News, Numbers and Nonsense

Cross-posted at Where's the Benefit?

The news that mental health conditions are now the most common reason for somebody to be on incapacity benefits is only the latest in a great slew of statistics published lately about disability benefit which are being used to imply something far beyond their significance. Statistics only become news when they are seen to be interesting - usually when something is going dramatically up, or down.

In this case, the real story here is that the numbers of people with chronic back pain on Incapacity Benefit dropped by 50% between 1997 and 2007 - that's the newsworthy bit, that should be the headline. Not because it's good news, but because it indicates an actual change. And whilst the Occupational Therapists looking at the data couldn't see why they could be responsible for this change, I think it says positive things about workplace conditions - both that workers have been made less vulnerable to back injury and strain at work and after the introduction of DDA, workers with chronic back pain have rights to accommodation so many can carry on working. I'm sure there's also better advice from GPs, maybe other improvements in medical treatment too.

But no, the story is about mental illness, to imply that it is remarkable so many people should be incapacity benefit with mental illness. Only it's not very many at all.

One in four people in the UK will experience mental illness at some point in their lives. According to the article's statitistics (once we do some maths of our own) about one in two hundred and fifty of the country's population is currently incapacitated due to mental ill health.

The same sum is useful to apply to that obesity statistic published a few weeks back. The headline was that 80,000 people are on incapacity benefits because of alcoholism, drug addiction or obesity, but it was the smallest proportion of this group, people with obesity, that gained the attention. My Dad had heard the news and declared that 80,000 people incapacitated by obesity. The Mirror delighted in the imagery, “People who are too fat to work are biting a huge hole in the country’s finances, figures revealed yesterday.”

In fact, it was more like 1800 who were obese. Almost one in four of us is obese, but these figures mean that only one in thirty-five-thousand of us are actually incapacitated by obesity, making the “Loads of people are too fat to work” trope rather moot.

These statistics demonstrate that it is very rare for mental illness or obesity to lead to incapacity. Given that these conditions, along with chronic back pain (usually reported as “a bad back” in the press and usually in inverted commas), are common*, this should lead to empathy as opposed to dismissal.

I have had chronic back pain and mental illness and I have been obese. Had I not been chronically ill as it was, the back pain and mental illness would have lead to significant time off work but neither would have been bad enough for long enough to take me out of work. Despite that, my mental health experiences have been by far the worst experiences of my life, far worse than any level of pain I have experienced. My back pain was intensely painful, tremendously frustrating, very sensitive to emotional tension and presented a constant battle between the need for rest and the need for movement. So when I hear about people being incapacitated by mental ill health or “a bad back”, I have great sympathy – they have what I had but probably worse and definitely for much longer.

The obesity was only a problem to me because I had put on weight very quickly and felt very self-conscious about it, so goodness knows how much more severe a person's condition has to be before it stops them working. People who are incapacitated with obesity are significantly unwell. To carry that kind of weight in the first place, there must be an underlying physical or mental health problem - if someone actually eats their way to that size, they have an eating disorder as serious and dangerous as anorexia or bulimia.

But my sympathy is utterly irrelevant. The point is that someone has to experience a significant level of functional impairment in order to qualify for any disability benefits. Just because a condition is common doesn't mean that a minority of people don't get it very bad. Almost everyone has had the flu at some point in their lives, but that doesn't make it remarkable that a few thousand people who die of it each winter.

* Mental illness can of course be a hundred different things, including relatively rare conditions, but for these purposes all these mental ill health is lumped in together. I'm not going to go to great pains to put this right because the whole matter of diagnostic labels and incapacity is highly problematic and plays into the hierarchy of disability.