Rishi Sunak had some choice words to say recently; in reference to the amount of people currently off sick for mental health reasons, he commented “We don’t just need to change the sick note, we need to change the sick note culture so the default becomes what work you can do – not what you can’t.”
I really don’t want this to become a political blog. I strongly feel everyone deserves the chance to heal, nomatter what side of the political spectrum they fall on. But the prime minister’s recent remarks do fall right into my purview, and they have stuck in my craw a little.
According to the Government website: “Latest figures from the Office for National Statistics suggest there are currently 2.8 million people who are ‘economically inactive’ due to long-term sickness, a near-record high. Of those inactive due to long term sickness at the start of last year, 53% reported that they had depression, bad nerves or anxiety.”
Before the pandemic, we had the second lowest amount of ‘economically inactive’ people in the G7. Since then, it has shot up.
If the word Pandemic particularly leapt out at you there, then well done, you’ve figured out what this blog will be focusing on.
The cold reality is that we endured a collective shared trauma when COVID reared its ugly head. We went from that, headlong into a cost of living crisis, and a lot of us never got the chance to process what happened. A lot of us still haven’t admitted to ourselves that actually, we were really scared. I know this to be the case because every single client I have had since, without exception, has mentioned the pandemic and lockdowns at some point during their sessions with me.
Businesses, both large and small, have also suffered. As a result of dropping profits, pressure has been put on staff to do more with less, thereby ramping up the general stress that people are experiencing. This may shock you, but increased stress levels rarely have a positive effect on one’s health.
The NHS, as brilliant and hard-working as it is, was chronically stretched during the pandemic and woefully under-prepared for the mental health crisis that followed it. It’s great that you can gain access to CBT treatments for anxiety on the NHS now, but the waiting lists are long, and there are things that CBT struggles to completely resolve.
Yes, the answer is not to just blindly sign everyone off sick, but in absence of any other solution, that’s what has been happening. My concern is that Sunak, with his ‘well, what CAN you do?’ approach, will, at best, completely miss this opportunity to put things right. His answer seems to be ‘but being in work is good for your mental health, so let’s put these people to work’.
Unfortunately, for a lot of us, work actually became a trauma trigger during the pandemic. The idea of going in meant potential danger of infection, so when/if we returned to the office, things immediately felt more fraught. Getting a slight sniffle suddenly meant more than taking some daynurse and powering through. Even being home is a potential unwelcome reminder of the cabin fever we all got during the shift to remote working. Overly scrutinising people who are still recovering from this is not going to help them.
So what’s my solution?
Simple, really. Expand the existing mental health services. Offer more than just CBT. Make Solution-Focused Hypnotherapy and NLP treatments available through the NHS. There are so many evidence-based treatments for anxiety and depression that have real, long term results in as few as ten sessions, yet the NHS only offers CBT. And even then, the waitlist is atrocious. The qualified practitioners are already out there. You don’t need to train them up, they already have advanced degrees in their field and they’re members of reputable organisations that provide oversight. I’m one of them, and my colleagues and I would jump at the chance to help people on the over-extended NHS waitlists. We are generally quite a nice group of keen, well-meaning science nerds, and we got into this line of work to do good rather than get rich.
The money that Sunak will spend on administrators trying to poke and prod the anxious and depressed of our nation could be much better used on making mental healthcare accessible, and it will save money in the long run. When people with anxiety-based conditions have had successful therapeutic treatments, the amount of time they take off sick will immediately go down. Do you know what causes the most sick days? Stress. Not anxiety, depression or anything that even requires a sicknote. 18 million work days a year on average are missed due to garden variety stress. This is the “everyday challenges and worries of life” that Sunak is concerned about ‘over-medicalising’, which in and of itself is a nonsense term. In context it’s like saying there’s no need to treat the sniffles until it becomes full-blown pneumonia.
I know some people will argue this next point because of all of the ‘workshy benefit scrounger’ rhetoric, but the vast majority of the public DO want to work. Or at least, they don’t want to eek out a meagre living on the pittance that benefits provide. They want to live meaningful lives, be challenged in their chosen fields, and find satisfaction in their existence. Something needs to be put into action so we can deal with the fallout of the global pandemic we all faced. And l know, I understand how keen we all were to get ‘back to normal’, but we can’t just pretend it didn’t happen. It can’t be an afterthought, mentioned only by our Prime Minister as a mark of time passed, rather than the massive contributing factor it was. We can’t just slap a plaster on and hope it’s fine in the morning.
Perhaps I’m not being cynical enough. Others have called Sunaks comments an attempt to demonise the mentally ill, stoke the culture wars and curry favour with the Tory power base. Maybe that’s what’s really happening here. But all the same, I would sincerely like to believe that someone in charge at least has their hearts in the right place, and that if they truly want to help people back to work, they will employ therapists rather than administrators. Because goodness knows we have enough of those already.