Sunday 14 November 2010

A Capitalist Take On Mental Health

This is an article by a member of the Socialist Party of England and Wales. They are talking about how they believe capitalism influences mental health problems and treatment, and the answer to the problems they believe capitalism poses. This is not necessarily our view, it is just one of many views of BPD worth discussing in order to learn more and understand more.

At Socialism 2010 I went to the session on Mental Health and Capitalism and I asked if I could feed back from it. This is a summation of the talk and discussions we had.

The speaker, Steve Bell, a mental health nurse and a Unison Service Group Executive, explained that he felt that mental illness is actually a sane reaction to the craziness of capitalism. Mental health problems are a natural reaction to stresses in our lives.

Everyone has stresses in their lives, but not everyone goes on to suffer mental health problems because of this. However, one in four people do experience some sort of mental illness during their lives. The sorts of stresses people have include neurological trauma pre-birth, during birth and in the vital months after birth, childhood abuse of any kind, bullying, existential and identity concerns during puberty and for women, often, pregnancy. 

There are also the stresses that are more explicitly linked to capitalism. Housing concerns, work stress, being downtrodden by management, long hours, banal jobs, underpayment, difficulty finding a job, lack of job security, lack of free time, lack of money to enjoy social activities, lack of sufficient childcare and education for one’s children... and all the other problems we often discuss. These stresses are increasing, especially in the current climate, and so too is the prevalence of mental health problems.

What a person with mental health problems essentially suffers is the reliving of these stresses over and over again every second of the day. Their body is shot by the stress and their mind is battered. The links between the mental and physical aspects of mental illness are shown in the cognitive behavioural model. In it, there is a triangle of factors that affect or are affected by mental ill health. They are behaviour, thoughts and feelings. For example, behaving in a negative way reinforces the person’s idea that they are a bad person, and this in turn makes them feel depressed. Feeling depressed they end up behaving negatively again. This makes them feel worse and thus reinforces their idea that they are hopeless. The cycle goes on, but can be broken.

The treatment of such illnesses is often a subject of heated debate by those on the left, with the ‘Big Pharma’ and all medication often being seen as entirely negative, and the anti-psychiatry movement resenting even the diagnosis of such problems as a way of labelling someone incurably ill. None of this, however, is a balanced reaction to the real problems. Medication IS effective in helping those with mental health problems. It tackles the ‘feelings’ bit of the cognitive-behavioural model – thus calming and stabilising the patient enough to be open and responsive to therapy. Talking therapy can then challenge the thought and behaviour patterns, and all together the medication and therapy can help to dramatically reduce the impact of the mental health problem on the person’s life, or, even, to cure it.

However, there is a problem with medication and the ‘Big Pharma’. And there is a point to be taken from the anti-psychiatry movement who resent labels that seem to give people a hopeless diagnosis of a seemingly perennial disease. There are two factors to this. The first is the link between pharmaceutical companies and the mental health practitioners. The companies want the practitioner to prescribe more and more drugs. 

Mental health problems are encouraged by the market to be treated with ‘medication, medication, medication!’ If one drug doesn’t quite work, they’ll throw another one in to balance the side effect, and then another for the side effects of that if necessary too. Most mental health patients are over-medicated. At the other end of the problem is the lack of therapy being offered by the NHS. Without therapy a diagnosis may seem like a life-sentence. Without therapy mental health problems can be seen as a weakness that someone has been labelled with forever. The anti-psychiatry movement no doubt gain momentum from the fact that the status quo is not to offer therapy. Therapy is expensive to the NHS and can take years to be effective to the state of a patient being considered ‘cured’ of their mental illness. In fact, when you ask a GP for counselling or therapy, they will no doubt refer you to a charity who is doing the government’s work for them, or to a private therapy company that the government is funding to do the job of the NHS for less. 

Of course, without the stresses of a capitalist society, there would be a lot less mentally ill people needing such services. Without imperialist wars there would not be another generation of ‘shell-shocked’ soldiers with PTSD. There would be suitable homes for all. Jobs for all. A good wage. A good and free education. Crime would no doubt have fallen. Drug abuse would be lower. However we cannot hold up socialism as a plaster to the wound – it would be an insult to those currently suffering. We cannot say ‘join the party, bring in the revolution, then you’ll be ok!’ Instead our demands and efforts need to be transitional.

We need to protest, lobby, petition, inform and even strike for the good of the mentally ill. Cuts to the NHS and to disability benefits can hit the mentally ill the hardest. Cuts to services such as talking therapies will see more over-medicated but under-therapised patients who see no future ahead. The mentally ill will fall foul of ‘fit to work’ initiatives due to nonspecialist practitioners seeing no visible symptoms of their problem and thus declaring they must seek work or their benefits be ceased. We need to fight the closure of acute mental health wards. We need to resist the privatisation of mental health services. We need to stand by the NHS workers when they strike. We need to fight against cuts to DLA and ESA. That way we can truly stand by the mentally ill and fight capitalism together as one.

Is there a link between politics and mental health? Is capitalism really the enemy or is socialism a far greater threat to health and the health service?