Momentum “The World Transformed” Policy Lab on Capitalism and Mental Health – Saturday 21st Sept 3.00-5.30 in Brighton

 

Nicola Saunders and Paul Atkinson are organising an event at Momentum’s The World Transformed on Capitalism and Mental Health on Saturday 21st September at 3.00 – 5.30 pm in Brighton. Jacqui Dillon and Malcolm Philips are joining us to introduce the meeting.

The focus of the event is to gather together from the people at the meeting concrete proposals for radical alternative policies on mental health for the next Labour Manifesto. This will be part of Momentum’s Policy Lab programme through which an alternative manifesto will be presented by John McDonnell and others to the LP manifesto discussion.

Our aim is to quickly identify together the main policy areas and spend as much time as possible in smaller groups discussing and formulating policy proposals for each area. It really matters then that we manage to attract as wide a range of experience and opinion on transforming mental health policy.

The online Momentum flyer for the event lists five “speakers”. This is a bit misleading. In fact, Nicola will chair;  Malcolm, Jacqui and Paul will kick things off with very brief talking points around the kind of issues we face in the mental health arena; Jon Ashworth, shadow Minister for Health, will say something brief at the end of the session.

As far as possible, the meeting will belong to the people who come along. So please come if you can. Get tickets here. And please circulate the invite to anyone who might be interested.

Warm greetings from Paul and Nicola
Contact  paulwilliamatkinson@gmail.com

Mental Wealth Alliance response to the psy professional bodies’ statement on benefit sanctions and mental health 30/11/16

From:

Mental Wealth Alliance[1]

 Mental Health Resistance Network; Disabled People Against Cuts; Recovery in the Bin; Boycott Workfare; The Survivors Trust; Alliance for Counselling and Psychotherapy; College of Psychoanalysts; Psychotherapists and Counsellors for Social Responsibility; Psychologists Against Austerity; Free Psychotherapy Network; Psychotherapists and Counsellors Union; Social Work Action Network (Mental Health Charter); National Unemployed Workers Combine; Merseyside County Association of Trades Union Councils; Scottish Unemployed Workers’ Network; Critical Mental Health Nurses’ Network; National Health Action Party.

To:

British Association for Behavioural and Cognitive Psychotherapies

British Association for Counselling and Psychotherapy

British Psychoanalytic Council

British Psychological Society

United Kingdom Council for Psychotherapy

30th January 2017

MWA response to the psy professional bodies’ statement on benefit sanctions and mental health  30th November 2016

We welcome the call from the psychological therapy bodies for the government to suspend the use of sanctions by the DWP subject to the outcomes of an independent review of its welfare policies and their potential damage to the mental health of benefit claimants. Given the accumulation of evidence over many years of the material and psychological suffering inflicted on benefit claimants by workfare-based conditionality[2], it has been frankly shocking that the professional bodies directly concerned with the mental health of the nation have preferred to welcome and participate in workfare policies rather than publicly and vociferously dissociate themselves.

The timing of the statement is given to be the recent report on sanctions by the National Audit Office. Welcome as its report is, the NAO’s perspective on government policy is primarily monetary, not one of health, ethics and social justice. Its “vision is to help the nation spend wisely”.  The choice of this timing represents realpolitik on the part of the professional bodies no doubt, as perhaps is the intention of the conditional statement: “The sanctions process may be detrimental to people’s mental health and wellbeing”. But surely as psychotherapists and counsellors we can do better to represent the overwhelming evidence of personal suffering on such a scale than point to poor returns on expenditure and an ambivalent proposal that sanctions may be detrimental to people’s mental health.

Sanctions are only one dimension, albeit at the sharp end, of a welfare regime based on the political assertion that people need to be coerced off benefits and “nudged” into work. The psychological pressure of WCA and PIP assessments, job search rules, work programmes on “good employee” behaviours and the regular cuts to welfare benefits generally are part and parcel of the psycho-compulsion of the DWP benefits regime.[3]

We dispute the government’s premise that work is a therapeutic priority for people suffering from mental health difficulties. The marshalling of evidence for this modern-day workhouse mentality lacks both substance and integrity. Work has become the ideological mantra for neoliberal welfare policies.

