Deborah Orr: Our obsession with economic growth is producing dissatisfaction and unhappiness

A society bristling with mental health problems is not a society at ease with itself
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The Independent Online

Early on in the last David Blunkett saga, an intemperate memo from Tony Blair was leaked. It ranted bossily about the long-awaited Welfare Reform Bill, and urged - more or less - that the Department for Work and Pensions should "get tough" on the assorted liars and malingerers who made their living from pretending to need incapacity benefit because they were "depressed" or "anxious" or "stressed".

Wisely, the present Work and Pensions Secretary, John Hutton, has decided that Blair's rhetoric would not ease the passage of this tricky Bill through Parliament. Instead, he has decided to accentuate the positive, explaining that the reforms are "not about saving money for the taxpayer" but about "giving literally millions of people the first opportunity to get back into the labour market where they most want to be".

Much is made of the fact that the labour market has changed a great deal since incapacity benefit was introduced by the Tories more than 20 years ago. Widely accepted as being one of the many ruses the Conservative government brought in to disguise rising unemployment, the benefit gave people a small financial incentive to sign off with medical problems rather than claim unemployment benefit.

Back then, a spokesman for the department explained yesterday, "only 27 per cent of claimants were women. The latest figures show that 41 per cent of claimants are women and that 39.5 per cent claim it because of stress and mental health problems." These difficulties are often triggered by stress at work, a fact which has inspired John Hutton to declare that stress at work is "as big a problem in this century as industrial injuries were in the last".

He cites the "rather grim statistic" that those who have been on incapacity benefit for more than two years are more likely to die or retire than return to work, and aims in his reforms to "focus resources on identifying mental health problems that impact on people's ability to work and find better ways to help people overcome them".

To this end, those identified by an updated version of the "personal capability assessment" as fit to work will be obliged to take part in initiatives such as counselling, training and advice. If they refuse this help, they risk losing part of their benefit. If they accept, it is hoped that about a million of them will find themselves back in work.

There's every indication that this strategy is being undertaken with the best of intentions. Much if it is modelled on the Pathways to Work pilots, which have proved successful in the areas where they have been launched. Bearing in mind that trained counsellors are already in short supply, it can only be hoped that the difference between placing top-notch staff in pilots and placing them in every town does not become an extremely challenging one.

But even with the best intentions, the architects of this policy cannot deny there are contradictions in a strategy that prescribes that those who have found paid employment too stressful to handle need nothing more than they need paid employment. The implication, if one thinks about the scenario for just a couple of minutes, is that if mental problems that have been caused by work can be addressed by counselling the former employee, then the fault must ultimately reside with that person.

The statistics on mental ill health - which is rising worryingly in most sectors of the population - point to a problem with the way our society is organised (more of this later). But the DWP approach, no matter how kindly or thoughtfully applied, suggests that the fault is with the malfunctioning individual, who can be reunited with the functioning society he has temporarily become unravelled from, with a little help from the experts.

The British Medical Association, for one, does not agree with this assessment. Doctors are often the subject of grumblings from politicians, as they are seen in a classically "shoot-the-messenger" way as the originators of the proliferating "sick-note culture". Recent statistics suggest instead that in a large number of cases, stress at work is caused by poor management rather than by employee vulnerability. And anyway, the vast numbers of people having to go to their doctor in order to prove they are not well hardly speaks of a widespread prevalence of excellent worker-employer relations.

To be fair, the Government is aware of this, even if it prefers to tackle the problem with poor employers rather more subtly than it does the problem with the wrung-out humans the employers in question have used up and discarded. A Health, Work and Well-being strategy was launched last year jointly by the department of Health, the Department for Work and Pensions and the Health and Safety Executive. The aim of the initiative, is to "cut absence by improving health in the workplace" , and a national director for health and work, Dame Carol Black, was appointed in Apriljust in time!)

There's every indication that the Dame has her work cut out if she is going to have an impact on the smoothing of the way for the Government's ambitions. Bert Massie, chairman of the Disability Rights Commission, has already pointed out that three out of every five employers say they would not employ someone with mental health problems. The Government may like to think that the difficulty in getting back to work after being signed off with such difficulties lies with the claimant. But the reality is a lot more complex and rather more sinister.

It's a sad indictment of the failure of the Government to deliver to us the "joined-up government" that it promised 10 years ago, that it has not felt compelled in this instance to really ask itself why it should be that mental health problems are rising so rapidly, not just in the workplace but in children and adolescents as well. A society bristling with mental health problems is not a society at ease with itself.

Perhaps the Government dare not ask because it knows the answer already, and knows it is contrary to its policies, which sacrifice any genuine commitment to the sort of equality that promotes social cohesion, and instead places an ever-expanding economy - with an ever-expanding workforce - at the centre of its ambitions.

Since the birth of capitalism, in the philosophical writings of Adam Smith, it has been an article of faith that a capitalist system offers the best way to organise society because it chimes with human nature's own instincts and desires. Yet much research has contradicted this, indicating that altruistic acts, rather than acts that result in personal gain, give humans satisfaction.

Vulnerable people tend to drop out of the employment market, and into the miserable pit of incapacity benefit, because they felt unsupported and unvalued at work in the first place. A culture of work that valued the happiness of the humans engaged in it more than it did its profits, would have fewer intractable difficulties, and quite often, by happy coincidence, higher profits as well.

d.orr@independent.co.uk

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