Mental health is not as personal as neo-conservatives would have you believe, writes Liam McLoughlin.
Last week, Carter Smith, a queer student passionate about the Safe Schools program, shared his thoughts on national television about the ongoing debate.
“I think the problem is politicians are using young, innocent, in pain children, as political bullets. That is unacceptable. Kids are being hurt when they hear this entire debate about, oh well, we can’t really talk about that and that’s not really safe. It’s still creating this idea that they are different, that they are wrong, that they are not being accepted. That is driving kids to hurt themselves, that is driving kids to kill themselves.”
Hear, hear, Carter. The link he makes between the actions of politicians and the mental health of the citizens they represent is vital.
It’s not the first time in recent memory this link has been made. Aboriginal writers Nakkiah Lui and Stan Grant mounted compelling arguments for just this kind of relationship in response to the suicide of a 10-year-old Aboriginal girl in far north Western Australia.
If politicians were genuine about tackling high rates of anxiety, depression and suicide in LGBTQI, asylum seeker and Aboriginal communities, amongst many others, they would connect public discourse and policy with these disturbing statistics.
Yet this obvious link is systematically ignored. Why?
Thatcher’s Shadow: Individual Problems, Individual Solutions
In a 1987 interview, UK Prime Minister Margaret Thatcher summed up her approach to personal hardship.
“I think we have gone through a period when too many children and people have been given to understand, “I have a problem, it is the Government’s job to cope with it!” or “I have a problem, I will go and get a grant to cope with it!” “I am homeless, the Government must house me!” And so they are casting their problems on society and who is society? There is no such thing! There are individual men and women and there are families and no government can do anything except through people and people look to themselves first.”
This philosophy – that your problems are yours alone and have nothing to do with society – is at the heart of the neoliberal nightmare from which we are slowly awakening.
Cultural theorist Mark Fisher has built on the work of psychologist David Smail to explain how politicians displace blame from social circumstances to individual actions.
“One of the most successful tactics of the ruling class has been responsibilisation. Each individual member of the subordinate class is encouraged into feeling that their poverty, lack of opportunities, or unemployment, is their fault and their fault alone. Individuals will blame themselves rather than social structures, which in any case they have been induced into believing do not really exist (they are just excuses, called upon by the weak).
What Smail calls ‘magical voluntarism’ – the belief that it is within every individual’s power to make themselves whatever they want to be – is the dominant ideology and unofficial religion of contemporary capitalist society, pushed by reality TV ‘experts’ and business gurus as much as by politicians.”
Blaming people for their own hardship distracts them from the many ways neoliberal governments around the world have fuelled this hardship.
For over three decades the neoliberal project has savaged working conditions, government services and the social safety net in the name of market freedom, productivity and growth. We saw this graphically in the 2014 budget and more recently in Malcolm Turnbull’s approach to taxation, social security, education, Medicare and industrial relations.
These sustained attacks have markedly increased rates of inequality, poverty, and job insecurity, making daily life far more difficult for millions of people.
There is plenty of evidence connecting these social ills with mental ills. A 2012 US study found the fear of unemployment can induce depression and anxiety attacks, while a 2013 US study found that poverty increases the risk of mental illness. 2013 Australian research found work pressure is the most common reason for mental stress and The Spirit Level showed us that economic inequality is dreadful for mental health.
Managers of the neoliberal system successfully deflect blame for these deteriorating conditions onto individuals. It must be some character flaw which explains the inability to cope with these ‘dynamic’, ‘flexible’ and ‘innovative’ new circumstances.
This process is succinctly put by Open Democracy writer and editor Ray Filar.
“As inequality increases under late capitalist patriarchy, driving people into poverty, abusive relationships, or otherwise helpless conditions – free market ideology says we deserve it. Nobody who is trying hard enough should need state support. The only surprise is that more of us aren’t sick.”
Malcolm Turnbull talks a big game on innovation, but in a piece for ROAR Magazine, researcher and writer JD Taylor uses the term more authentically.
“What is innovative is the effective management of the reality presented to entirely remove any collective, public or social basis for these growing problems. Instead responsibility is attributed to the individual, who has either been unfortunate or ineffective at adapting to the world around them.”