Obviously where people want to work and where employment possibilities exist that will support and nourish people’s mental health, then encouragement, training and professional support should be available. But why is there no acknowledgement of the hundreds of thousands of claimants with mental health difficulties who cannot work, whether they want to or not?[4] Where is the evidence that people with mental health difficulties are actually benefiting from what is now two decades of workfare conditionality in the UK? Where is the evidence that in our current labour market decent jobs exist that will nourish people’s mental health? And where is the evidence that psychological therapy for benefit claimants with long-term mental health disabilities succeeds in supporting them into decent jobs they want, can survive and maintain?

When the professional bodies say, “an estimated 86-90% of people with mental health conditions that are not in employment want to work”, they are supporting the proposition that getting into work is an overwhelmingly important and efficacious goal for this group of benefit claimants. It is not clear where this figure comes from and what it means.

A similar figure is quoted by The Royal College of Psychiatrists’ report on Mental Health and Work (2013)[5], making use of a Sheffield study by J. Secker and others (2001)[6]. In fact, Secker finds that of their sample of 149 unemployed service users, when asked if they were interested in work of any kind – including voluntary and supported work –  “around half (47%) responded positively, and almost the same proportion (43%) had a tentative interest. Only 15 people (10%) had no interest in work”. At the same time, only 25% of respondents saw full-time employment as a long-term goal. 71% said that their preferred vocational assistance would be “help for mental health/keep current service”.[7]

This study does not translate into “86-90% of people with mental health conditions that are not in employment want to work”.[8] What it points to is the complex texture of attitudes, desires and fears around waged work that are the common experience of service users, alongside the harsh realities of the current labour market, the socio-economic environment generally, and the dire state of mental health services of all kinds more particularly.[9]

From our point of view, the professional bodies’ statement is a step in the right direction. It is a step that must now be followed through with active political pressure on the DWP and the Dept of Health to suspend sanctions and set up an independent review of their use, including the damage they inflict on people’s mental health.  Parliament has already called for such a review.[10]

But more than this, the remit of such a review should include all aspects of conditionality in a benefits system that deploy psycho-compulsion through mandatory rules or through the more subtle imposition of behavioural norms which aim to override the claimant’s voice.

We again suggest that the psy professional bodies would benefit by widening their own conversations to include service users and the rank and file of their membership. They would also win more credibility as organisations with ethical and social values independent of the government’s policies of dismantlement of social security and the welfare state if they were willing to make transparent their currently private conversations with DWP.


[1] Mental Wealth Alliance (MWA), formerly the Mental Wealth Foundation, is a broad, inclusive coalition of professional, grassroots, academic and survivor campaigns and movements. We bear collective witness and support collective action in response to the destructive impact of the new paradigm in health, social care, welfare and employment. We oppose the individualisation and medicalisation of the social, political and material causes of hardship and distress, which are increasing as a result of austerity cuts to services and welfare and the unjust shift of responsibility onto people on low incomes and welfare benefits. Our recent conference focused on Welfare Reforms and Mental Health, Resisting the Impact of Sanctions, Assessments and Psychological Coercion.

[2] Parliamentary committees, the national press, endless reports from charities, service user organisations, people with disabilities, claimants unions and workfare campaigners have been reporting the physical and psychological damage of ‘welfare reform’ and its tragic outcomes for a decade.

[3] On psycho-compulsion and the benefits system see Friedli and Stearn http://mh.bmj.com/content/41/1/40.full and https://vimeo.com/157125824

[4] In February 2015 over a million people claiming ESA under a MH diagnosis were in either the Support Group or WRAG. Over 70% of new applicants for ESA are found unfit for work

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/470545/3307-2015.pdf

[5] https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212266/hwwb-mental-health-and-work.pdf p.17

[6] Secker, J., Grove, B. & Seebohm, P. (2001) Challenging barriers to employment, training and education for mental health service users. The service users’ perspective. London: Institute for Applied Health & Social Policy, King’s College London.

