From Jonathan Naess’s office on the 15th floor of a block in Vauxhall, you get a good view of the City of London. Round a bend in the Thames, it seems far away, peaceful, glinting in the afternoon sun. Naess – ex-corporate financier, manic depressive and mental health campaigner – remembers it fondly.
“It’s a buzzing, exciting, vibrant place to work, a place I always enjoyed working in,” he says. At the height of the financial boom, he recalls, to burn out while at work was “a badge of honour, to show how important you were”. They called it executive stress. “Stress in a good sense,” he says, “as well as a bad sense.” Naess is, by his own admission, not well. He suffers from anxiety, depression, lack of concentration. He first had such symptoms in his twenties and then, unexpectedly, they struck again. “When it happened a second time, it was frightening and upsetting. I was in the middle of my career and I thought, ‘Well, there’s no way back from this.'”
He hadn’t seen it coming. Nor had his colleagues. “Nobody tapped me on the shoulder to say, ‘Jonathan, I think you need to get some help here,'” even though his behaviour was becoming extreme. Unable to sit still, he kept having to go outside to clear his head, talking too fast, his brain “going off at three thousand tangents all at the same time”. He was sectioned, then hospitalised. And then he bounced back – making deals again, proving he could still cut it. Now he campaigns on behalf of people with mental health problems at work. And today he’s worried. He looks out of the window at the blue sky. “The time you’re most vulnerable to suicide is just about now. Quite often you’re too depressed to take your life, but as the good weather comes around, people may just have enough energy to do something terrible.”
The statistics show that there is usually a rise in suicides in the spring and summer. And this is no ordinary summer. The recession has deepened. On 12 August, it was reported that the jobless rate in the UK had increased by 220,000 in the three months to June, reaching a 15-year high. There are now more than 2.4 million people unemployed across the country – 7.8 per cent of the workforce – and that figure is expected to rise; the British Chambers of Commerce recently predicted that it would peak at roughly 3.2 million next year. Beyond the immediate economic and social consequences such as lower productivity, thousands more people claiming jobseekers’ allowance and a young generation in effect excluded from the labour market, high unemployment is having a psychological effect. Studies show that joblessness can have as great an impact as divorce or bereavement on mental well-being.
Successive periods of recession over the past century have been linked to surges in mental illness, and suicide in particular. During the Great Depression in the United States, suicide rates hit a 99-year high (of 17 per 100,000 people). In the UK they peaked at 13.5 per 100,000 in the early 1930s, when unemployment reached its highest level for a century. And the collapse of the east Asian bubble economy in the late 1990s led to a huge increase in suicide rates. In Japan in 1998, suicides increased by more than a third, soaring to more than 30,000 for the year and then nearly 35,000 in 2003 (a rate of 27 per 100,000, compared to six per 100,000 in the UK in the same period).
Some say the link between recession and suicide is exaggerated – that, as Naess puts it, a public mythology has grown out of the shocking headlines about fortune-losing Wall Street bankers leaping to their deaths during the 1929 crash. But the evidence clearly shows a correlation. In July, the Lancet released a study looking at suicide rates in 26 European countries. It found that for every 1 per cent increase in unemployment, the suicide rate for people younger than 65 increased by 0.8 per cent. Research from the Wellington School of Medicine in New Zealand spells it out: you are two to three times more likely to kill yourself if you’re not working.
Across the river from Vauxhall in the House of Lords, the Labour life peer Richard Layard – economist and prominent promoter of happiness – is concerned about the psychological impact of the current financial gloom. How much additional mental illness will there be? A lot, he thinks. But one should not exaggerate that, he says, “because there’s so much already”. There are about a million people on incapacity benefit in the UK due to mental illness, and roughly six million people suffering from depression or anxiety.
The problem, as Layard sees it, is not just unemployment, but a fear of unemployment – what Naess calls the “fear cycle”, where people fear losing their jobs and, if they do, fear never being able to find another one. He refers to a German study which shows that being out of work for a significant period of time affects people’s happiness for the rest of their lives. It is a traumatic experience, haunting its victims again and again.
David Spiegel, a psychiatrist who runs the Centre on Stress and Health at Stanford University in the US, supports Layard’s view. The latest figures put the US unemployment rate at 9.4 per cent (a slight fall from June’s 9.5 per cent, but otherwise the highest rate for 25 years). Nearly a quarter of a million people lost their jobs in July alone. Spiegel says that over the past few months there has been a significant rise in the number of people coming to his clinic, badly damaged both financially and psychologically. “It’s probably no accident that the economic term – depression – is the same as the psychiatric one. People tend to feel bad when what they have planned seems suddenly to come apart, when their ability to be effective in the world is challenged.” He believes that the reason people become depressed when they lose their job, or fortune, is not just the obvious sense of despair which comes with financial insecurity, but self-blame. “When you’re depressed, you feel hopeless, helpless and worthless; you feel like you deserve everything bad that happens to you. Those are the people who get suicidal.”
