Hostname: page-component-54dcc4c588-gwv8j Total loading time: 0 Render date: 2025-10-08T01:41:15.282Z Has data issue: false hasContentIssue false
  • English
  • Français

Unemployment, sanctions and mental health: the relationship between benefit sanctions and antidepressant prescribing

Published online by Cambridge University Press:  25 October 2019

EVAN WILLIAMS Open the ORCID record for EVAN WILLIAMS [Opens in a new window]
EVAN WILLIAMS*
Affiliation:
Room 133, 29 Bute Gardens, Urban Studies, University of Glasgow, Glasgow G12 8RS email: e.williams.1@research.gla.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

International social security systems increasingly place work-related conditions on individuals claiming out-of-work benefits, and enforce requirements through the use of benefit sanctions. The literature on the impacts of benefit sanctions considers both labour market and wider social effects, which this study contributes to through a focus on mental health. It considers the period of Coalition government (2010–15) in the UK, which imposed a comparatively high number of benefit sanctions and increased their severity through the Welfare Reform Act 2012. A longitudinal dataset is constructed using quarterly local authority-level data on Jobseeker’s Allowance (JSA) sanctions and antidepressant prescriptions in England. Results from fixed effects analyses indicate that, in the post-reform period, every 10 additional sanctions are associated with 4.57 additional antidepressant prescribing items (95% CI: 2.14 to 6.99), which translates to approximately one additional person receiving treatment. Importantly, this finding indicates that sanctions are associated with both adverse mental health impacts and wider public expenditure implications, which motivates further investigation at the individual-level. In addition, punitive sanctions form a core part of the new Universal Credit (UC) and so the results suggest the need to reassess the use of sanctions within the contemporary social security system.