[7] Ibid, pp. 397-399

[8] Compare a DWP survey of disabled working age benefit claimants in 2013. 56% of 1,349 respondents agreed that they wanted to work. Only 15% agreed that they were currently able to work. Only 23% agreed that having a job would be beneficial for their health. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/224543/ihr_16_v2.pdf

[9] For example, some of this complexity is flagged by Blank, Harries and Reynolds (2012) The meaning and experience of work in the context of severe and enduring mental health problems: An interpretative phenomenological analysis Work: 47 45(3)    “Stigma, the disclosure of a mental health problem and the symptoms of the mental health problem are frequently described, as well as feelings of hopelessness, seeing recovery as uncertain, and feeling a lack of encouragement from services. Difficulties in accessing occupational health services, having a disjointed work history, lack of work experience, age, lack of motivation and fears about competency, as well as the social benefits system and caring commitments, are also experienced as barriers to accessing employment for people with mental health problems.”

[10] https://www.parliament.uk/business/committees/committees-a-z/commons-select/work-and-pensions-committee/news/benefit-sanctions-report

 

Mental health activists, workfare campaigners and therapists protest against work cure therapy for benefit claimants with mental health disabilities

  It’s time for the psy professional bodies to stop colluding with the DWP 

Join the protest against the professional bodies supporting work cure therapy for benefit claimants with mental health disabilities

Tuesday 5th July at 9 am at the New Savoy Conference

Hallam Conference Centre, 44 Hallam Street, London W1W 6JJ

Central London @ Great Portland Street tube (Map here)

See the conference programme here


For a decade or more, the Government has been deploying psychotherapy to get people with mental health difficulties off benefits, back to work and mapped into the neoliberal labour market. Since 2010, austerity policies of welfare reform – punitive Work Capability Assessments, benefit cuts, workfare, sanctioning – have intensified government strategies of psycho-compulsion and work cure for welfare claimants. IAPT therapists are being co-located in Jobcentres, DWP mental health advisers and employment coaches in GP surgeriesfood banksschools and libraries.

The big five national organisations representing the professions of counselling, psychotherapy and clinical psychology* have welcomed these policies and the state funding of back-to-work therapy.

As members of the New Savoy Partnership, they have been major players in The New Savoy Conference, an annual jamboree and market stall for state therapies in the NHS. The NSC frequently stages opening addresses by DWP and Health ministers to assert the close relationship between the professional bodies, MH charities and Government mental health and work-cure policies and funding. Hundreds of mental health workers accredited by the psy professional bodies have been hired by the DWP to provide “support into work”. These are jobs that are experienced as deeply unethical by many of the professionals being steered into this kind of work.

In March this year, the Mental Wealth Foundation (see below) wrote to the five professional organisations challenging their support of the government’s use of psychological therapies to put pressure on people with mental health disabilities to get into work. You can read the exchange of letters between us and the professional bodies here.

So far, all but one of these organisations are refusing to speak to us and continue to argue that they have had private reassurances from the DWP that “work cure” therapy will not be mandatory for claimants, and will not involve setting entry into employment as a therapeutic outcome. This claim defies the reality of the DWP’s record of punitive and coercive policies of workfare, Work Capability Assessment and sanctioning and its growing determination through its Work and Health initiatives to prioritise work as the therapy of choice for long-term mental health disability.

