Just when you think the Tories can’t get any more cruel or inhuman, they demonstrate the depths to which they will sink. The Telegraph reported yesterday that Tories are considering withdrawing benefits from those off work due to depression unless they receive mandatory “treatment”.
The news that depression is treatable because Ian Duncan-Smith says so will come as news to millions who suffer with what is in may ways the defining epidemic of our society. The clue to this particular piece of policy lies in the words of the senior Tory source quoted in the article:
A senior government source said “a huge number” of claimants on ESA who cannot work have treatable mental health issues such as “depression and anxiety”.
“We know that depression and anxiety are treatable conditions. Cognitive behavioural therapies work and they get people stable again but you can’t mandate people to take that treatment,” the source said.
“But there are loads of people who claim ESA who undergo no treatment whatsoever. It is bizarre. This is a real problem because we want people to get better.
“These are areas we need to explore. The taxpayer has committed a lot of money but the idea was never to sustain them for years and years on benefit. We think it’s time for a rethink.
“At some point something has to be done. Right now it’s an open ended contract.”
The source suggested that successful treatments could reduce the numbers of people with mental health issues claiming the benefits by up to 90 per cent.
The plan, then, is to compel those diagnosed with depression and anxiety to undergo Cognitive Behaviour Therapy. And this exposes the Tory rationale, and the cruelty underlying it. Depression and anxiety are notoriously difficult to diagnose, because of the subjectivity inherent in the symptoms, and the causes vary. It may for example be a manifestation of post-traumatic stress – sometimes as a result of things that have happened in the workplace. And although CBT undoubtedly brings improvements for many people, it is no use for others. Treating – or more accurately managing – depression is difficult, complex and varies according to the individual. The idea that it can be bulk-treated by a single approach shows a breathtaking misunderstanding of the condition.
So what is the agenda?
First, a one-size-fits-all treatment can easily be supplied by the private sector, for profit. Despite the lessons of ATOS, the Tories still seem to think that this kind of provision is workable. But even more so than with ATOS assessments, it isn’t. It becomes an exercise in the sort of combination of casual cruelty and incentivised box-ticking that has discredited every example of pseudo-scientific schemes to get people off benefits.
And pseudo-science is the operative word. This is all of a piece with the ideology behind the way in which private companies like Unum and ATOS have rationalised their pitch to reduce the numbers receiving benefits for profit; a treatment of illness as if it were a form of social deviance. I have blogged about this before – and although since then the Labour Party’s position has changed significantly, with Ed Miliband making really progressive pledges on the treatment of mental illness under a Labour government (and Liam Byrne moved to a shadow job where his trademark lack of empathy is much less damaging), the issues remain the same. Indeed, the choice of CBT – a form of therapy that notoriously seeks to return the behaviour of individuals to socially-determined “norms” – only confirms the ideological nature of this project.
For all the soft rhetoric about “helping” people, we should be under no illusion: this is pure ideology, the pursuit of pseudo-science in order to reduce the number of people receiving benefits, and represents the approach of private companies seeking to profit from doing so. It has nothing to do with compassion or decency; it’s ideology, pure and simple.