Jon Dale, Mansfield Socialist Party
‘Too many people are being diagnosed with mental health conditions, driving up the benefits bill when people could be in work.’ That’s what Labour health secretary Wes Streeting was claiming last March. Now, after the government was forced into a disability benefit cuts U-turn and strong criticism from doctors, teachers, disability charities and others, he has partially rowed back from his ignorant comments. Instead, he’s setting up an inquiry into the apparent growth of mental health problems, particularly for those of working age.
There have certainly been big increases in measurements of mental ill-health and psychological conditions, affecting all ages. In England:
- In 2011, 3,840 prospective students declared an existing mental health condition in their application for university; in 2020, there were 21,105
- Autism diagnoses went up 787% between 1998 and 2018
- Children and young people identified with special educational needs and disabilities up from 1.3 million in 2014 to 1.7 million in 2024-25
- Adults on prescribed drugs for ADHD rose 24.3% to 190,000 in the year to 2024-25
Streeting’s comment aped his Tory predecessors. “There is a real risk now that we are labelling the normal ups and downs of human life as medical conditions,” said former Tory minister Mel Stride in March 2024, “which then actually serve to hold people back and, ultimately, drive up the benefit bill.”
In April 2024, then prime minister Rishi Sunak attacked a “sick-note culture”, where people supposedly choose to get signed off work as unfit and claim lavish benefits. He and his wife’s personal wealth grew over £2.3 million each week in 2024. He should try living on £118.75 a week statutory sick pay!
Nigel Farage joined in the attack on people suffering mental ill-health, saying in April 2025: “I think we are massively overdiagnosing those with mental illness problems and those with other general behavioural disabilities.”
Being an MP or minister, writing newspaper columns and making highly paid speeches, gives very different ‘satisfaction’ to rushing round a huge warehouse picking orders, driving hours in crawling traffic or standing on a packing line all day long with bullying management on one’s back. Neither the Tories, Farage nor Wes Streeting have ever done jobs like these.
Overwork and ill-health
A 2019 study showed women working over 55 hours a week were more likely to become depressed than those working 35-40 hours. Regular weekend working was associated with more depression among men and women than in those who did not work weekends. Many low-paid workers are forced to work long hours, often two or three jobs, to make enough to live on. And many workers have to work weekends, not just those in essential services.
However, hard unpleasant work is nothing new for millions of workers, so what else explains the apparent big increase in mental health problems? Far from this being ‘overdiagnosis’ by GPs, evidence shows massive underdiagnosis.
Recent research published in the Lancet medical journal analysed 9 million GP records and found just 0.32% of patients have a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD). That’s less than 1 in 10 of the 4% of all adults estimated to have ADHD.
Another study estimated there were between 435,700 and 1,197,300 people in England in 2018 who may be autistic and undiagnosed.
A large recent study found 12 times as many people with severe mental ill-health symptoms but no diagnosis, compared to people who had been given a diagnosis but did not have symptoms (although they might have done when originally diagnosed).
Child mental health
For children, too, there’s underdiagnosis. Years of local authority cuts have stripped out hundreds of education psychologist posts. It’s harder to get a child diagnosed with neurodivergent conditions like autism or ADHD. Parents and schools need to follow exhausting lengthy processes. Huge workloads and loss of support services have led to burnt-out education psychologists leaving the profession.
In September: the Association of Education Psychologists stated, “The Government’s current commitment to fund training places for education psychologists is nowhere near sufficient to meet rising demand. Without additional, long-term funding and a national workforce plan, there will simply not be enough … in the years ahead.”
In 2022-23, nearly one million children and young people were referred to Child and Adolescent Mental Health Services (CAMHS), 8% of the 11.9 million children in England. 305,000 started treatment. 270,300 were still waiting by the end of the year. And 372,800 (39%) had their referrals closed before accessing CAMHS.
Government Special Educational Needs and Disabilities (SEND) funding has risen at a rate far below rising demand and costs. The many children not getting their special needs recognised or provided for at school are more likely to experience mental ill-health in adult life and lack of work opportunities, addiction and risk of falling into the criminal justice system.
As well as underdiagnosis, there has been widespread misdiagnosis of neurodivergent conditions, especially for girls and women. The male:female ratio of those with these conditions was used to be thought to be around 10:1. More recent studies have shown how girls in particular learn to mask their conditions. Masking tends to break down during other stressful events. More adult women are now recognising their underlying neurodivergence, bringing the gender ratio down to 3:1. It may fall further.
Fighting the stigma
There has been wider discussion about mental health over recent decades. Trade unions have campaigned for mental health support for members and their families. There’s been less secrecy and shame suffered by those with mental ill-health, although it’s still a taboo subject for many. ‘Victim-blaming’ by politicians and their big business backers threatens to turn the clock back.
Growth in anti-depressant prescriptions has boosted pharmaceutical industry profits, while NHS talking therapies remain severely under-resourced. A six-session course is not enough for most people to overcome mild anxiety or depression, let alone longstanding and deeper problems. A comprehensive course of talking therapy has been shown to be equally effective, if not more so, than medication.
But neither talking nor pharmaceutical therapies, though needed, ultimately change life’s conditions. Money and housing insecurity, bullying bosses and harassment, long hours and insufficient leisure time or facilities contribute to mental stress. Racism, homophobia and attacks on disabled people add to anxiety and depression.
Employers demanding more and more at faster speeds, and without adjustments for neurodivergence or disability, make it harder to remain at work.
Trade unions should campaign for workers to have democratic control over their working conditions, a real living minimum wage, a maximum 32-hour week without loss of pay, work adjustments for health and disabilities and to root out all forms of bullying.
Councillors should fight for government money to build good-quality council housing, provide youth and community services, and cheap or free leisure facilities.
Government should fully fund local councils and the NHS, including mental health services, increase training of psychologists and other health professionals and nationalise the pharmaceutical companies to bring down the cost of drugs. Schools should be fully funded to meet the needs of all pupils.
Sickness and disability benefits need to be raised to the equivalent of a living minimum wage.
The capitalist system based on brutal exploitation and competition is bad for our mental health. Fight for a socialist society based on cooperation to meet the needs of all.
