Progress | Centre-left Labour politics

A six-year strategy

Mental illness has overtaken unemployment as our major social ill. The government must act

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A key issue for the first 100 days should be a better deal for people with depression and anxiety disorders.

This is the great hidden problem in our society. According to the ONS Survey, six million adults suffer from clinical depression or crippling anxiety disorders like agoraphobia. If you think it’s an overestimate, try asking the next person you speak to if they know anyone with these problems.

The problem is huge, but it’s not much discussed because people are so ashamed. And it’s not much lobbied for. But for one family in three it causes massive distress, and huge worry for the rest of the family. It is also a big problem for employers. It should be a key issue for Labour.

In fact if you ask, what is the biggest single cause of misery in the country, surveys show that a history of depression or anxiety disorders accounts for more misery than poverty does. When we think about deprivation, we should think of mental illness as one of its most common forms.

We now have more mentally ill people on incapacity benefits than the total number of people claiming unemployment benefits. So mental illness has overtaken unemployment as our biggest curable social problem.

The tragedy is that only a quarter of those affected receive any form of treatment. The majority would like psychological therapy and the evidence shows that modern evidence-based treatments like cognitive behavioural therapy will in less than 16 sessions cure more than half of them. These therapies also have a better record than drugs at preventing subsequent relapse. For these reasons the NICE guidelines tell GPs to offer patients the option of these therapies. But most GPs simply cannot do it because in most parts of the country the therapists are not there within the NHS.Labour has a 2005 manifesto commitment to rectify this shocking situation, and it is urgent that we do it. There are millions of people out there in real distress, and they and their families would turn with gratitude to any party which took their problem seriously.

But can we afford to address it? Easily, because the therapy will pay for itself. At present depression and anxiety disorders are costing the Exchequer some £7 billion in incapacity (and related) benefits and in lost taxes. Each month that someone spends on incapacity benefits costs the Exchequer £750. This is exactly the same as the total cost of a course of psychological treatment. So the treatment pays for itself if on average it saves only one month of time on incapacity benefit. The evidence says that it does: if people are still in work, it helps to keep them there; and, if they are out of work, it helps them to get back.

What we need now is a government commitment to provide state-of-the-art treatment for depression and anxiety disorders – just as we have with cancer or diabetes. To get satisfactory provision throughout the country will take about six years, so we need a six-year plan to train the therapists and make sure a satisfactory evidence-based service is available in every part of the country. This should figure as a major new Labour initiative – something different, which shows that we understand the real problems affecting people in every social class.

How can we not do it? It is a manifesto commitment. It is prescribed by NICE and it will cost the Exchequer nothing. If money is short, that makes it even more desirable.

The depressed and anxious may make little noise, but they can recognise their friends. Let us show that we in Labour are their friends.

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Richard Layard

Lord Richard Layard is Professor Emeritus of Economics at the London School of Economics

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