Spiegel argues that Americans don’t help themselves by obsessively watching the financial news channels. He describes how “we’re all becoming minor manic-depressives” as people track the markets up and down. Research done after the 11 September 2001 terrorist attacks, he also says, showed that those who watched the news for more than three hours a day suffered noticeably more than those who didn’t. “The same is true with the Dow or the Nasdaq . . . you can drive yourself nuts because you’re trying to relieve your anxiety, but you’re actually increasing it.”
Dainius Puras, a Lithuanian psychiatrist, explains how it is the uncertainty and unpredictability of the economic situation that have such a detrimental affect: “People don’t like change.” Puras knows the brutal reality well. Lithuania has the highest suicide rate in the world (39 per 100,000). It has also gone through a 20-year period of dramatic social and economic change since the fall of the Soviet Union.
He describes the reaction to freedom in 1989: “Many people could not manage to cope with this change, with this huge societal stress . . . [they] regressed to destructive or self-destructive behaviour.” The stress, he says, prompted an unprecedented crisis of mortality, one that still exists. In Lithuania, with a population of just three million, 5,000 people die every year because of “external causes” – suicide, homicide, violence. He describes it as an epidemic.
Puras sees Lithuania’s experience as a prophetic microcosm of the global crisis: a society undergoing enormous stress because of the effects of a toxic system, culminating in an “explosion” in the form of a financial crisis. He also points out a strange trend: the more severe the threat to human life, the better societies and individuals seem to fare in their mental health. “History shows that when it is a real crisis like war, or when people are starving, there is a huge decrease in mental health problems, including suicide. During the war you have to survive physically; existential problems are not so important. Suicide is mainly the price we pay for civilisation.”
Figures for the UK support his theory – during the First World War, the suicide rate dropped to 8.5 per 100,000. It then leapt to 13.5 in the interwar years, and fell again during the Second World War to 9.2. Immediate, life-threatening crisis, Puras says, creates a sense of purpose: there’s not as much time to worry about yourself.
The Samaritans in New York spotted a similar trend after 11 September 2001. The organisation’s director, Alan Ross, says it anticipated a surge in calls after the attacks. It never came. There was what Ross calls a “collective, protective, survival factor” in the face of the direct threat. People rallied and supported each other. But since the financial crisis began, people have been calling the Samaritans in their thousands (the Mental Health Association of New York City recorded a 36 per cent increase in calls to the National Suicide Prevention Lifeline between 2007 and 2008).
“There’s no question this is different,” Ross says. “This is a long, ongoing, insidious undermining . . . It doesn’t have a clear middle and end. It’s hard to see who caused it, who the enemy is, or how it’s going to be solved.” And although it is affecting everyone, people feel it individually. Money worries are lonely, however many people might be having them at the same time.
According to Ross, the high-risk group is middle-aged white men. They are the group with the highest suicide rates, despite being, he says, “the group with the most education, the most political power, the most financial power”. In Lithuania, 80 per cent of the suicide “epidemic” was middle-aged men taking their own lives. Puras argues that it’s to do with the sudden loss of status. “They feel humiliated, then they are drinking and then they commit suicide.” Both he and Ross are keen to point out, however, that suicide is a complex action – not usually the result of a single event such as losing your job, but a desperate, final act driven by any number of interlocking factors.
The spate of suicides in the US and the UK apparently provoked by the financial crisis (not just high-profile Wall Street and City financiers, but people who have lost savings, jobs, homes) has prompted commentators to coin a new word – “econocide”. Ross calls it a “humbling and scary” period for people who might anyway be vulnerable. When Layard describes the recession as a “very tragic thing”, he looks genuinely pained. “The world elite has let the world population down, hasn’t it?” he says.
Spiegel points to the lack of support available for Americans who are struggling. “There’s been a lot of stimulus money thrown around, but I have not heard of any of it being thrown into mental health support services.” What’s more, most people in the US get their health care through their employer’s health insurance scheme. So once you are unemployed, you have to pay. “The very people who need help the most are the least likely to be able to afford it” – a cruel irony with which President Obama is wrestling, in the face of bitter opposition from Republicans and right-wing groups.
The British government is bringing forward an investment of £173m in talking therapies at the primary health-care level to cater for what it imagines will be a huge increase in demand. This year alone, 81 new cognitive therapy services will be set up across the country with employment support workers to help people get back into work. But will it be enough?
A new report by the Audit Commission points out that it is only now that the “second wave” of the downturn is hitting, and predicts an increase in alcoholism, addiction and domestic violence in areas particularly stricken by rising unemployment. Another report, by the Resolution Foundation, suggests that it is those earning the very least who are most often overlooked by both business and government initiatives (which focus mostly on those with no skills at all). Both sets of findings suggest that further action is required to protect the most vulnerable, and to prevent economic crisis morphing into deep social distress.
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