Keywords

conditionalityactivationunemploymentbenefit sanctionsmental health

Information

Type
Article
Information
Journal of Social Policy , Volume 50 , Issue 1 , January 2021 , pp. 1 - 20
Copyright
© Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Adler, M. (2016), ‘A New Leviathan: Benefit Sanctions in the Twenty‐first Century’, Journal of Law and Society, 43, 2, 195–227.10.1111/j.1467-6478.2016.00749.xCrossRefGoogle Scholar
Allison, P. (2009), Fixed effects regression models (Vol. 160), London: Sage.10.4135/9781412993869CrossRefGoogle Scholar
Arni, P., Lalive, R. and Van Ours, J. C. (2013), ‘How effective are unemployment benefit sanctions? Looking beyond unemployment exit’, Journal of Applied Econometrics, 28, 7, 1153–1178.10.1002/jae.2289CrossRefGoogle Scholar
Barr, B., Taylor-Robinson, D., Stuckler, D., Loopstra, R., Reeves, A. and Whitehead, M. (2016), ‘‘First, do no harm’: are disability assessments associated with adverse trends in mental health? A longitudinal ecological study’, Journal of Epidemiology and Community Health, 70, 4, 339–345.10.1136/jech-2015-206209CrossRefGoogle ScholarPubMed
Beatty, C. and Fothergill, S. (2013), Hitting the poorest places hardest: The Local and Regional Impact of Welfare Reform, Sheffield: Centre for Regional Economic and Social Research and Sheffield Hallam University.10.7190/cresr.2017.6378897426CrossRefGoogle Scholar
Bonoli, G. (2010), ‘The Political Economy of Active Labor-Market Policy’, Politics and Society, 38, 4, 435–457.10.1177/0032329210381235CrossRefGoogle Scholar
Clasen, J. and Clegg, D. (2011), ‘Unemployment protection and labour market change in Europe: towards ‘triple integration’?’, in Clasen, J. and Clegg, D. (eds.), Regulating the risk of unemployment: National adaptations to post-industrial labour markets in Europe, Oxford: Oxford University Press, 1–12.10.1093/acprof:oso/9780199592296.001.0001CrossRefGoogle Scholar
Davis, O. (2019), ‘What is the Relationship between Benefit Conditionality and Mental Health? Evidence from the United States on TANF Policies’, Journal of Social Policy, 48, 2, 249–269.10.1017/S0047279418000363CrossRefGoogle Scholar
Department for Work and Pensions (DWP) (2013), Jobseeker’s Allowance: overview of revised sanctions regime, London: Stationary Office.Google Scholar
Department for Work and Pensions (DWP) (2014), Universal Credit Pathfinder Evaluation, London: Stationary Office.Google Scholar
Department for Work and Pensions (DWP) (2015), ‘Universal Credit national expansion – Tranches One and Two’, https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/414936/universal-credit-national-expansion.pdf, [accessed 04.06.2018].Google Scholar
Department for Work and Pensions (DWP) (2018), ‘Stat-Xplore’, https://sw.stat-xplore.dwp.gov.uk/, [accessed 04.06.2018].Google Scholar
Dorsett, R., Rolfe, H. and George, A. (2011), The Jobseeker’s Allowance Skills Conditionality Pilot, London: Department for Work and Pensions.Google Scholar
Dumitrescu, E.-I. and Hurlin, C. (2012), ‘Testing for Granger non-causality in heterogeneous panels’, Economic Modelling, 29, 4, 1450–1460.10.1016/j.econmod.2012.02.014CrossRefGoogle Scholar
Dwyer, P., Jones, K., McNeill, J., Scullion, L. and Stewart, A. B. R. (2018), Final findings: Disabled people. Welfare Conditionality: Sanctions, Support and Behaviour Change, York: University of York.Google Scholar
Dwyer, P. and Wright, S. (2014), ‘Universal Credit, ubiquitous conditionality and its implications for social citizenship’, Journal of Poverty and Social Justice, 22, 1, 27–35.10.1332/175982714X13875305151043CrossRefGoogle Scholar
Fletcher, D. R. and Wright, S. (2018), ‘A hand up or a slap down? Criminalising benefit claimants in Britain via strategies of surveillance, sanctions and deterrence’, Critical Social Policy, 38, 2, 323–344.10.1177/0261018317726622CrossRefGoogle Scholar
Health and Social Care Information Centre (HSCIC) (2015), ‘General Practice Prescribing Data FAQs’, http://content.digital.nhs.uk/media/10048/FAQs-Practice-Level-Prescribingpdf/pdf/PLP_FAQs_April_2015.pdf, [accessed 04.06.2018].Google Scholar
Hoechle, D. (2007), ‘Robust standard errors for panel regressions with cross-sectional dependence’, Stata Journal, 7, 3, 281–312.10.1177/1536867X0700700301CrossRefGoogle Scholar
