5 Terrains for the Struggle for Mental Health

Radicals of the past knew about madness. The anti-psychiatry movement was inextricable from the Marxist, anarchist and feminists currents of the 1960s and 70s. A forgotten moment of May 1968 is the occupation and ransacking of the office of Jean Delay, a senior French psychiatrist among those responsible for the creation of neuroleptics. In 1969 the Department of Psychiatry at Tokyo University was occupied and remained so for 10 years. In 1970 and 1973 gay rights activists held demonstrations at the American Psychological Association’s conferences, as well as continuing a persistent campaign against the pathologisation of homosexuality in between. By 1974 homosexuality was removed from the list of psychiatric diseases (although gender dysphoria, a condition applied to trans people, remains). The German SPK (Socialist Patients’ Collective) outfit demanded that the concept and experience of ‘mental illness’ be turned into a weapon. Today mental illness is on the rise and authentically therapeutic support is being removed. However, aside from a few individuals and groups, the politics of mental health remains neglected.

1. Me, you, and everyone we know.

According to the Mental Health Foundation one in four people will experience some kind of mental suffering in any one year. Nine out of ten prisoners in the UK have some form of diagnosed mental disorder. The majority of people with such diagnoses tend to be ‘poorer people, the long-term sick and unemployed‘; that is, the mass of the working class. Women, people of colour and LGBTQ people also have disproportionately high rates of psychiatric diagnoses, and we could reasonably assume this isn’t unconnected from white hetero-patriarchal capitalism. Like all official statistics, it is more than likely these figures are under-reported. With ongoing labour recomposition and crises in social housing and the NHS, it is likely the figures are going continue rising.

2. The relationship between economic crisis, austerity, depression and suicide.

The suicide rates after 2008 have been clearly linked with the financial crisis that occurred at the same time, and to the destruction of social protection mechanisms.  This shouldn’t be surprising given that it has been well established that key risk factors for suicide, such as depression and hopelessness, are linked to unemployment and the breakdown of support networks. One study has even indicated a potential two to three times increase in the risk of suicide among the unemployed, while it’s been reported that many among the generation growing up within the great recession are “contemplating suicide“. More distal in the cause-effect chain are the cuts to funding psychiatric institutions, with some 1700 beds being lost between 2011 and 2013. At the same time many people are being declared fit for work when they clearly aren’t, some of whom may find themselves exposed to the precarity of zero-hour contracts, even by charities set up to support and advocate on their behalf.

3. Big Pharma is Big Capital.

I am not about to launch into  pill-shaming or to pretend that psycho-pharmacology doesn’t bring benefit to a lot of people. At the same time I’m not about to get any warm fuzzies either. The pharmaceuticals industry is an industry. According to that den of anti-psychiatric firebrands the World Health Organisation, in 2014 the global pharmaceutical market is worth in the region of US$300billion (with that figure expected to grow to US$400billion in three years). According to research reported by clinical psychologist Richard Bentall in 2002 the top ten pharmaceutical companies in the Fortune 500 exceeded the profits generated by the remaining 490 combined. Psycho-pharmaceuticals account for a vast proportion of this profit. There is thus a lot of capital, value creation, and GDP and private wealth tied into the psycho-pharmaceutical-industrial complex. This is an industry that lies, suppresses negative research and propagates ideas about ‘brain diseases’ despite an absolute lack of evidence for their existence. As a slew of books, articles and interviews from psychiatrists, psycho-pharmacologists, historians and survivors of the psychiatric system has made clear, pharmaco-centric capital is in crisis. Talk to almost any mental health worker and they’ll tell you the drugs are nasty and all too often don’t really work.

4. Deaths in detention.

According to the Independent Advisory Panel on Deaths in Custody, between 2000 and 2010 there were 3628 deaths in psychiatric custody. Around 501 of these were caused by suicide and may or may not have been preventable in the custodial setting. This makes up 61% of all deaths in state custody. Matilda MacAttram, director of Black Mental Health UK,  has written that evidence shows that black men are 44% more likely to be detained under the Mental Health Act than white men. Surely this qualifies as the systematic killing, in some cases simply murder, of people who are among the most vulnerable in society?

5. Psychopathology is depoliticised.

These socio-economic and political aspects of mental suffering have been made increasingly invisible. This depoliticisation is partly the blame of the excesses and recuperation of the anti-psychiatry movement: we should not lose sight of how neoliberalism promotes, supports and extends discourses around brain diseases and moral character defects. It is you who are responsible; mental health is not a collective or political question. Instead of only liberating psychiatric detainees, deinstitutionalisation and community psychiatric care also liberated the asylum from its own walls, letting psychiatric power flow throughout the entire social field, turning social problems and dissent into biocognitive pathologies of the self. The psychiatric ward and the therapist’s office become the new law of the modern.

The recuperation of ‘survivors’ of mental illness and psychiatry into a rights-based consumer movement is part of this depoliticisation. The ongoing month-long occupation of a mental health centre by its users and other events suggest that a repoliticisation may be on the horizon. The question is whether radicals and revolutionaries, some of us survivors ourselves, will be part of any such movement.