A report finds substantial age and class disparities in the number of people with serious mental illness
“You might say the reduction in stigma makes it easier for people to seek help, but the real impact of that on public services and public finances is that the caseload that the NHS and benefits system has to deal with is growing.” Heidi Karjalainen, co-author, Inequalities in disability report, Institute of Fiscal Studies
Young people are twice as likely to be claiming disability benefits today as the same age cohort 20 years ago, a new report has found.
The report, from the Institute of Fiscal Studies (IFS), says that the increase has been caused by a “staggering rise” in mental health problems among young people.
It also notes significant class differences in incidence of both physical and mental illness, stating that “inequalities in the prevalence of disability, defined across educational qualifications, are large. As with health inequalities, they emerge steadily across all ages of the life cycle, although this emergence is patterned somewhat differently for physical versus mental disabilities.”
The report adds that the traditional pattern of disability increasing with age has been inverted for mental health. People in their 30s without qualifications are 10 times as likely to have serious mental illness as people in their 60s with a degree. Among those aged 66, 7% of those with no qualifications have a disabling mental illness, compared with under 3% of those the same age with a degree. Amongst people aged 36, 28% with no qualifications have a mental health problem that limits their daily life, compared with 9% of those the same age with a degree.
“Among the oldest cohort, prevalence of poor mental health is low, and relatively stable – or even falling – with age,” the report says. “In fact, the prevalence of poor mental health is higher for each later cohort, and the rate of increase is also faster among younger cohorts.”
The figures show, the report says, that “low levels of education and old age are strongly linked to higher prevalence of physical disability, but with mental health we have seen a generational shift where, regardless of educational group, each successive younger cohort is more likely to have poor mental health functioning.”
The IFS warns that the social class gap in rate of mental illness is causing incapacity spending to rise, and that the rise in mental illness in the young will push this cost up even further as this generation ages.
Heidi Karjalainen, one of the report’s authors, told the Times that there had been a “really striking” growth in mental health problems among young adults, adding: “We’re seeing similar trends among children so it doesn’t look like it’s slowing down, and if anything it’s starting earlier.”
It is unclear whether the increased rates in mental health problems among young people is the result of a real increase in illness, or greater social willingness to acknowledge those problems, better diagnosis or more acceptance of mental illness in the benefits system. Karjalainen said: “You might say the reduction in stigma makes it easier for people to seek help, but the real impact of that on public services and public finances is that the caseload that the NHS and benefits system has to deal with is growing.”
She added that there was a “real risk” that the early gaps in disability, as a result of mental illness, would translate to bigger gaps in economic output in later life: “When we’re seeing higher rates of disability among children there’s this risk that these people will end up with less education, either because they’re struggling at school or through different educational expectations.” This would then lead to a situation where the gap between employment rates between those with a disability and those without are much bigger, she said.
The analysis of disability in the report is based two main sources: the Understanding Society data, known as the UK Household Longitudinal Study, from 2009–19; and the English Longitudinal Study of Ageing (ELSA), a representative panel of the over-50 population in England running since 2002, with the latest wave of data collected in 2018–19.
These findings from the IFS paint a striking picture of social class and age disparities in rates of mental illness. While it is not entirely surprising that graduates are less likely to experience mental illness than those with no qualifications, the finding that people in their 30s are three times more likely to have a disabling mental illness than those in their 60s is startling. Whatever the reason for this difference, the implications for an ageing society that relies on the economic engagement of young people are deeply worrying. Policy-makers need to turn their attention, as a matter of urgency, to the potential problems caused by growing rates of mental ill health among the young.