“Treading in sand”: A qualitative study of the impact of austerity on inequalities in mental health

Abstract

Successive UK governments since 2010 have adopted policies of austerity characterized by public spending and social security cuts.There has been little qualitative research exploring the effects of these policies on inequalities in mental health. This article presents findings from a case study of Stockton-on-Tees, a local authority in the North East of England with exceptionally high spatial and socio-economic inequalities. Qualitative interviews were undertaken with people experiencing mental health problems in different areas of the local authority, alongside interviews with key stakeholders. The findings offer an insight into spatial inequalities in people's lives, and the impact of deprivation on mental health. They suggest that austerity measures are having a damaging impact on individuals and communities in the most deprived areas of this unequal place, whilst leaving those from less deprived areas relatively unscathed-with the exception of increased job insecurity. The cuts in social security are impacting on health through both material and psychosocial pathways including increased financial hardship and chronic stress. The intrusion of the state into people's everyday lives was such that the notion of the "home as an asylum" was broken, giving many no respite from the draining day-to-day experiences of poverty. The findings are discussed in relation to the continuing program of welfare changes and public spending cuts in the United Kingdom, including avenues for further research and key recommendations for policymakers. KEYWORDS health inequalities, neighborhood effects, social determinants of health, social policy

Impact of Universal Credit in North East England: a qualitative study of claimants and support staff

“…Managing the UC digital claims process caused frustration and confusion and adversely affected claimant’s mental health, increasing the possibility of serious self-harm and suicidal ideation, reinforcing other qualitative research on the mental health impact of welfare reform undertaken before UC was rolled out 29 30. Furthermore, punitive deductions pushed vulnerable claimants into debt and destitution, risk of alcohol and substance use relapse, increasing reliance of foodbanks, family and friends.…”

“…This increase was greater for people with low levels of education, widening inequalities in mental health 42. Recent UK research on mental health, austerity and welfare reform has concluded that cuts in social security are impacting on health through a combination of material and psychosocial pathways that include increased financial hardship and chronic stress 29. Strong associations between debt, depression, mental illness and suicide were identified in a systematic review 43.…”

Inequalities in mental health and well-being in a time of austerity: Follow-up findings from the Stockton-on-Tees cohort study

“…For example, Barr et al (2015a) suggest that geographical inequalities in mental health and wellbeing in the UK increased after austerity and that people living in more deprived areas experienced a larger increase in poor mental health ( Barr et al, 2015b ) and self-harm ( Barnes et al, 2016 ). Similarly, qualitative research with people with existing mental health conditions also found that austerity exacerbated their situation ( Mattheys, Warren, & Bambra, 2018 ). Internationally, Karanikolos et al (2013) , Stuckler and Basu (2013) , Niedzwiedz et al (2016) and Helliwell et al, (2017) also found that weakened social protection systems adversely effected mental health in Europe, particularly amongst the most disadvantaged social groups.…”

‘Everything takes too long and nobody is listening’: Developing theory to understand the impact of advice on stress and the ability to cope

“…Social welfare benefits are hypothesised to improve health-related quality of life, mediated by reduced stress, the adoption of more advantageous social arrangements and healthier behaviours [1]. Yet since 2010, successive governments in the UK have embarked on a programme of austerity, involving cuts to the funding of public services, [2,3] including social welfare benefits. This constitutes the most significant and longest-sustained reduction in state spending since World War II [4].…”