Do benefit sanctions lead to suicide?

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Fishnut
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Do benefit sanctions lead to suicide?

Post by Fishnut » Thu Mar 03, 2022 1:00 am

Who knows - the DWP won't let researchers find out. A Glasgow university study examining whether benefit sanctions are linked to claimant ill-health, including mental illness and suicide has been stuck in limbo after the DWP spent 5 years blocking access to the data and now ministers have insisted they reapply for access to the data.
The chair of the Commons work and pensions select committee, Stephen Timms, accused the DWP of blocking vital research: “This emerging pattern of obstruction suggests that a culture of secrecy is entrenched in DWP. It must wake up to the harm that it is doing and commit to a new spirit of openness.”...

The DWP has repeatedly faced criticisms it is blocking or burying politically uncomfortable research. Last month MPs had to force the publication of a DWP-commissioned report showing people on low incomes reliant on disability benefits struggled to meet basic living costs.

Ministers have refused to publish the DWP’s own internal evaluation of sanctions effectiveness, also promised to MPs in 2019, while research originally commissioned back in 2018 assessing the impact of benefit policies on food bank use has also yet to see the light of day.
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Re: Do benefit sanctions lead to suicide?

Post by dyqik » Thu Mar 03, 2022 1:22 am

I think we can take it that the DWP think the answer may very well be yes, then.

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Re: Do benefit sanctions lead to suicide?

Post by Millennie Al » Thu Mar 03, 2022 4:09 am

The DWP has legitimate grounds for concern, though I suspect they are unaware of them and are objecting for inappropriate reasons.
The Glasgow study proposed to link anonymised DWP data and NHS health records to track changes in the health status of sanctioned individuals, identifying for example if they had been given antidepressant prescriptions, treated for a worsening of underlying conditions such as asthma, or even taken their own life.
This is a classic confusion of correlation and causation. For example, it's possible that deteriorating mental health causes both benefit sanctions and suicide. In order to find out the effects of sanctions you need to do a randomised study. One way to do this would be to secretly take a group of people who would normally be sanctioned and pick half at random. Let the normal sanctions apply to this half and have no sanctions for the other (e.g. making it look like it's an administrative error). Then check what effects have been caused by the sanctions. Since there's no suggestion that lack of sanctions is harmful (to the individuals) there should be no ethical objection.

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Re: Do benefit sanctions lead to suicide?

Post by Woodchopper » Thu Mar 03, 2022 8:23 am

Millennie Al wrote:
Thu Mar 03, 2022 4:09 am
The DWP has legitimate grounds for concern, though I suspect they are unaware of them and are objecting for inappropriate reasons.
The Glasgow study proposed to link anonymised DWP data and NHS health records to track changes in the health status of sanctioned individuals, identifying for example if they had been given antidepressant prescriptions, treated for a worsening of underlying conditions such as asthma, or even taken their own life.
This is a classic confusion of correlation and causation. For example, it's possible that deteriorating mental health causes both benefit sanctions and suicide. In order to find out the effects of sanctions you need to do a randomised study. One way to do this would be to secretly take a group of people who would normally be sanctioned and pick half at random. Let the normal sanctions apply to this half and have no sanctions for the other (e.g. making it look like it's an administrative error). Then check what effects have been caused by the sanctions. Since there's no suggestion that lack of sanctions is harmful (to the individuals) there should be no ethical objection.
It is still useful to find out whether or not there is a correlation. The problem, as you write, would be if people assumed causality based upon a correlation alone. In practice, the method you outlined would be expensive to carry out. In order to get funding to actually conduct such a study it might be necessary to first identify whether a correlation exists at all. Its also possible that no correlation is identified, in which case the research would have been worth doing.

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Re: Do benefit sanctions lead to suicide?

