DR MAX PEMBERTON: It’s time to prescribe some tough love: How work can help heal the mental health epidemic

A job is fundamental to our well-being. Sure, there are the financial rewards, but work should be about so much more than our salary. It gives us purpose, structure and routine and can boost our self-esteem and mental health.

Yet I am constantly amazed that so many do not understand the importance and value of working. Only last week, Mel Stride, the work and pensions secretary, said Britons must return to what he called the ‘old-fashioned belief’ that work is good for us.

Stride addressed the increasing number – especially among the young – who are unemployed due to mental health problems. That job satisfaction is considered ‘old fashioned’ is both worrying and discouraging.

Last week, Mel Stride, the work and pensions secretary, said Britons must return to what he called the “old-fashioned belief” – that work is good for us

The irony is that while many people do not work (or are on long-term sick leave) due to mental health issues, there is good evidence that the best treatment for mild to moderate depression and anxiety is… work!

Waking up knowing you have work ahead of you is often the best antidote to dealing with life’s other challenges. Not only does it cost nothing, it puts you in touch with other people and it actually pays off!

I see many patients struggling with their mental health and I despair that they have spent years – sometimes their entire lives – out of work. For many of them, a job would be far more beneficial than any pill I could prescribe. But what I often encounter is an attitude that work is for other people and that mental health problems automatically make employment impossible.

When I went to medical school, I lived with a group of friends in a flat on a council estate. It was well planned, with low blocks, lots of green spaces and trees. Our neighbors were lovely, but it gradually dawned on me that no one in the household worked. The mother had a bad back, the father suffered from ‘stress’ and the two sons in their early 20s had depression. All claimed benefits.

As a doctor, I see people battling the most debilitating and life-changing illnesses who simply cannot work because their daily lives are ruined by their condition. They deserve every help the state has to offer.

But that was not the case with my neighbours, whose daily life was in no way hampered. I watched every day as the sons and their friends played a game of football in front of the apartments. And that’s not the case with many others either.

A patient I saw recently had been told she was not eligible for disability benefits because she was able to work. She called me a ‘sugar’ because I had a job and then added that if I didn’t write a letter of support for her appeal she would hurt herself and I would be to blame.

Believe me, I am the last person to belittle the impact of mental illness and the way it can destroy lives. But it is rare to see people who are so incapacitated by depression that they actually cannot work at all.

We know that unemployment and depression are inextricably linked, with the unemployed far more likely to suffer from depression than those in work. And those suffering from long-term depression will often be moved from unemployment benefit to sickness benefit, where they languish. Lifting people out of this spiral of hopelessness and instilling the idea that work will help them is a tough challenge. Yes, jobs can be boring and tiring sometimes, but I firmly believe it’s better than the alternative.

Therefore, we must continue to emphasize the value and importance of work for health and well-being. In the long term, it will not only reduce the number of people claiming benefits, it will also be therapeutic – a sensible and compassionate way of improving people’s mental wellbeing.

Tough love? Yes. But sometimes it is necessary.

Joe Wicks and I disagree about diets

Joe Wicks said he ‘ran on sugar’ as a child and believes his love of foods such as Wagon Wheels and jam sandwiches is what caused his behavioral problems

Fitness trainer Joe Wicks has blamed ultra-processed food for the explosion in young people being diagnosed with ADHD. Wicks said he ‘ran on sugar’ as a child and believes his love of foods such as Wagon Wheels and jam sandwiches is what caused his own behavioral problems.

Food plays an important role in things like mood, but there is no evidence that high sugar food or drink has any real effect on children’s behaviour.

However, I agree with him that there are external factors at play in much of the ADHD epidemic. I worry that things like smartphones and multi-screening (watching TV while also on your tablet, etc.), along with social media where kids are bombarded with short pieces of information in rapid succession, are partly to blame for the apparent collapse in their attention.

The French government has announced that it will start fining patients who miss their doctor’s appointments.

They have a different health care system than we do, but it’s an idea that’s been pushed here over the years, and I can understand why. The NHS wastes incredible amounts of taxpayers’ money every year on missed appointments – £220 million on GP appointments alone and a total of around £1 billion when hospital appointments are included.

My view is that as long as we continue to see deals as ‘free’, we don’t feel they cost us and therefore we don’t value them.

I have tried my best to investigate and understand the absences in my own clinic to see how we can improve things. I have spent a lot of time calling patients in the evening and asking them why they didn’t show up. Many of them had pretty pathetic excuses (a sale day at Selfridges that they ‘couldn’t miss’ was one!)

However, I also found that there were a number of people who had genuine reasons and quite a few cases where the admin staff had messed up. Letters go astray, the phone lines are permanently busy. How can we ever be sure that the patient is really to blame?

Fines will just result in complaints and refusal to pay, so what? It is likely that the NHS could end up spending more money chasing these fines than we could ever make from them.

Dr. Max prescribes: A pen and paper

An excellent bit of research last week looked at the best way to deal with anger. The study found that running, taking deep breaths and screaming into a pillow helped. But the most effective thing was to write down what made you angry on a piece of paper and then throw it away! The method is so effective that it eliminated feelings of anger ‘almost completely’, scientists found.

A mother wants ketamine to be upgraded to Class A after her son died. Clare Rogers is right to say that it is more dangerous than many people think. While not fatal, it can still cause serious bladder problems – sometimes the bladder needs to be removed.