The ‘sick man of Europe’ — how poor mental health is impeding the UK’s economic recovery

The phrase the ‘sick man of Europe’, was reputedly first coined by Tsar Nicholas 1st when referring to the decline of the Ottoman Empire. It was a pejorative term widely applied to the UK during the 1970s following the devaluation of the pound in 1967. With many commentators drawing parallels between the 1970s and current events — not least over the waves of public sector strikes and a stuttering economic performance — we examine, in the light of a recent report published by the Institute for Public Policy Research (IPPR), how valid that description really is and how worsening mental health is impacting economic recovery 

In a paper entitled 'Getting Better,' published by the Institute for Public Policy Research on 7 December 2022, the main author Chris Thomas, Head of the Commission for Health and Prosperity, sets out a number of stark facts based on official statistics released by the Office for National Statistics (ONS). These reveal:

• 2.5 million people or 6.1% of the working age population are ‘economically inactive’ because of poor health — the highest since records began.
• There remains a wide geographical divergence within the UK, with the North East, North West, Yorkshire, East Midlands and the devolved nations having significantly higher rates of ill health.
• The “levelling up” agenda is being undermined as sickness is twice as likely to force people out of work in the North East and Northern Ireland as in London and the South East.
• More than 6 in 10 people “economically inactive” because of long term illness are struggling with poor mental health (ONS data).
• Economic inactivity has risen by 42% amongst those aged between 25 years old and 34 years old.
• The UK is the only G7 nation where the employment rate has not returned to pre-pandemic levels.
• Economic inactivity has risen in the UK whilst it has fallen in the rest of Europe.
• Compared to 2019, even those in work were 13% more likely to have one health concern and 30 % more likely to have multiple health concerns.

In the press release accompanying the report, its author Chris Thomas comments: “We are getting sicker and poorer as a country with deepening health inequalities undermining national prosperity, particularly in the North and in the devolved nations.”

Is COVID-19 to blame?

The UK has seen over 180,000 excess deaths attributable to COVID and has an estimated 1.7 million people living with “Long COVID” of which two thirds have symptoms which impact their daily lives. Its impact has undoubtedly exacerbated underlying trends given that Wales, Scotland, the North and the Midlands have geographically higher Long COVID rates than the UK average.

The principal cause of ill health is, however, poor mental health with 6 in 10 cases attributable to anxiety, stress or depression.

We have seen from other sources, namely the HSE Summary Statistics published on 23 November 2022, that existing and new cases of workplace stress, depression and anxiety have reached a staggering 914,000 (measured from April 2021 to March 2022) — a 14 % rise compared to the previous year.

Younger people have in particular been impacted with a 25% rise seen in hospital admissions for self-harm and assault since the start of the pandemic and the number of eating disorders doubling (Thomas et al 2020). Viewed globally, the Lancet reported in March of this year that there have been an additional 75 million cases of anxiety, stress and depression since the start of the pandemic.

Comment

Although parallels between the UK’s economy today and that of the 1970s may be drawn on several key economic indicators — rising inflation, public sector strikes and stagnant growth- the absence of historical data on mental health precludes a direct comparison.

What is clear from the ONS data is that the nation’s collective poor mental health is contributing significantly to those who are economically inactive. This, in turn, is holding back economic recovery with geographical disparities becoming wider and putting at serious risk the UK Government’s levelling up agenda.

The prospect of extra funding and resources to tackle rising levels of poor mental health appears unlikely to manifest given budgetary concerns and the Government’s apparent unwillingness to increase the burden on taxpayers even further.

In this context, it is perhaps time for a change in emphasis upon how health funding is allocated, with mental health services receiving a larger slice of the pie. This should perhaps be allied to a programme aimed at building resilience amongst the younger generation.

To ignore the data would appear to be potentially calamitous. In the words of Chris Thomas, the author of 'Getting Better': “Without a proactive response from policymakers in health and beyond, we
will likely see an increase in avoidable deaths and morbidity for many years yet to come”.