British Association for Behavioural and Cognitive Psychotherapies; British Association for Counselling and Psychotherapy; British Psychoanalytic Council; British Psychological Society; United Kingdom Council for Psychotherapy

Come and join the protest against work cure therapy for benefit claimants with mental health disabilities. All welcome. Gather at 9am on Tuesday 5th July outside the Hallam Conference Centre, 44 Hallam Street, London W1W 6JJ. For more info contact eventsatfpn@yahoo.com


The Mental Wealth Foundation (MWF) is a broad, inclusive coalition of professional, grassroots, academic and survivor campaigns and movements. We bear collective witness and support collective action in response to the destructive impact of the new paradigm in health, social care, welfare and employment. We oppose the individualisation and medicalisation of the social, political and material causes of hardship and distress, which are increasing as a result of austerity cuts to services and welfare and the unjust shift of responsibility onto people on low incomes and welfare benefits. Our recent conference focused on Welfare Reforms and Mental Health, Resisting the Impact of Sanctions, Assessments and Psychological Coercion.

Currently, seventeen organisations are gathered under the MWF umbrella: Mental Health Resistance Network; Disabled People Against Cuts; Recovery in the Bin; Boycott Workfare; The Survivors Trust; Alliance for Counselling and Psychotherapy; College of Psychoanalysts; Psychotherapists and Counsellors for Social Responsibility; Psychologists Against Austerity; Free Psychotherapy Network; Psychotherapists and Counsellors Union; Critical Mental Health Nurses’ Network; Social Work Action Network (Mental Health Charter); National Unemployed Workers Combine; Merseyside County Association of Trades Union Councils; Scottish Unemployed Workers’ Network; National Health Action Party

Manchester Conference Saturday 21st May 2016

Mind the Gap: Free Psychotherapy in an Unjust World

Sat, May 21, 2016 at 11:00 AM

Friends Meeting House, – 6 Mount St, , Manchester M2 5NS, United Kingdom – View Map

A conference organised by the Free Psychotherapy Network

The state of our emotional and psychological lives is as fundamental as our material standard of living – our incomes, our physical health, our working conditions, our education and housing. Yet we live in a society whose dominant political and cultural messages over-emphasize money, profit, property and consumption. At the same time, the quality of our emotional lives and relationships with our families, friends, co-workers, neighbours and wider communities is undervalued.

This conference is an opportunity to explore and develop sustainable networks of psychological support which are community led. The aim is to create a collaborative space for therapists, service users, survivors, claimants’ unions and community groups to explore our experience, our needs and desires together. We have much to learn from each other!

The day will be workshop based. Workshop themes may include: sick individual or sick society?; peer led groups – what works, what doesn’t; the experience of FPN so far – free work and working free of funding and institutional restraints; minding the gap between the ‘professional’ and the ‘client’ – exploring the power relationship between therapists and clients; building the relationship between FPN and community groups; developing FPN local groups.

If you would like to suggest or run a workshop, please email: eventsatfpn@yahoo.com – add your suggestions here

The conference is free. All welcome.

If you would like help with travel costs we may be able to help, email: paulwilliamatkinson@gmail.com

 

The venue is wheelchair accessible.

Book a free place via Eventbrite here

 


Happiness and the capture of subjectivity

The Happiness Movement and the capture of subjectivity

I am a kind of paranoiac in reverse. I suspect people of plotting to make me happy.

~ J.D. Salinger              


In November last year (2014), I went to an Action for Happiness event in central London. It was organised to mark the publication of Thrive: the Power of Evidence-Based Psychological Therapies by Richard Layard (a founder of Action for Happiness) and David Clark[1]. Conway Hall was full. The authors spoke for twenty minutes each and took questions from the floor. The occasion was a celebration of the marriage of Layard’s campaign for government action to promote psychological well-being, Clark’s championship of CBT and the resulting roll-out of the IAPT programme. Having failed to get a question or comment into the Q & A session, I wrote to the event organiser with my thoughts on the happiness movement, CBT and IAPT in the context of neoliberal capitalist society. This is a version of the thoughts I put together on the idea of happiness as a campaign slogan for social change, in response to the event and the email exchange that followed.

I want to say first that despite my misgivings about the happiness movement[2] (a term I am using to cover a number of political and cultural initiatives campaigning for the promotion of happiness over economic growth on government policy agendas, here and worldwide), I recognise that it does have a life-giving intention and a commitment to social change.