Post by Bird on a Fire » Thu Mar 03, 2022 9:17 am

Also, if somebody's health is deteriorating to the point they attempt suicide, I'm not sure that's the right moment to also be sanctioning their benefits. Any correlation would identify a problem, regardless of the direction of causation.
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Re: Do benefit sanctions lead to suicide?

Post by tom p » Thu Mar 03, 2022 1:09 pm

Millennie Al wrote:
Thu Mar 03, 2022 4:09 am
The DWP has legitimate grounds for concern, though I suspect they are unaware of them and are objecting for inappropriate reasons.
The Glasgow study proposed to link anonymised DWP data and NHS health records to track changes in the health status of sanctioned individuals, identifying for example if they had been given antidepressant prescriptions, treated for a worsening of underlying conditions such as asthma, or even taken their own life.
This is a classic confusion of correlation and causation. For example, it's possible that deteriorating mental health causes both benefit sanctions and suicide. In order to find out the effects of sanctions you need to do a randomised study. One way to do this would be to secretly take a group of people who would normally be sanctioned and pick half at random. Let the normal sanctions apply to this half and have no sanctions for the other (e.g. making it look like it's an administrative error). Then check what effects have been caused by the sanctions. Since there's no suggestion that lack of sanctions is harmful (to the individuals) there should be no ethical objection.
Oh great, someone with no experience in the area of such research suddenly becomes an expert.

With such longitudinal health records, you would have all their visits to the doctor and health notes included over many years. It would be perfectly possible to identify those who had started to be depressed before the sanctions (or in the peri-sanction period) and not count them as becoming depressed after* the sanctions.


*the word after is meaning it in the chronological sense, rather than implying causality

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Re: Do benefit sanctions lead to suicide?

Post by Allo V Psycho » Thu Mar 03, 2022 5:56 pm

Millennie Al wrote:
Thu Mar 03, 2022 4:09 am
The DWP has legitimate grounds for concern, though I suspect they are unaware of them and are objecting for inappropriate reasons.
The Glasgow study proposed to link anonymised DWP data and NHS health records to track changes in the health status of sanctioned individuals, identifying for example if they had been given antidepressant prescriptions, treated for a worsening of underlying conditions such as asthma, or even taken their own life.
This is a classic confusion of correlation and causation. For example, it's possible that deteriorating mental health causes both benefit sanctions and suicide. In order to find out the effects of sanctions you need to do a randomised study. One way to do this would be to secretly take a group of people who would normally be sanctioned and pick half at random. Let the normal sanctions apply to this half and have no sanctions for the other (e.g. making it look like it's an administrative error). Then check what effects have been caused by the sanctions. Since there's no suggestion that lack of sanctions is harmful (to the individuals) there should be no ethical objection.
Well...

...I wonder if what you are thinking of is a cohort study https://ebn.bmj.com/content/22/4/95. While these provide good estimates of risk, they typically take a long time and cost a lot of money. There would also be ethical challenges: you say 'secretly', and that seems to suggest participants have not enrolled into a cohort study on an informed and consented basis. It is hard to get ethical approval for studies of this kind.

An RCT would be tricky, because I am not clear that clinical equipoise https://en.wikipedia.org/wiki/Clinical_equipoise exists between 'sanctioned' and 'unsanctioned': presumably someone would decide who is sanctioned, and who is not, and if I was the ethics reviewer, I would accept it as likely that sanctions have a negative impact. Consent would also be an issue here.

Sometimes there are more urgent requirements for information than a cohort study can provide, of course, and case-control studies may be used in these circumstances. A case-control study https://www.bmj.com/about-bmj/resources ... -sectional does not provide estimates of risk directly, but can determine the odds ratio, which is helpful.

I'm not absolutely clear from the article which kind of study is being described. If it is correlational, then the degree of sanctions would have to be quantified, which might be possible, but the outcome (suicide/not suicide) is not a quantity but a category. If anyone has more info, I'd be grateful for it.

