Mental health: an anatomy of a very British crisis

The Daily Retina

No victory is ever final in politics – and the wrecking-ball of lockdowns seems to have destroyed all of the coalition government’s work in education inequality and welfare. ‘We will be able to get people back into work later,’ one Cabinet member explained to me during the lockdowns, ‘We know how to do this now.’

The confidence was understandable given the jobs miracle of 2012-20 but, as we now see, calamitously misplaced. Britain has made a worse job than G7 or EU country in this crucial mission of rebuilding the workforce: the below graph keeps the (awful) score.

Worse, the UK economy is crying out for workers, with vacancies at 1.1 million. Meanwhile, a staggering number of Brits are on benefits. Here’s the chart, which you can also take back to 1979 to grasp the full extent of it. Remember, this joblessness is not induced by recession but has been incubated by welfare to exist amidst something approaching a crisis in lack of workers (and this in spite of record immigration).

So what’s going on? Look at the below: it’s a terrifying chart showing how the monthly number signing on long-term sick has doubled on pre-pandemic levels: almost 5,000 people a day. Yes, a day. Rushing out of the workforce. And mental health is the biggest single complaint.

Before the pandemic, just under 8 per cent of the working-age population was claiming some kind of sickness benefit. In a devastating verdict (that I’d recommend anyone trying to understand this issue should read) the OBR now says (p108-9) it will rise to 12 per cent. This is staggering, unprecedented and vastly costly – in terms of human life and cash (the cost has been revised up by £8 billion in the last four months).

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The below graph is heartbreaking and hugely important: two decades of progress reducing the number out of work due to long-term sickness – and the number seems to surge ever-higher.

If it was a form of long covid, then the phenomenon would be seen worldwide – but this is concentrated in the UK. Is this due to perfectly-healthy people telling their doctor that they’re feeling suicidal – after being told that this is the phrase that pays? There will be an element of that but we have to acknowledge that actual mental health diagnoses are up, significantly, across the board. Let’s look at the number taking antidepressants:

All of this feeds into the number signed off sick (broken down by duration):

If you take the number of sick notes and multiply it by the lower estimate of the number of days signed off, you get about 3 million a week. I’d say this is economically significant, and ought to be factored in when we talk about the cost of treating mental health.

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Another side of this is eating disorders: typically a young woman (or girl) who has been losing weight, is seen by a GP and referred for psychiatric treatment (usually a combination of talking therapy and medication). And make no mistake: this is serious. Anorexia has the highest mortality rate for any mental disorder.

We’re now getting away from UK economic workforce and more into the territory of children’s mental health. Here’s another graph I found, showing a 20 per cent rise in under-18s seen by mental health services:

But while there has been a spike in all of the above, there hasn’t been a spike in hospital activity for self-harm:

Another metric held by NHS hospitals is self-poisoning:

Yes, there will be an element of medicalising perfectly normal human emotion. An element of chicanery and benefit fraud. But I’d like to sign off this blog by quoting a recent Bloomberg column by the historian Niall Ferguson

If no one in your circle of family and friends is mentally ill, count yourself lucky — or maybe you’re just deluding yourself. In my intimate social network, I can think of at least six cases. I’m not talking just about relatives or friends or the children of friends who say they are depressed. I’m talking about medically diagnosed mental illness requiring treatment. Three cases of chronic addiction. Two cases of severe eating disorder. One case of attempted suicide. And those are just the ones I know about….The big mental health pandemic of our time is the one that is driving tens of millions of adults to shorten their lives by suicide or by an addictive intake of alcohol and drugs that amounts to slow suicide.

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This is a mixture of fake claims and very real claims: I can see why politicians don’t want to touch it. But mental health seems, to me, to be the next big conundrum. It is impacting the lives of our family and friends, as well as the economy. We need to do far more to understand it, and the figures unearthed in this blog are intended as a contribution towards that.

This may not be a political talking point any time soon, given how terrified politicians seem to be about this topic. But we plan to do much more on this in The Spectator in the coming weeks and months.

Source: World – The Spectator Australia