There is clear and direct causation from government rhetoric and policy to shocking mental health statistics for young people, LGBTQI groups, asylum seekers, Aboriginal and Torres Strait Islanders, as well as the broader population. Yet so long as free-market ideology prevails, these statistics will primarily be seen as a result of individual actions rather than institutional policy.
Ray Filar in the same piece for Open Democracy articulates this well.
“The silence and social stigma around mental health is deliberate, the product of an institutional refusal to talk about the affective impact of socio-political conditions. Some people get depressed, or psychotic, we think, because of chemical imbalances or individual traumatic experiences. They’re just lazy or making it up. We don’t talk about austerity, poverty, demonisation of the unemployed – the politically-driven stigmatising of the least privileged groups of people – but is it any wonder we’re unhappy?”
Ignoring Politics: Australia’s Individualist Approach To Mental Health
The Thatcherite idea that your problems are personal not social in origin is an insidious and powerful belief which, nearly 30 years later, still permeates our entire social fabric.
We see it in the mainstream media with gross stereotypes I’d rather not air again here.
We also see it in more progressive media. The Guardian runs articles suggesting depression is caused by inflammation in the body’s immune system. Whose immune system wouldn’t inflame when exposed to the homophobic garbage of Cory Bernadi and his mates?
It’s also noticeable in the ABC’s Mental As coverage each October, which has been brilliantly dissected by Helen Razer. She argues its coverage focuses on individual stories and ignores issues of institutional reform.
“The ABC, the nation’s biggest employer of journalists , has a responsibility to report not only what “you” can do to “fight the stigma” but what government isn’t doing to treat the symptoms and causes of mental health. And what it isn’t doing is a lot… like just about every other government funded service, the ABC has begun to embrace the ideology of the individual.”
We also see the cult of individual responsibility and blindness to social causes in the mental health profession. Psychiatrists are often criticised for reducing complex mental experiences to a physical basis, but psychologists usually do no better in discussing the broader social and political causes of a patient’s anguish.
As Mark Fisher writes in The Guardian:
“It would be facile to argue that every single case of depression can be attributed to economic or political causes; but it is equally facile to maintain – as the dominant approaches to depression do – that the roots of all depression must always lie either in individual brain chemistry or in early childhood experiences.
Most psychiatrists assume that mental illnesses such as depression are caused by chemical imbalances in the brain, which can be treated by drugs. But most psychotherapy doesn’t address the social causation of mental illness either.”
Again, Ray Filar shows insight regarding the silence of therapists on the political causes of mental illness.
“While often helpful, talking therapies can also act as a process of depoliticizing pain. Broader politics are barred from the cool blue counselling room. In therapy, as with neoliberal ideology, families become the problem; we ignore the ways in which structural oppressions – capitalism, patriarchy, white supremacy – create misery. Family becomes harmful within a political context; structures are about individuals.
By substituting drugs or therapy for tackling underlying social hierarchies, governments and global pharma can conveniently avoid or dismantle the collective empathy that might at the same time undermine their rule.”
A quick survey of the leadership of some of the country’s most influential mental health organisations highlights the links between the neoliberal political project, the emphasis on individual responsibility, and the silence about social causes.
The chair of Mental Health Australia, the peak NGO representing Australia’s mental health sector, is Jennifer Westacott. Westacott also happens to be the Chief Executive of the Business Council of Australia. You can rest assured Westacott backs the neoliberal orthodoxy of low corporate taxes and cuts to services. Just read her opinion piece in the Daily Telegraph supporting the 2014 budget.
And then there’s Chairman of Beyondblue, Australia’s most prominent organisation tackling depression and anxiety, Jeff Kennett. As Premier of Victoria, Kennett closed 350 public schools, privatised Victoria’s basic services and cut tens of thousands of public service jobs.
In 2012 he also urged a future Abbott government to adopt Campbell Newman style funding cuts.
It’s no wonder these bodies fail to address the social causes of mental illness when their leaders support the very political project responsible for increased rates of depression, anxiety and suicide in many communities.