Nevertheless, I feel very uncomfortable with ‘happiness’ as a goal and/or a campaign banner slogan, and especially with the way it is being linked with ‘mental health’. I will say a bit more about that in a moment. I am also unconvinced that either Action for Happiness or the authors of Thrive are really interested in the social and economic causes of psychological distress. The focus of Thrive is clearly on the subjective, despite its notional critique of some aspects of capitalist society and culture.

On the marriage of happiness and the evidence-base of CBT and IAPT – the issue closest to my heart and experience as a psychotherapist – I am afraid I am disgusted and dismayed. Here, I am focussing on idea of ‘happiness’. Its linkage with CBT and IAPT deserves a separate discussion, especially given the peculiarly disingenuous nature of Layard and Clark’s book in its celebration of the success of “evidence-based” therapy.

Is happiness a valid common good?

As an organising banner for social change, happiness is a simplistic concept. It is labile.

A huge range of things and experiences make me feel happy at one level or another. My iPad, my new VW Polo, losing half a stone, my relationship with my wife and children, a pint of cider, women I fancy on the street, many moments in my consulting room, the cormorant fishing the canal, a decent pair of nail clippers, a new gadget for my bike, my friendships, having a few thousands in a savings account, not being 18 again, etc, etc make me happy.

Happiness needs ground to have substance and value – a context in space, time and relationship. Being happily married is not in the same cosmos as being happy with my chocolate bar. Being happy looking at pornography is something very different from being happy that death has come to me at last! Happy to have survived that awful accident is not related to happy I caught that bus. The Skidelskys talk about all this in “How much is Enough?[3]. So do many of the academic critiques of the happiness and well-being movement.

Capitalism of course sells us happiness all the time, and is adept at recognising changing social mores and fashion as opportunities to make profit selling back to us our quest for happiness.

Coca-Cola is probably the best-selling source of happiness throughout the world – perhaps because it is the ‘real thing’. Bisto gravy sells the happy family to the UK. Apparently, Christmas advertising on TV in 2013 generated ten times more happiness then anger.[4]

Happiness is modern capitalism’s most important sales pitch. It makes money by attaching its products and services to our desire to be HAPPY. It markets a version of society in which happiness is the primary – in fact, the only – goal in life that matters. In its neoliberal incarnation, it excels at selling us the promise of happiness, as it immiserates a significant proportion of the population.

So when Action for Happiness and Lord Layard assert self-reported happiness to be a primary social good to be prioritised by political policy-makers, I want to ask what is it that distinguishes their happiness from the happiness that sells us goods and services, and can make us feel good about our lived experience? Why is their version of happiness not simply a sales pitch for CBT, physical exercise, buying Thrive, positive thinking, meditation, group facilitation, mindfulness, life coaching, spiritual training, advice on nutrition, etc, etc?

Is happiness actually a valid common good, taken out of the complex contextual debate of what gives meaning to our lives?

Happiness and mental health

What kind of context does the connection with mental health give to happiness? If mental health is thought of as states of mind that can be negative or positive, and happiness is defined as having a positive state of mind, then the link Richard Layard and others have been making between unhappiness and untreated mental illness has a very obvious popular appeal. If we focus on helping people develop more positive states of mind, more people will feel happier and suffer less mental illness. Focus on helping people feel happier, and they will have more positive states of mind and less mental illness.

No-one, of course, thinks that mental health is just a state of mind. We all know that what gets called mental health is in fact a complexity of lived experience involving subjective and objective conditions, personal history and circumstances, as well as social, economic and political history, and circumstances, personal opportunities and socio-economic opportunities. Mental health is, by definition, in terms of lived experience, a misnomer in all sorts of ways – for example, it involves a mind/body split which more and more people see as unhelpful; it associates psychological life with the mind and thinking – a sort of Cartesian fantasy of who we are as human beings; in other words, it tends to separate subjective states from lived experience and circumstances; it also tends to treat the psychological and the subjective as symptoms of the individual rather than the collective.