HM Government (2017), Jobseeker’s Allowance (Hardship) (Amendment) Regulations 2017, London: Stationary Office.Google Scholar
Hyde, J., Evans, J., Sharp, D., Croudace, T., Harrison, G., Lewis, G. and Araya, R. (2005), ‘Deciding who gets treatment for depression and anxiety: a study of consecutive GP attenders’, British Journal of General Practice, 55, 520, 846–853.Google ScholarPubMed
Immervoll, H. and Knotz, C. (2018), How Demanding Are Activation Requirements for Jobseekers? (IZA DP No. 11704), Bonn: IZA Institute of Labor Economics.Google Scholar
Immervoll, H. and Scarpetta, S. (2012), ‘Activation and employment support policies in OECD countries. An overview of current approaches’, IZA Journal of Labor Policy, 1, 1, 1–9.10.1186/2193-9004-1-9CrossRefGoogle Scholar
Johnsen, S. and Blenkinsopp, J. (2018), Final findings: Lone Parents. Welfare Conditionality: Sanctions, Support and Behaviour Change, York: University of York.Google Scholar
Johnsen, S., Watts, B. and Fitzpatrick, S. (2018), Final findings: Homelessness. Welfare Conditionality: Sanctions, Support and Behaviour Change, York: University of York.Google Scholar
Katikireddi, S. V., Molaodi, O. R., Gibson, M., Dundas, R. and Craig, P. (2018), ‘Evaluating the impacts of restrictions to Income Support for lone parents on health: a natural experiment study’, Lancet Public Health, 3, 7, e330–e340.10.1016/S2468-2667(18)30109-9CrossRefGoogle Scholar
Kennedy, S. and Keen, R. (2016), Benefit Claimants Sanctions (Required Assessment) Bill 2016–17 . House of Commons Briefing Paper no. 7813, London: House of Commons Library.Google Scholar
Knotz, C. M. (2018), ‘A rising workfare state? Unemployment benefit conditionality in 21 OECD countries, 1980–2012’, Journal of International and Comparative Social Policy, 34, 2, 91–108.10.1080/21699763.2018.1472136CrossRefGoogle Scholar
Lambie-Mumford, H. (2014), Food bank provision and welfare reform in the UK, Sheffield: Sheffield Political Economy Research Institute.Google Scholar
Lindsay, C. (2007), ‘The United Kingdom’s ‘work first’ welfare state and activation regimes in Europe’, in Pascual, A. Serrano and Magnusson, L. (eds.), Reshaping Welfare States and Activation Regimes in Europe, Brussels: Peter Lang, 35–70.Google Scholar
Lindsay, C., McQuaid, R. and Dutton, M. (2007), ‘New approaches to employability in the UK: Combining ‘Human Capital Development’ and ‘Work First’ strategies?’, Journal of Social Policy, 35, 4, 539–560.10.1017/S0047279407001171CrossRefGoogle Scholar
Loopstra, R., Reeves, A., McKee, M. and Stuckler, D. (2015), Do punitive approaches to unemployment benefit recipients increase welfare exit and employment? A cross-area analysis of UK sanctioning reforms. University of Oxford Sociology Working Papers 2015-01, Oxford: University of Oxford.Google Scholar
Loopstra, R., Fledderjohann, J., Reeves, A. and Stuckler, D. (2018), ‘Impact of Welfare Benefit Sanctioning on Food Insecurity: a Dynamic Cross-Area Study of Food Bank Usage in the UK’, Journal of Social Policy, 47, 3, 437–457.10.1017/S0047279417000915CrossRefGoogle Scholar
Lundin, A. and Hansson, A. (2014), ‘Unemployment and dispensed prescribed antidepressants in Stockholm County 1998–09’, European Journal of Public Health, 24, 4, 666–668.10.1093/eurpub/cku079CrossRefGoogle ScholarPubMed
Morrison, J., Anderson, M.-J., Sutton, M., Munoz-Arroyo, R., McDonald, S., Maxwell, M. and Wilson, P. (2009), ‘Factors influencing variation in prescribing of antidepressants by general practices in Scotland’, The British Journal of General Practice, 59, 559, e25–e31.10.3399/bjgp09X395076CrossRefGoogle ScholarPubMed
National Audit Office (NAO) (2016a), Benefit Sanctions, London: Department for Work and Pensions.Google Scholar
National Audit Office (NAO) (2016b), Benefit sanctions: detailed methodology, London: Department for Work and Pensions.Google Scholar
NHS Digital (2018), ‘Prescribing by GP practice’, http://content.digital.nhs.uk/gpprescribingdata, [accessed 04.06.2018].Google Scholar
NICE (2015), ‘First-choice antidepressant use in adults with depression or generalised anxiety disorder’, https://www.nice.org.uk/advice/ktt8/chapter/evidence-context, [accessed 04.06.2018].Google Scholar
Office for National Statistics (ONS) (2018), ‘NOMIS’, http://www.nomisweb.co.uk, [accessed 04.06.2018].Google Scholar
