As the number of working-age adults unable to work on the grounds of poor mental health continues to grow, UK health secretary Wes Streeting made a valuable intervention at the weekend. Speaking on the BBC’s Sunday With Laura Kuenssberg, Streeting said that mental-health conditions are being ‘overdiagnosed’. Too many people who could be enjoying productive lives are ‘being written off’, he said. They’re effectively being decommissioned and left to live lives sustained by various, limited forms of state support.
Streeting was talking ahead of this week’s government announcement on changes to the welfare system. Labour plans to overhaul the eligibility criteria for certain disability and sickness benefits – in particular, personal independence payments (PIPs). It is anticipated these changes will therefore take benefits away from a lot of those Streeting says are ‘overdiagnosed’ with conditions such as depression, anxiety and so on. Defending the government’s plans, Labour minister Pat McFadden said it’s not ‘a progressive thing to watch, two million, then three million, then four million people go on to these benefits, many of them never working’.
There has been an all-too-predictable backlash from the liberal-left establishment to Labour’s welfare reforms. An array of Labour backbenchers, long-time worshippers at the altar of welfarism, are complaining that cutting benefits and trying to get people back into work is ‘not a Labour thing to do’ – presumably on the grounds that Labour should be the party of the non-working classes. They’re being backed by assorted patronising charity bods and posh pundits who are dressing up Labour’s proposals as an austerity-fuelled attack on ‘the most vulnerable in society’.
The response captures a major part of the problem. Our political and cultural elites are far too willing to cast large swathes of the population as ‘vulnerable’. Too ‘vulnerable’, that is, to work and to live as independent members of society. They are to be treated instead as the officially incapacitated, as wards of the state in perpetuity.
PIP claims themselves are not related to people’s ability to work. One can claim a PIP and work at the same time. Yet many choose not to. The numbers of people in such a situation are huge. We’re not talking here about the roughly 1.3million people who are officially unemployed and looking for work. We’re talking about the over nine million people who are classified as ‘economically inactive’ – who are neither working nor looking to work. Students, full-time carers and early retirees make up over half that figure. But that still leaves near enough four million people who are classified as physically or, increasingly, mentally incapable of working.
A large proportion of those will be suffering from debilitating physical or mental conditions. If anything, those people (and their family members, who are often their permanent carers) need far more state support than is currently available. Indeed, their needs are crowded out in a system that deals with vast swathes of the population. But that still leaves an ever-growing number of people – now well over two million – claiming a PIP, a disability living allowance or some other form of state support on the grounds that they are too ‘sad’, ‘depressed’ or ‘anxious’ to work or even to complete daily tasks.
This is a profound societal problem that is only getting worse. Indeed, the official data show that the number of people on disability benefits who list a mental-health condition as their main condition has increased over the past decade by 1.2 million to nearly 2.5million. Over 800,000 of whom now reportedly suffer from ‘anxiety’.
What’s more, this growth in mental ill-health is happening overwhelmingly among young and young-ish people. In 2023, the Institute for Fiscal Studies reported that the proportion of 30-year-olds claiming disability benefits has risen from around two per cent in 2002 to around four per cent in 2022, with most of the increase happening in the past decade. A study published last year revealed that people in their early twenties are now more likely to be not working due to ill-health – and specifically mental ill-health – than those in their early forties.
It’s difficult not to agree with Streeting that there is a serious problem of overdiagnosis here. Virtually every mental-health condition, each one increasingly vaguely defined, seems to be rapidly increasing in prevalence in the population at large, a trend exacerbated by the Covid lockdowns. This is not because people really are more afflicted with mental illness than at any point in human history. It’s because over the past few decades, everyday moods and emotional responses to challenges have been gradually pathologised and reconceived as mental-health conditions. Recent research from University College London found a 20-fold increase in diagnoses of ADHD between 2000 and 2018. The Office for National Statistics tells a similar story for depression and anxiety diagnoses. Between 2019 and 2023, the number of economically inactive working-age adults diagnosed with depression or anxiety rose by 40 per cent, to 1.35million.
This is not a medical but a social crisis. Far too many younger people, immersed in our therapeutic culture, are now actively seeking out a mental-health identity for themselves. They want to be recognised and validated as depressed, anxious or ‘on the spectrum’. And a significant proportion of people are now being incentivised by the state benefits on offer to view their mental-health diagnosis as an impediment to work.
These people are being failed culturally and institutionally – indeed, the vast majority of doctors themselves feel that mental ill-health is being overdiagnosed. By endorsing the idea that so many people are mentally unwell, by promoting the idea that we really are in the grip of a so-called mental-health crisis – rather than a mental-health overdiagnosis crisis – our cultural and political elites are depriving millions of people of their potential independence. Stripping them of their capacity to live a full life and realise their potential.
The government’s revision of eligibility criteria for certain benefits is no panacea, of course. It appears to be driven as much by Labour’s worst technocratic, bean-counting impulses as any principled commitment to the value of work and individual autonomy. Its aim is to make a reported £5 billion of savings by the end of the decade, rather than reverse the therapeutic colonisation of people’s interior lives.
The willingness of an ever-growing number of people – especially younger people – to perceive themselves as mentally incapable of enjoying a productive life is a serious social and cultural problem. It will take more than a tweak to existing schemes to reverse decades of therapy culture. But there is at last now political space to talk about it.
McFadden is right. On this score, at least. There is nothing progressive about a government putting huge numbers of people out to pasture. That would rather citizens languish at home than create a society and economy that provides meaningful employment and the independence that comes with it. That would rather treat millions of people as wards of the state, even if this means those who are most in-need lose out. Perhaps finally the penny is dropping.
Tim Black is a spiked columnist.
