Stress and work It's an ill wind Dec 30th 2003 | GLASGOW Why so many people are off

sick while the economy is healthy FEELING a bit stressed? Pop along to the doctor and explain how you can't sleep, can't eat, don't want to go out and, by the way, a nasty boss at work is making your life hell. Stress, increasingly given as a reason for being off work, is conveniently hard to diagnose. A recent survey of 67 doctors by Aberdeen University researchers, published in the British Medical Journal, found that most tended to hand out sick notes when asked. The fact that family doctors, whose main job is to cure illness, have a secondary job of being gatekeepers to the benefit system, goes a long way to explain an odd thing about the British workforce. The employment rate is at a record 74.7% and unemployment is down to 5%, the lowest level since 1974. But record numbers of people 5.9m are off sick. About 3m of the workless sick claim some sickness or disability benefit, mostly incapacity benefit (IB), generally available if for more than four days someone is too sick to work. The government says that the number getting this benefit is falling, but that is only because, since 1995, pensioners have not been allowed to claim it. Excluding pensioners and people off sick for less than six months, the numbers claiming IB have risen inexorably to more than 2m (see chart). In parts of south Wales, over 25% of working age men claim sickness benefit; in London's commuter belt, by contrast, fewer than 5% do. The government has tried to cut the IB bill, now 6.9 billion a year, by banning people on unemployment benefit from moving on to IB. It has also brought in more stringent tests for people on IB for more than six months. But numbers are still going up because, although the numbers of new IB claimants are falling, fewer people are coming off IB. Industrial injuries, of the sort that used to afflict workers in heavy industry, are on their way out. More and more, people are off for mental or behavioural disorders such as depression: numbers in those categories rose between 1995 and 2003 from 445,000 to 846,000. That is partly because mental illness is no longer considered shameful. Cary Cooper, professor of organisational psychology and health at Lancaster University, also blames economic insecurity and geographical mobility. Moving to find work takes people away from neighbours and relatives who can help when times are hard. Americans, he says, are used to this. Britons aren't. They visit their doctors and take to their beds. Stress is hard to diagnose. Doctors have to get patients to list their symptoms, describe their behaviour, make a diagnosis and work out whether the root of the problem is at work, home, or in something as vague as fear of crime, all within ten minutes, says Mary Church, a Lanarkshire doctor. We just don't have the time to work through people's problems, so they are likely to get some quiet sympathy and a sick note.