Why I’m thankful that Atos found me fit to work

I was signed off work five years ago. I had lost my job and was, unsurprisingly, feeling low; I went to see my GP, as I was having difficulty sleeping. Rather than dishing out a few sleeping pills, as I had hoped, my doctor googled the letters PHQ-9 on his computer and quickly went through the multiple-choice test for depression he found. Within a few minutes, I walked out of the surgery with a diagnosis of depression and a sick note stating that I was, in his medical judgment, unfit for work. Looking at the Patient Health Questionnaire now, one thing immediately stands out: the copyright notice. The copyright in PHQ-9 was held by Pfizer, the pharmaceutical corporation — which, since it holds patents in antidepressants such as Zoloft, has a financial incentive in patients’ being diagnosed with depression. But it would be unfair to criticise PHQ-9 merely because it was developed for a private company; not when there are so many other criticisms to make. PHQ-9 asks the patient if they have been bothered in the last fortnight by nine separate indicators of depression. The possible answers range from ‘Not at all’ (0 points) to ‘Nearly every day’ (3 points). Your points are added up at the end: the higher the score, the more certain the diagnosis of depression and the more likely that a sick note will be issued. The problem is not just that the scoring system is utterly transparent for anyone attempting to game it — the internet has more sophisticated quizzes to find out which Disney princess you are: you can’t ensure you’ll be Rapunzel by always going for option d — but that the possible indicators of depression are so broad that it is almost impossible not to have been bothered by some of them. Do you have trouble falling or staying asleep, reads one, or do you sleep too much? Both are indicators of depression, regardless of whether you oversleep — or undersleep — by ten minutes or ten hours.