Meanwhile, the ‘health’ in mental health tends to think of the psychological realm in the same categories as physical health and medicine. We think of medicine as a science. We assume an objective norm of the healthy body, in relation to which sickness is a deviation to be cured. Medicine has an evidence-base close to the natural sciences – anatomy, bio-chemistry, x-rays and scans, lab-work, microscopes etc, etc. Illnesses are diagnosed and treated on the basis of scientifically evidenced efficacy.

We know that, to an important but under-acknowledged degree, evidence-based medical science has its limitations. Any doctor will tell you that much of medicine is trial and error, diagnosis is often a process of elimination, cure achieved by the placebo of a pill or an empathic ear. But most of us will accept that to a very significant degree the evidence-base of medical science works for us as far as the body is concerned.

This just is not the case for working with psyche – emotions and emotion-laden thinking, negative fantasies, repetitive cycles of anxiety and fear, emotional conflict in relationships, lack of self-esteem, martyrdom, harsh self-judgement, depression, self-loathing etc. Much of what might be diagnosed as mental illness is not something comparable with symptoms of physical illness. The “norm” for every human being, if there is one, is to have experience and symptoms of all psychological disorders in some shape and degree. We all get anxious, depressed, obsessive, paranoid, addicted, aggressive, cut off, manic, psychotic to some degree or other, at some time or another.

The diagnosis of mental illness is a hugely contentious business among psychologists, psychotherapists and counsellors, and psychiatrists. Many of us are very concerned at the growing industry of diagnosing psychological suffering and distress as mental illness – across the spectrum of severity of symptoms. Critical psychiatrists all over the world have protested at the mushrooming and distortions of diagnostic categories in the DSM5.[5]

Psychiatrists and psychotherapists with a social perspective on psychological distress are increasingly wary of the diagnosis of depression and anxiety as mental illness rather than either the sickness of society or a reasonable response to social and economic deprivation and exploitation.[6]

For many counsellors and psychotherapists, depression and anxiety are part of the human condition, as much to do with the existential struggles of identity and emotional/ethical conflict as any diagnostic category of mental ill-health.

But whatever we think about the term mental illness, what exactly is the connection between that and happiness?

Is happiness a natural binary of depression or anxiety? “I used to be depressed/anxious, now I’m happy”? What about “I used to be depressed, but now my life feels more meaningful”. Or “less empty”. Or perhaps “looking back, I can see that getting depressed has made me more appreciative of the other people in my life”. Or “I see now that this stuff I call depression is a mixture of a number of things – rage, loss, fear. I feel more alive recognising these feelings, though I wouldn’t call it ‘feeling happy’”. If I feel less anxious or depressed, frightened or violent, cut off or manic does that mean I must feel happier? Maybe, but unless I give you some context, it would be very simplistic of you or anyone else to assume so. Happiness is not the primary goal of life. And suffering is certainly one of its everyday ingredients.

None of this is to deny that there is an awful lot of psychic pain in the world that people need help with. Nor that much of this suffering is unrecognised and stigmatised, and that help is often in short supply.

Psychological and material well-being

But if, for the moment, we allow that having more happiness than unhappiness in your life is a rather good thing – for you, those around you and society in general; if, therefore, we would like to influence society to attend more to what it is that helps us feel happier with life; if we also allow, for the moment, that psychological suffering is a major indicator of unhappiness, that it is more widespread than is normally acknowledged, and therefore society and government need to attend to it; then we need to know something about what psychological suffering is and what causes it, in order to develop policies for change.

One of the most common themes of mental ill-health is the familiar dichotomy of nature and nurture. Does mental illness originate from within, or from without? Is it more to do with genes, or more to do with environment? Is it located more in the individual/subjective/personality/inner world, or more in the collective/objective/inter-personal/external world?