Coming To Light: Structural Problems, Structural Solutions
Despite increased investment in mental health services in recent decades, the mental health of Australians is only getting worse.
Between 1992 and 2004, federal government spending on mental health services increased 149 per cent, and this increase was 67 per cent for the states.
In 1997, Australia’s first National Survey of Health and Wellbeing found 18 per cent of adults had experienced a mental disorder in the previous 12 months and 38 per cent of those had accessed help from a health service. By 2007, 20 per cent had experienced a disorder and only 12 per cent accessed mental health services. Other surveys up until 2011 found worsening mental health for some communities.
The news has been deteriorating since then. A 2014 National Mental Health Commission Report found “fundamental structural shortcomings” with the mental health care system. Sydney University researcher Sebastian Rosenberg described an overwhelming unmet need for mental health services and said 87 per cent of young men with a mental illness received no care in 2014.
So Australia has combined a poorly structured, underfunded mental health care system with a merciless neoliberal policy agenda making it harder and harder for people just to get by.
The starting point for reversing this disturbing trend is, like Carter Smith, understanding that mental health is political.
We need to develop the kind of sophisticated understanding of mental illness articulated by Johanna Hedva in her brilliant piece in Mask Magazine called Sick Woman Theory.
“Sick Woman Theory maintains that the body and mind are sensitive and reactive to regimes of oppression – particularly our current regime of neoliberal, white-supremacist, imperial-capitalist, cis-hetero-patriarchy. It is that all of our bodies and minds carry the historical trauma of this, that it is the world itself that is making and keeping us sick.”
If the causes of our high rates of depression and anxiety are deeply political, it follows that the remedies are political too.
Several theorists write with insight on this subject. In that same piece for ROAR magazine, JD Taylor writes:
“Things will worsen unless we politicise anxiety and depression, and start the fight to prioritise the welfare of our societies. Many of us feel paralysed, buckling under the pressure to keep it all together but knowing that the way we work — and live — is damaging us and our relationships. Globalisation of neoliberal political and economic practices is now creating an equality of insecurity and misery for all people, particularly the young, who have little chance of getting even a pension or affordable care in their final years. In such a moment of over-extended transition, where the credibility and legitimacy of the 0.01 per cent has never looked weaker, what future is ours?
It will be the future that we dream of, that we refuse to abandon, and that we cannot possibly entrust to the deceptive economic motives of our undemocratic elites. Societies must express collective desire or they will not be at all.”
Johanna Hedva’s Sick Woman Theory outlines a different way of relating to each other as an antidote to the psychologically destructive individualism of the contemporary age.
“The most anti-capitalist protest is to care for another and to care for yourself. To take on the historically feminized and therefore invisible practice of nursing, nurturing, caring. To take seriously each other’s vulnerability and fragility and precarity, and to support it, honor it, empower it. To protect each other, to enact and practice community. A radical kinship, an interdependent sociality, a politics of care.
Because, once we are all ill and confined to the bed, sharing our stories of therapies and comforts, forming support groups, bearing witness to each other’s tales of trauma, prioritizing the care and love of our sick, pained, expensive, sensitive, fantastic bodies, and there is no one left to go to work, perhaps then, finally, capitalism will screech to its much-needed, long-overdue, and motherfucking glorious halt.”
It’s this turning to each other in a spirit of care and solidarity, rather than turning away in a spirit of competition, which promises an escape route from neoliberal capitalism.
According to Richard Brouillette, a psychotherapist in New York and former community organiser, the idea that mental health is political is a revelation for many of his patients. It empowers many to express solidarity and offers them much hope.
“You would be surprised how seldom it occurs to people that their problems are not their fault. By focusing on fairness and justice, a patient may have a chance to find what has so frequently been lost: an ability to care for and stand up for herself. Guilt can be replaced with a clarifying anger, one that liberates a desire — and a demand — to thrive, to turn outward toward others rather than inward, one that draws her forward to make change.”
Carter Smith made a brave statement to the nation that mental health is political.
Let’s recognise the truth of Carter’s words.
Let’s turn towards each other and begin properly treating mental illness by tackling the social and political ills of our time.