A study has found that the government's reform of disability benefit may be causing people to commit suicide.
In 2010 the Department for Work and Pensions (DWP) changed the rules so everyone who receives disability benefit has to undergo an examination to determine whether they are fit for work. For the previous two years, only new claimants had to undergo these "work capability assessments" (WCAs).
Campaigners have claimed for years that WCAs are harming vulnerable people, and one coroner cited the WCA as "triggering" a suicide. However, the new study appears to be the first time a statistical link has been shown.
The DWP has rejected the research as "misleading". However, one of the study's authors told BuzzFeed News that the evidence shows that examinations probably do cause suicides, and said that the DWP "chose not" to do a trial of its own or release data that would allow a more precise study.
The research, published in the Journal of Epidemiology and Community Health and carried out by scientists at the universities of Oxford and Liverpool, looked at the rates of mental health issues and suicide in different local authorities in England.
It found that the authorities with a greater number of people undergoing WCAs also had more people reporting mental health problems, more people being prescribed antidepressants, and more people taking their own lives. It says that every 10,000 assessments lead to around six suicides.
For comparison, isotretinoin, the acne medication which was notoriously linked to suicides, is associated with about four extra deaths per 10,000 treatments.
There have been more than 1 million assessments since the WCA was introduced, which suggests that there may be more than 600 people who have killed themselves who would otherwise have not. The authors say: "Our study provides evidence that the policy in England of reassessing the eligibility of benefit recipients using the WCA may have unintended but serious consequences for population mental health."
There have been earlier claims that the DWP's reforms have led to deaths. However, the DWP has refused to release data which would make it possible to assess whether the death rate for people found fit for work is higher than would be expected.
A separate study released last week found that the government's wider austerity drive has been a significant factor in the rising suicide rate among British men. However, this appears to be the first time the DWP's disability policies have been specifically assessed.
Due to the nature of the study the authors have been unable to prove that the WCA causes suicides. However, they have made efforts to rule out other possible causes – for instance, there is no similar effect found in people over 65, who are not subject to the WCA – and say their results suggest that that the link is not due to "confounding" factors, but is most likely causal.
The authors warn that, despite the DWP's goal of reducing welfare dependency, "it is likely that targeting the people living in the most vulnerable conditions with policies that are harmful to health will further marginalise already excluded groups, reducing, rather than increasing, their independence".
Prof Thom Baguley, a psychologist at Nottingham Trent University, said in a briefing given to the Science Media Centre that "the effects hold up when trying to account for many other explanations".
Dr Jed Boardman, a psychiatrist at King's College London, said in the same briefing: "This is a high-quality piece of work conducted by a respected group of researchers. Whilst the design used in this study cannot determine whether this is a causal relationship, the methods used do rule out several possible additional factors… The associations found do seem to be valid."
The study found that for every 10,000 people assessed, the central, or most likely, estimate is that there have been six extra suicides (with a range between two and nine). Similarly, there were an estimated 2,700 further cases of mental health problems (range between 548 and 4,840) and 7,020 additional prescriptions of antidepressants (range between 3,930 and 10,100)
The DWP has rejected the study's findings. When contacted by BuzzFeed News, a spokesperson said in a statement: "This report is wholly misleading, and the authors themselves caution that no conclusions can be drawn about cause and effect.
"In addition, it is concerning that they provide no evidence that the people with mental health problems highlighted in the report even underwent a Work Capability Assessment."
But Dr Benjamin Barr, one of the researchers from Liverpool University, told BuzzFeed News that a causal link was likely. "Whilst we cannot prove from our analysis that this is causal, there are various reasons why this is a likely explanation," he said.
He agreed that a study looking specifically at people who had undergone a WCA would be more precise, but said that the DWP has not released that information. "If the DWP has data on this they should make it openly available to independent analysis." He added that the DWP has so far chosen not to run a trial of its own into a link between WCAs and suicides.
BuzzFeed News has previously requested under the Freedom of Information Act that the DWP release data showing the death rate among people found fit for work, but the department refused on the grounds that it would involve too much work.