I'm not assuming, Al, that you don't know this stuff - you might well, and just have provided a quick response. But I thought it might be useful to spell out some of the detail for the benefit of anyone who found it useful.

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Re: Do benefit sanctions lead to suicide?

Post by Millennie Al » Fri Mar 04, 2022 3:37 am

Woodchopper wrote:
Thu Mar 03, 2022 8:23 am
It is still useful to find out whether or not there is a correlation. The problem, as you write, would be if people assumed causality based upon a correlation alone.
I would be astonished if a correlation were to be found yet the Guardian failed to hail it as proof that sanctions cause suicide. I would further expect that the result, suitably garbled, mis-quoted, and misinterpreted, would spread very widely as it was used by people who already object to benefit sanctions.

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Re: Do benefit sanctions lead to suicide?

Post by Millennie Al » Fri Mar 04, 2022 3:43 am

tom p wrote:
Thu Mar 03, 2022 1:09 pm
With such longitudinal health records, you would have all their visits to the doctor and health notes included over many years. It would be perfectly possible to identify those who had started to be depressed before the sanctions (or in the peri-sanction period) and not count them as becoming depressed after* the sanctions.
It's also perfectly possible to be depressed without seeking medical help. And there seems to be a current fashion for claiming that anything people dislike as harming their mental health (e.g. wearing masks), so in the absence of sanctions actually causing depression it's possible that sanctions cause people to claim depression which does not exist, or to seek treatment for pre-existing depression.

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Re: Do benefit sanctions lead to suicide?

Post by Millennie Al » Fri Mar 04, 2022 4:17 am

Allo V Psycho wrote:
Thu Mar 03, 2022 5:56 pm
...I wonder if what you are thinking of is a cohort study https://ebn.bmj.com/content/22/4/95. While these provide good estimates of risk, they typically take a long time and cost a lot of money. There would also be ethical challenges: you say 'secretly', and that seems to suggest participants have not enrolled into a cohort study on an informed and consented basis. It is hard to get ethical approval for studies of this kind.
No. I'm thinking of a controlled trial. And ethical approval is rather a red herring. There is no ethical approval needed to sanction benefits. It is rather ironic that people feel that ethical approval is needed to study whether an intervention (in this case sanctions) is effective, but not to appply it indescriminately without knowing its effects.
An RCT would be tricky, because I am not clear that clinical equipoise https://en.wikipedia.org/wiki/Clinical_equipoise exists between 'sanctioned' and 'unsanctioned': presumably someone would decide who is sanctioned, and who is not, and if I was the ethics reviewer, I would accept it as likely that sanctions have a negative impact. Consent would also be an issue here.
While someone would deceide who is sanctioned, this would simply be the normal process already used. The intervention for the study would be to randomly overrule this decision (by preventing those in one group from being sanctioned - the randomisation is by benefit claimant and not by decision to sanction). Whoever decides to apply a sanction should be unaware that the study is taking place and that their decsion is potentially not going to take effect. Consent would not be sought. Benefit sanctions, like so many interventions made by government, do not take into account any form of consent. Unless someone can explain how failure to sanction someone could harm them, participation in the study would be guaranteed not to harm participants.
I'm not absolutely clear from the article which kind of study is being described. If it is correlational, then the degree of sanctions would have to be quantified, which might be possible, but the outcome (suicide/not suicide) is not a quantity but a category. If anyone has more info, I'd be grateful for it.
The best I can do is to note that the Guardian article quotes Prof Nick Bailey, who is a co-author of The Impacts of Benefit Sanctions: A Scoping Review of the Quantitative Research Evidence published 14th February 2022, which says:
This review also highlights the urgent need for more studies of the impacts of sanctions to extend the knowledge base in this contested policy field. In particular, there is an urgent need for more studies to examine the wider outcomes of sanctions using quasi-experimental or experimental methods. A strong commitment from policy makers to improve the evidence base would be invaluable here since the design of policies (e.g. the use of controlled trials or phased roll-outs) can greatly aid the delivery of strong evidence.

