Meeting of the Parliament 02 April 2014
I thank Jim Hume and his Liberal Democrat colleagues for bringing this debate to the chamber. Although there is some contention among the parties on what response is appropriate from the Scottish Government, there is something approaching unanimity across the Parliament in recognising the importance of mental health as a public health issue. That has not always been the case.
I want to look in particular at the importance of poverty and its impact on mental health. Deprivation can be both a cause and an effect of poor mental health. That should be reason enough for us all to worry, but inflation has outstripped wage rises for every month bar one over the past four years, and the average household has seen a drop in income of between £1,200 and £1,600, which has created the new phenomenon of widespread in-work poverty. Child poverty, which we pledged as a country to abolish, is instead set to rise again, and if we can expect an increase in mental health issues to match those increased levels of poverty, it is even more worrying that the welfare systems that we should be able to rely on in times of need are now in danger of making things worse.
The welfare state that was established to give us peace of mind in times of economic difficulty is now being used to make judgments about those of us who might at some point need some support and—which is worse—is becoming a system that actively discriminates against people who suffer from poor mental health.
At the Welfare Reform Committee earlier this week, Inclusion Scotland was just one of the organisations that presented powerful evidence on the impact of sanctions on some of our most vulnerable citizens. It highlighted that Department for Work and Pensions figures that were released in February 2012 showed that about 45 per cent of employment support allowance sanctions are given to people with mental health conditions, learning difficulties or behavioural conditions such as autism, even though they make up only about 30 per cent of ESA recipients.
The Jimmy Reid Foundation produced a paper just last month entitled “In Place of Anxiety—Social Security for the Common Weal”, which describes how welfare systems are being calibrated to create an environment of fear and insecurity—evils that can take just as much of a physical and psychological toll on people as poverty itself.
The University of Glasgow’s paper “General Practitioners at the Deep End” is based on a survey of doctors working in the 100 most deprived general practice areas in Scotland, who were asked how austerity measures are affecting them. Their central concern was to highlight the number of patients with deteriorating mental health, and they identified a problem at two ends of the mental health spectrum: on the one hand, there is an increasing amount of in-work stress and pressure of job insecurity, and on the other hand, there are people who have been assessed as being fit to work but who are suffering from chronic mental health issues.
SAMH intends to publish next week an even more detailed report on mental health that is based on a survey of its clients and staff that reveals their everyday experience of the subject. I know that the Scottish Government and the Parliament’s Welfare Reform Committee will greet that with interest.
The evidence that has been given to Parliament makes it clear that claimants and observers alike regard the welfare reforms as punitive and unfair actions that strip people of their respect and dignity, and that instead of improving our wellbeing, are contributing to poorer mental health. I certainly do not hold the Scottish Government responsible for those developments, and I believe that we are usually united against the Conservatives on welfare reform. However, we also have to ensure that in introducing mitigation measures we do not implicitly or inadvertently repeat the same judgments—for example, it is clear that claimants of crisis loans from the Scottish welfare fund are more likely to receive vouchers than cash. There is an implicit judgment there that, at best, we do not trust people with cash and, at worst, we assume that all claimants are potential fraudsters.
Mental health is not just an issue for our health services to cope with; it is a set of attitudes, a prejudice or a stigma that we all have to overcome individually and as a society. We have to be careful that we do not make things worse through our public policies and our social and economic policies.
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