Peters, M. and Joyce, L. (2006), A review of the JSA sanctions regime: summary research findings, London: Department for Work and Pensions.Google Scholar
Plümper, T. and Troeger, V. E. (2007), ‘Efficient estimation of time-invariant and rarely changing variables in finite sample panel analyses with unit fixed effects’, Political Analysis, 15, 2, 124–139.10.1093/pan/mpm002CrossRefGoogle Scholar
Raffass, T. (2017), ‘Demanding Activation’, Journal of Social Policy, 46, 2, 349–365.10.1017/S004727941600057XCrossRefGoogle Scholar
Sage, D. (2018), ‘Reversing the Negative Experience of Unemployment: A Mediating Role for Social Policies?’, Social Policy and Administration, 52, 5, 1043–1059.10.1111/spol.12333CrossRefGoogle Scholar
Saunders, T., Stone, V. and Candy, S. (2001), The impact of the 26 week sanctioning regime, London: Department for Work and Pensions.Google Scholar
Shadish, W. R., Cook, T. D. and Campbell, D. T. (2002), Experimental and quasi-experimental designs for generalized causal inference, New York: Houghton Mifflin.Google Scholar
Smith, K. E. and Anderson, R. (2018), ‘Understanding lay perspectives on socioeconomic health inequalities in Britain: a meta‐ethnography’, Sociology of Health and Illness, 40, 1, 146–170.10.1111/1467-9566.12629CrossRefGoogle ScholarPubMed
Spence, R., Roberts, A., Ariti, C. and Bardsley, M. (2014), Focus On: Antidepressant prescribing, London: The Health Foundation and the Nuffield Trust.Google Scholar
Sreeharan, V., Madden, H., Lee, J. T., Millett, C. and Majeed, A. (2013), ‘Improving Access to Psychological Therapies and antidepressant prescribing rates in England: a longitudinal time-series analysis’, British Journal of General Practice, 63, 614, e649–e653.10.3399/bjgp13X671641CrossRefGoogle ScholarPubMed
Stewart, A. B. R. and Wright, S. (2018), Final findings: Jobseekers. Welfare Conditionality: Sanctions, Support and Behaviour Change, York: University of York.Google Scholar
Sturgeon, J. A., Arewasikporn, A., Okun, M. A., Davis, M. C., Ong, A. D. and Zautra, A. J. (2016), ‘The psychosocial context of financial stress: Implications for inflammation and psychological health’, Psychosomatic Medicine, 78, 2, 134–143.10.1097/PSY.0000000000000276CrossRefGoogle ScholarPubMed
Taulbut, M., Mackay, D. F. and McCartney, G. (2018), ‘Job Seeker’s Allowance (JSA) benefit sanctions and labour market outcomes in Britain, 2001–2014’, Cambridge Journal of Economics, 42, 5, 1417–1434.10.1093/cje/bex088CrossRefGoogle Scholar
van den Berg, G. J., Uhlendorff, A. and Wolff, J. (2017), Under Heavy Pressure: Intense Monitoring and Accumulation of Sanctions for Young Welfare Recipients in Germany (IZA DP No. 10730), Bonn: Institute of Labor Economics.Google Scholar
van den Berg, G. J. and Vikström, J. (2014), ‘Monitoring Job Offer Decisions, Punishments, Exit to Work, and Job Quality’, The Scandinavian Journal of Economics, 116, 2, 284–334.10.1111/sjoe.12051CrossRefGoogle Scholar
Vincent, J. (1998), Jobseeker’s Allowance Evaluation: Qualitative Research on Disallowed and Sanctioned Claimants, London: Department for Education and Employment.Google Scholar
von Soest, T., Bramness, J. G., Pedersen, W. and Wichstrøm, L. (2012), ‘The relationship between socio-economic status and antidepressant prescription: a longitudinal survey and register study of young adults’, Epidemiology and Psychiatric Sciences, 21, 1, 87–95.10.1017/S2045796011000722CrossRefGoogle ScholarPubMed
Watts, B. and Fitzpatrick, S. (2018), Welfare Conditionality, London: Routledge.10.4324/9781315652047CrossRefGoogle Scholar
Watts, B., Fitzpatrick, S., Bramley, G. and Watkins, D. (2014), Welfare Sanctions and Conditionality in the UK, York: Joseph Rowntree Foundation.Google Scholar
Webster, D. (2015), ‘Briefing on the DWP’s JSA/ESA Sanctions Statistics Release, 11 Nov 2015 and Hardship Payments Ad Hoc Statistical Release, 18 Nov 2015’, http://www.cpag.org.uk/david-webster, [accessed 04.06.2018].Google Scholar
Webster, D. (2016), ‘Explaining the rise and fall of JSA and ESA sanctions 2010–16’, http://www.cpag.org.uk/david-webster, [accessed 04.06.2018].Google Scholar
Supplementary material: File

Williams supplementary material

Williams supplementary material Appendix

Download Williams supplementary material(File)
File 191.2 KB