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Re: Do benefit sanctions lead to suicide?

Post by EACLucifer » Fri Mar 04, 2022 4:52 am

Bird on a Fire wrote:
Thu Mar 03, 2022 9:17 am
Also, if somebody's health is deteriorating to the point they attempt suicide, I'm not sure that's the right moment to also be sanctioning their benefits.
This.

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Re: Do benefit sanctions lead to suicide?

Post by discovolante » Fri Mar 04, 2022 8:22 am

Millennie Al wrote:
Fri Mar 04, 2022 3:43 am
tom p wrote:
Thu Mar 03, 2022 1:09 pm
With such longitudinal health records, you would have all their visits to the doctor and health notes included over many years. It would be perfectly possible to identify those who had started to be depressed before the sanctions (or in the peri-sanction period) and not count them as becoming depressed after* the sanctions.
It's also perfectly possible to be depressed without seeking medical help. And there seems to be a current fashion for claiming that anything people dislike as harming their mental health (e.g. wearing masks), so in the absence of sanctions actually causing depression it's possible that sanctions cause people to claim depression which does not exist, or to seek treatment for pre-existing depression.
This is a real nonsense post. 'I feel like some people use the term mental health very broadly therefore it's not possible to tell from clinical records whether sanctions increase depression'.
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Re: Do benefit sanctions lead to suicide?

Post by Stephanie » Fri Mar 04, 2022 8:24 am

Millennie Al wrote:
Fri Mar 04, 2022 3:43 am
tom p wrote:
Thu Mar 03, 2022 1:09 pm
With such longitudinal health records, you would have all their visits to the doctor and health notes included over many years. It would be perfectly possible to identify those who had started to be depressed before the sanctions (or in the peri-sanction period) and not count them as becoming depressed after* the sanctions.
It's also perfectly possible to be depressed without seeking medical help. And there seems to be a current fashion for claiming that anything people dislike as harming their mental health (e.g. wearing masks), so in the absence of sanctions actually causing depression it's possible that sanctions cause people to claim depression which does not exist, or to seek treatment for pre-existing depression.
Wearing a mask is not the same. A sanction is an actual punishment with actual loss of income to those with very little money.
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Re: Do benefit sanctions lead to suicide?

Post by Woodchopper » Fri Mar 04, 2022 8:46 am

Millennie Al wrote:
Fri Mar 04, 2022 4:17 am
Allo V Psycho wrote:
Thu Mar 03, 2022 5:56 pm
...I wonder if what you are thinking of is a cohort study https://ebn.bmj.com/content/22/4/95. While these provide good estimates of risk, they typically take a long time and cost a lot of money. There would also be ethical challenges: you say 'secretly', and that seems to suggest participants have not enrolled into a cohort study on an informed and consented basis. It is hard to get ethical approval for studies of this kind.
No. I'm thinking of a controlled trial. And ethical approval is rather a red herring. There is no ethical approval needed to sanction benefits. It is rather ironic that people feel that ethical approval is needed to study whether an intervention (in this case sanctions) is effective, but not to appply it indescriminately without knowing its effects.
In Western Europe and North America it’s normal for academics to need ethical approval for any kind of collection and processing of personnel data. That means that an academic would need to get approval for actions that are perfectly normal for everyone else (for example asking someone whether being sanctioned has affected their mood).

There is an exception for anonymised data (ie no one would be able to work out the identity of an individual data point).

Based upon my own experience I’d be surprised if the controlled trial you suggest could be carried out without the informed consent of all the participants. That poses three problems.

Firstly, getting ethical approval for such a trial would be a lengthy process, perhaps involving lengthy and detailed discussions on research design with the regulator.

Second, getting informed consent from a large sample of people would be time consuming and therefore expensive.

