The pandemic undoubtedly plays a big part in these figures, with PIP claims for anxiety and stress both up by 130 per cent between January 2020 (the eve of the pandemic) and January this year.
The issue is particularly prevalent among the young. In the mid-2010s, just 4 per cent of people aged 25 to 39 were recorded as having mental health problems, according to NHS Digital, a figure that has now risen to 23 per cent. Almost one in 30 people in the UK now claim benefits for mental health problems.
Rather than use taxpayers’ money to solve this mental health crisis, however, the Government is funnelling the sick into long-term unemployment. Of those claiming PIP, or its predecessor the Disability Living Allowance, 91.7 per cent have no work requirements attached to their benefit payments.
Work is bad for you
Replacing work with benefits for people experiencing mental health difficulties did not start with the pandemic. During Sir Tony Blair’s premiership of 1997-2007, Labour’s union paymasters waged a relentless campaign to portray workplaces as a threat to mental health.
John Monks, the then-TUC General Secretary, painted a picture of Britain’s workplaces as the most dangerous in Europe, saying in 2002 that “long hours and heavy workloads combine to make a lethal mixture which leads to heart attacks, mental illness and social problems like divorce and alcoholism”.
Far from being “the best prize that life has to offer”, as Roosevelt said, working hard had now become “lethal”.
Monks’ successor Brendan Barber continued the theme in 2005, when a TUC report said that working long hours was “the biggest demon for UK families”, and Barber demanded that employers “prioritise measures to reduce stress”. Barber was given a peerage by Sir Keir Starmer last year and Monks was given a peerage by Gordon Brown in 2010.
Labour ministers paid lip service to pushing back against this idea: work and pensions secretary Peter Hain said in 2007 that “being in work is usually good for people with all types of mental health problems”, while Lord McKenzie of Luton, a junior minister in the same department, said in 2009 that “well-managed work can help to develop people’s mental health, resilience and well-being”.
The problem was that no-one in government was prepared to get tough by restricting the ever-greater flow of benefits to people claiming for mental health problems.
Over time it has become easier and easier for people to claim benefits for mental health conditions, partly because of government policies and partly because of the courts.
Sir Iain Duncan Smith, who simplified the welfare system by introducing Universal Credit when he was Lord Cameron’s work and pensions secretary, says: “The biggest problem is that we have managed to medicalise the normal difficulties of life.
“We should be working with the individual to make sure they get talking therapies or other treatment, but that they have to stay in work. The money you save by keeping people in work will pay for those therapies.
“Once you tell everyone you are going to be expected to look for work, take work and stay in work, you will see those claims go down.
“This is not something that is irrecoverable but it does take guts. I have the knife wounds in my back from my work on Universal Credit to show that.”
The British exception
If 21st-century life – or work – was an inevitable cause of depression and anxiety the UK’s mental health crisis would be mirrored in other comparable countries.
Yet it appears to be a uniquely British phenomenon. While the number of working-age people receiving health-related benefits in England and Wales leapt by 38 per cent in the four years to 2024, to 3.9 million people, the figure fell or remained steady in Australia, Austria, Canada, France, Germany, Ireland, the Netherlands, Norway, Sweden and the US.
Many of those other countries do not have as generous a benefits regime as the UK. The Centre for Social Justice think tank calculated earlier this year that an unemployed single parent claiming Universal Credit, PIP and a carer’s allowance for looking after a child with mental health problems would receive almost £37,000 a year, or £14,000 more than someone working full time on the minimum wage, and around £6,000 more than the net pay of someone on the average wage.
This is not lost on ministers, but they have so far failed to come up with a solution.
The roots of the mental health benefits boom can be traced back to the Human Rights Act of 1998, introduced at the start of the Blair government. It brought the European Convention on Human Rights into UK law, enabling people to sue for discrimination on human rights grounds, such as discrimination over their mental health.
The Equality Act 2010 consolidated anti-discrimination laws, the Health and Social Care Act 2012 formalised in law the parity between mental and physical health, and in 2017, when the DWP tried to distinguish between mental and physical health conditions to keep the welfare bill down, the High Court ruled that doing so was “discriminatory” and they had to be treated the same.
Giving mental health parity of esteem with physical health was a constant theme under the last government, and while it was a laudable aim they never provided the resources to back it up. So while people were being encouraged to seek help if they were struggling, they found that the help simply wasn’t there. Waiting lists for psychiatric assessments and help stretched to months, meaning that people with genuine mental health crises were having to stay at home rather than being helped to recover and get back to work quickly.
Meanwhile, the method of assessing people’s fitness to work has become rudimentary at best – and open to abuse by those who don’t want to work.
Gaming the system
During the pandemic, face-to-face assessments for PIPs – which made it easier to weed out fakers – were abandoned, and to this day many assessments are still carried out over the phone.
Rather than relying on a medical diagnosis, the DWP will ask applicants about their ability to carry out certain tasks, with points awarded for each one. It is a system that is ridiculously easy to game.
