy, who first brought the 2014 figures to the attention of DNS, said: “The change in suicide rates these figures show is just staggering.

“It is the greatest increase in suicide rates for any population that I can recall in the literature, and can I emphasise this is from the largest, most reliable data set on the mental health of the nation out there.

“It is simply inexcusable to treat people like second-class citizens, to deny them the means to live, and to punish them, for example via sanctions, for not being able to comply with the neoliberal dream of working.

“The shame, guilt and anxiety, as well as material deprivation, caused by the current benefits regime is killing disabled people.

“These figures must be a wake-up call to government – benefits reform is the simplest, most useful thing we can do to reduce deaths by suicide.

“We need reform now before more people die. We need this to be the number one issue people turn to when thinking about improving the mental health of the nation.

“How dare we think of ourselves as having a decent, progressive society when we treat people so badly?”

Marsha de Cordova, the shadow minister for disabled people, said: “On the face of it, these figures are a truly damning indictment of the government’s social security policies, and show they are unfit for purpose.

“The government need to wake up and act fast. It is unacceptable that disabled people are made to suffer like this.

“Labour would scrap the WCA, end the punitive sanctions regime and change the culture of the social security system, from one that demonises people not in work to one that is supportive and enabling.”

A Department for Work and Pensions spokeswoman refused to say if the minister for disabled people, Sarah Newton, agreed that the WCA and the government’s austerity-related ESA policies had had a significant negative impact on the mental health of ESA claimants, or whether she would launch an inquiry into the links.

But she said in a statement that suicide was “a very complex issue, so it would be wrong to link it solely to anyone’s benefit claim” and that the government’s welfare reforms were “restoring fairness” and “supporting people into work”.

She added: “We have made significant improvements to the WCA since its introduction in 2008.

“This includes implementing changes to address issues raised through five independent reviews and strong quality and customer experience improvements in partnership with our WCA provider.

“We remain committed to further improving the WCA, which is why on 29 September 2017 we stopped reassessments for those with the most severe conditions.

“There still needs to be a gateway in place for disability benefits to provide support to those who need it most.

“It’s very important that we get the assessment reform right, which is why we will use this parliament to build our evidence base for what works and we will continue to work with stakeholders to do that.”

*McManus said the survey was the government’s “primary source of information about the extent of mental illness in the population, and whether it’s going up or down over time” and is the “longest-standing mental health survey in the world to use consistent methods over time”. Every seven years since the early 1990s, a large random sample of the general population is invited to take part. In the latest survey, about 7,500 people were interviewed in their own homes, with each interview taking about an hour and a half to complete. Questions include whether they have ever thought about suicide, made a suicide attempt, or self-harmed in some other way.

Samaritans can be contacted free, 24 hours a day, 365 days a year, by calling 116 123 or emailing [email protected]

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