Third, being sanctioned is rare and suicide is also rare, so an academic is going to need a really big sample to be likely to capture enough events in which someone killed them self after being sanctioned. It’s likely that lots of people won’t give consent to be part of the trial, so the academic is going to have to approach even more people to get a representative sample.

You might point out that biomedical research deals with these issues all the time. That’s correct, but these issues are one reason why biomedical research is so expensive. There is far less funding available for the kind of social science research you suggest.

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Re: Do benefit sanctions lead to suicide?

Post by EACLucifer » Fri Mar 04, 2022 8:48 am

Stephanie wrote:
Fri Mar 04, 2022 8:24 am
Millennie Al wrote:
Fri Mar 04, 2022 3:43 am
tom p wrote:
Thu Mar 03, 2022 1:09 pm
With such longitudinal health records, you would have all their visits to the doctor and health notes included over many years. It would be perfectly possible to identify those who had started to be depressed before the sanctions (or in the peri-sanction period) and not count them as becoming depressed after* the sanctions.
It's also perfectly possible to be depressed without seeking medical help. And there seems to be a current fashion for claiming that anything people dislike as harming their mental health (e.g. wearing masks), so in the absence of sanctions actually causing depression it's possible that sanctions cause people to claim depression which does not exist, or to seek treatment for pre-existing depression.
Wearing a mask is not the same. A sanction is an actual punishment with actual loss of income to those with very little money.
This. And disappointingly, a lot of the public don't realise what that means in practise. It means going hungry, it means being cold, it can very easily mean becoming homeless, it means being forced into choices one would never make otherwise.

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Re: Do benefit sanctions lead to suicide?

Post by Fishnut » Thu Mar 10, 2022 10:55 pm

If sanctions don't lead to suicide, this definitely will.
[A Department for Work and Pensions (DWP) whistleblower], who has asked not to be identified, has told Disability News Service (DNS) that she and her colleagues are being “bullied and harassed” into forcing claimants with significant mental distress into attending work-related meetings...

The work coach, Jane, says DWP managers are telling work coaches that they should not have any “white spaces” in their diaries, and so should tell claimants waiting for their WCA to come into the jobcentre even if they know they will eventually be placed in the LCWRA [limited capability for work-related activity] group.
So, people who are unable to work are being forced to go every week to the job centre in order to ensure staff meet their targets, whether or not those meetings are useful or even necessary.
[The whistleblower] said she was also deeply concerned that DWP decision-makers appear to be overturning recommendations made by assessors from Maximus – the private sector contractor that is paid by DWP to carry out WCAs – that disabled claimants should be placed in the LCWRA group.

She said: “I have been told of instances where LCWRA was recorded by the Maximus assessor, but when the DWP decision-makers looked at the reports sent back, they made their own decisions – completely ignoring the assessment – and just put LCW (limited capability for work).”
Roadside Mum has a thread indicating that this is just the tip of the iceberg - they are going to force all benefits claimants in the work group to attend in person meetings every week, regardless of where you live (so if you're in the middle of nowhere with only one bus a day, tough luck). The brief time I was on jobseekers I had to go to the next town over to visit the job centre. There was a bus every hour, and was unreliable, so I had to catch the bus before to make sure I made it. And, of course, sod's law meant that the appointment would end just after the bus home had gone, so that'd be close to another hour. So a 15 minute appointment where they did f.ck-all to actually help me find work would take half a day door-to-door. Fortunately I only had to do it once a fortnight and not for long as I was able to find work pretty quickly, I was fit and healthy, and was still living at home. I can't imagine what it would be like to go through that while suffering from severe mental or physical health problems, and knowing that if you didn't do it you'd not have enough money to live.

This is eugenics. I can't see any other reason for these measures unless it's to try to kill people, either through forcing people to suicide or simply letting them starve/freeze to death. The government hates the poor and the disabled and their solution isn't to try and raise people out of poverty or provide the support disabled people need so they can be active members of society. Their solution is to get rid of them. It's evil. Pure evil.
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