Even if the DWP tries to turn down claims, 70 per cent of refusals are overruled by independent tribunals when claimants decide to challenge the DWP’s decision. No government has yet had the gumption to bring the appeals process into the DWP, a move that would allow greater control over it.
Christopher Prinz, a senior labour market analyst at the Organisation for Economic Co-operation and Development, who has written a number of books on disability and work, says that offering out-of-work benefits before every in-work avenue has been exhausted is the wrong way around.
“It’s just completely the wrong sequence,” he says. “I told the Government probably 15 times in the last 15 years… they all understood and nodded, but the system remains the same.
“You should not be able to move on to long-term disability payments until all employment support and so forth has been tried. This is a rule that many countries have.
“All the Nordic countries, [as well as] Austria, Switzerland and Germany have such an approach today. You literally cannot offer long-term disability payments until they’ve tried to get you back into employment.”
Prinz says that the Netherlands had a complete overhaul of its benefits system, putting the cost of the first two years of sickness benefits on to the employer. That gave insurance companies the incentive to create an early intervention service that would give people support if they were struggling with their mental health and enable them to carry on working rather than taking time off.
According to the Centre for Social Justice think tank, restricting mental health benefits to the most severe cases could save between £7bn to £9bn per year, which would free up plenty of money to pay for rapid interventions and treatment for people who need it and who would otherwise end up being signed off sick.
Prinz agrees with Sir Iain that unless people are kept in work, giving them support after they have spent months on a waiting list is unlikely to help them back into employment and is usually a waste of time from the point of view of getting the welfare bill down.
He says: “We know from the data that if someone has been out of work for sickness for more than nine months, the likelihood they will ever return to work is quite low. The chance that person will leave the labour market forever is much higher than the chance they will return. So it’s really a relatively short window where policymakers would have to act.
“You need to have a good policy. If people are away for two to five months and you don’t do anything there, you will lose those people.
“At some point, both an employer and employee need help. But in the UK, the way the system is built, you would eventually end up on long-term sickness, will eventually receive some disability-related payments, and will have been out of work for a year or two before anyone thinks of offering to help you to get back into work. Then you start thinking about that at a time when it’s too late.
“We can really see from other countries that support offered after [nine months] is often a complete waste of time if people don’t return to work.”
Self-defeating self-diagnosis
Joe Shalam, director of policy at the Centre for Social Justice, says: “The Government’s botched attempt to trim the welfare bill earlier in the year ended in a U-turn because they tried to top-slice across all disability benefits, disproportionately affecting people with conditions like arthritis or cancer.
“Instead they should have focused on the soaring mental health claims and questioned if the system is up to the job of actually providing proper support for those people, rather than parking them at home or facilitating an existence out of work.”
He also believes that too many people are self-diagnosing mental health problems, with recent research suggesting that mental health awareness programmes in schools “end up creating more mental health problems than they solve because ruminating on their challenges and focusing on their difficulties prompts children to become more anxious and worried”. That, in turn, feeds into the workforce when they leave school.
The trend towards companies offering staff “duvet days” or “mental health sick days” has also been unhelpful, he suggests, as they imply that work is inherently bad for mental health.
Gemma Byrne, policy and campaigns manager at the mental health charity Mind, agrees that work is good for mental health and suggests that the workplace cannot be blamed solely for the mental health crisis.
“Good work is often good for our mental health,” she says. “It provides income, purpose, structure and connection. When we’re well supported, paid fairly and are treated with dignity and respect, we can thrive at work.
“However, although poor mental health is framed as the leading cause of long-term sickness, particularly among younger workers, there are significant underlying social causes. Issues such as poor housing, in-work poverty and racism all have an impact.
“We know the likelihood of returning falls sharply the longer someone is out of work, but returning to work when the underlying causes persist can make our mental health problems worse. Early support is critical.”
The shadow chancellor, Sir Mel Stride, is concerned at predictions that the bill for sickness benefits, which stood at just over £50bn in 2020, is forecast to hit more than £85bn by 2029/30.
He said: “Welfare reform can be done, we saw that in the early 2010s when we brought in Universal Credit, brought down the benefits bill and got millions more people into work. But reform requires a government that can get the tough decisions through Parliament. At the moment, Labour seem to be completely failing at that, and in the meantime the bill will only keep climbing.”
In his close ally Pat McFadden, Sir Keir Starmer has at least chosen a new work and pensions secretary with the political heft to attempt change.
Mr McFadden says: “For too long, people with mental health conditions have been denied the support they need to get back to health and back to work.
“We’re determined to change this by shifting our focus from welfare to work, skills and opportunities, and from sickness to prevention, and grow the economy as part of the Plan for Change.”
The Government has set aside £3.8bn for programmes like WorkWell and Connect to Work, which aim to keep people in employment or get them back into work, and has increased spending on mental health services by £688m under its 10-Year Health Plan.
Mr McFadden has only been in the job for a week. But he will need to act quickly if Labour is to have any chance of curing the uniquely British disease of blaming work for poor mental health – rather than seeing it as a vital part of the cure.
