What's the issue?
Mentally distressed claimants are being offered simplistic and ineffective remedies and are being pressurised by the social security system to seek employment of any kind, including in poor-quality jobs that can aggravate their mental health conditions.
How should a progressive government respond to the plight of mentally distressed social security claimants?
Analysis
Over the last two decades mental health problems have become a key issue in social security policy. This is because, first, unemployment has fallen and benefits for the healthy unemployed are now only a small fraction of social security expenditure. Instead, long-term illness and incapacity makes up a much larger proportion of both caseloads and expenditure. Second, long-term illness itself now predominantly takes the form of mental distress, with anxiety and depression more frequent than physiological problems, such as back pain, which used to account for most sickness-related benefit claims.
In the UK, and in many other advanced economies, social security claims related to illness increased rapidly in the wake of the deindustrialisation of the 1980s. Without questioning the good faith of the claimants, who were certainly unwell, these increases can be interpreted as a form of disguised unemployment in that they would not have risen so rapidly if demand for industrial workers had remained buoyant. The geography of sickness benefits confirms this interpretation: for example, Merthyr Tydfil, devastated by the decline in Welsh heavy industry, was a notorious sickness benefit black spot.
In the 1980s, policy-makers tended to accept the increased sickness benefit bill as the lesser of two evils, preferable to much higher levels of recognised unemployment and providing some compensation to the most vulnerable victims of structural change. However, as high numbers of sickness claims persisted and began to affect more recent generations, governments started to search for ways to limit the cost. Labour market ‘inactivity’, neither having nor seeking employment (through sickness or for other reasons), was to be discouraged. One sign of this switch was a reformulation of labour market objectives: an increase in employment was now seen as a better target than a reduction in unemployment, because the latter took no account of high rates of inactivity. In the drive to maximise employment, benefit conditions became less supportive of full-time mothers and housewives.