Article published: Saturday, February 4th 2012
Suicide rates and prescriptions of anti-depressants in Manchester have risen since the onset of recession according to a new report presented to councillors responsible for monitoring health issues.
The increases have been linked to mounting unemployment, with the report voicing concerns that “the suicide rate increases and worrying prescribing trends will be difficult to contain” if “economic growth is slow and training and employment opportunities are limited.”
Prescriptions of the main drug treatment for anxiety and depression according to NHS guidelines, SSRIs, have shot up 8.5 per cent in the last twelve months. While the report argues the data should be treated with caution due to differences in prescription practices, it notes that NHS Manchester view GPs as reporting “increasing numbers of people presenting with mild to moderate health problems as a result of the recession.”
Deaths from suicide and self-harm have also risen since 2007, according to a November report authored by the local Director of Public Health David Regan. Although the report notes that the increase could be due to other factors, for example “poorer reported mental wellbeing” of middle-aged men, it notes that “there seems to be an underlying increase in self-harm deaths across the region.”
Physical and mental impacts
Past research by the Department for Work and Pensions (DWP) has found links between unemployment and mental and physical ill-health. A major review carried out in 2008 uncovered associations with increased rates of mortality from heart and lung diseases, psychological distress and “minor psychological and psychiatric morbidity”, increased admissions to hospital and use of medicines and “much worse prognosis and recovery rates”.
Other key findings highlighted by the study were of the greatest impacts of unemployment on mental health being felt three to six months after the loss of a job, negative effects on healthy lifestyles and of poorer health for the families of those out of work.
In addition, the review found job insecurity to have “an adverse impact on health”, with symptoms such as rising blood pressure, and increased risk of diabetes and infections “classic consequences” of stress. The report to Manchester City Council noted how these effects “will be present in a significant proportion of the local population during the current economic downturn.”
MULE spoke to clinical psychologist Dr Steve Eccles, who explained that while links between unemployment and mental health are complex, loss of employment is “a very stressful life event” which can have “a profound effect on people’s identity” while increasing social isolation.
Dr Eccles advised people experiencing symptoms of stress, anxiety or depression to attempt to maintain a normal daily routine and to keep up social connections with family and friends as much as possible. He further said people with such symptoms should try to monitor drug and alcohol use, stay active and exercise, keep time for pleasurable activities and hobbies, and consider taking part in voluntary work, while those with more severe symptoms should access services via their GP, or A&E for emergencies.
However, the report also noted that for employment to have real health benefits jobs would “need to be sustainable, offer a decent living wage, have opportunities for in-work development, have flexibility to enable people to balance work and family life, and protect employees from adverse working conditions that can damage health.”
And Alan Hartman, chair of Manchester Users Network, claimed the findings should not be used to neglect mental health care needs in favour of a “culture, which is dangerous, that if you’re in work you’re not mentally ill anymore”. Hartman also warned that cuts to welfare benefits for people with mental health issues, the loss of welfare rights officers and changes to legal aid for welfare benefit cases would leave people unable to secure support.
Hartman further labelled attempts to deal with poor mental health which would primarily aim at returning people to work “a con” given the lack of available employment. “If it was in the 1970s it’s be positive”, he argued, but said in recent years “there’s no jobs and people are being pushed off their benefits.”
Government welfare reforms include the highly controversial Work Programme, a taxpayer-funded but private sector-run project with the stated aim of moving people from benefits into employment through training, increased sanctions and unpaid and enforced “volunteering” for companies and other organisations. A DWP spokesperson claimed the scheme allows contractors to use specialist knowledge “to deliver individual tailored support to meet the needs of all out of work claimants – including the most vulnerable and hard to help.”
Although the Work Programme is delivered independently of Manchester City Council’s services, executive member for Adult Services Councillor Glynn Evans said the council would “support” the DWP and others to “assess what people can do – rather than what they cannot – to help them find the right kind of job that will improve their lifestyle and health, while reducing their dependency on public services and benefits.”
Similar “Welfare to Work” projects mentioned in the report have seen limited success however, with only two out of 70 Ardwick residents on one trial stream delivered by training provider Work Solutions, a “jobs broker” for private sector giant G4S, having entered “sustained employment” of longer than 13 weeks. While the report said this figure was expected to rise in the next month, it acknowledged that “not surprisingly, supporting people with long term mental health problems on the pathway to work in such a tough job market is impacting on these problems.”
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