The link between psychological well-being and socio-economic well-being is complex. The autonomy of the individual and the collective realms needs to be respected while at the same time recognising their interdependence. In terms of national policy, it matters how we understand this relationship, where we put the emphasis, and therefore how we pitch campaigns to improve psychological well-being.

On the Action for Happiness website[7] and in Thrive, the interwovenness of the psychological, social and material are acknowledged, but the emphasis is distinctly on the genetic and the subjective. This for me distorts and undermines the integrity and value of the use of words like happiness, well-being, mental health and therapy. If the focus of people’s sense of well-being is pulled too far away from social, economic and political reality, it begins to lose touch with real lives and moves towards the realm of ideology, marketing, and public relations.

On the website, the emphasis is on the individual, his/her genes, personality and subjectivity as something quite independent of material circumstances, social class, ethnic background and so on.

With a quick scan of the site, I can only find one example (I am sure there may be others) of a more nuanced conception of how material and psychological well-being are intertwined, [8] and this is not an Action for Happiness document it seems.

On the AfH site’s front page there is a pie-chart “Our Happiness is not Set in Stone”:

ImageGen.ashx

Although our genes influence about 50% of the variation in our personal happiness, our circumstances (like income and environment) affect only about 10%.

As much as 40% is accounted for by our daily activities and the conscious choices we make. So the good news is that our actions really can make a difference.

Though “the pie” says “Genes and Upbringing”, the text reduces this to genes. Confusing! Upbringing, of course, is family background, childhood, family dynamics and its social and economic circumstances. I put these factors in “environment”, not “genes”. Moreover, despite the fashion for genetic and neuroscientific theories of emotional and psychological states of mind, the jury is still way out for many of us on simple equations of genes and psychological states. The assertion of a significant connection between depression and inheritance is still precisely that – an assertion. So for example, the Human Genome Study has produced no evidence so far for a “depression gene/s”.[9]

In Thrive, Layard and Clark do offer a somewhat more nuanced discussion of the genetic/environment relationship in their chapter 7 – What causes mental illness? But genes still come first, and in the “genetic” section they make the unfounded claim for scientific evidence of a gene/depression connection. Thriving (being happy) is primarily associated with subjective states of mind, located within the individual, rather than a more realistic and holistic picture of a relationship between internal and external worlds. The obstacles to individual thriving are primarily negative states of mind that the individual can remove or moderate through positive thinking and positive actions. The social and economic causes of psychological ill-health are consistently underplayed, to my mind.[10]

This downplaying of the social, political and material contexts of subjective states involves sidestepping overwhelming evidence over decades that economic and social deprivation is a major cause of psychological ill-health. See, for example:

  • The WHO 2014 report on the social determinants of mental health worldwide.[11]
  • The Institute of Health Equity and Michael Marmot on the impact of the Coalition’s austerity policies in London, published in 2012.[12]
  • The American Psychological Association’s Resolution on Poverty and Socioeconomic Status 2000.[13]
  • The Royal College of Psychiatrists 2004 paper Poverty, social inequality and mental health.[14]
  • The Mental Health Foundation’s working paper of 2013.[15]

In their chapter on the causes of mental illness, the authors of Thrive devote the first nine pages to talking about genes.[16] There is one page on childhood, and just over one page on job loss, stressful work environments, physical illness and disability. The two pages on social class and income argue that these are not causal factors in the aetiology of psychological ill-health. The section on what makes mental ill-health persist goes back to genes and innate personality.

The final section, on the nature of society, identifies four factors affecting well-being across a society – the level of corruption, freedom, trust and social support. Financial inequality and poverty are dismissed. Ideologically-led policies of social and economic exploitation, the debasement of democratic processes, and the exploitation of the majority by a political and financial elite are not discussed, nor are the structures of power in society generally.

The neoliberal turn of capitalism

For me, it is this marginalising of the socio-economic in favour of the genetic and individual subjective that puts Action for Happiness in danger of becoming a palliative to neoliberalism rather than a real challenge to it. Without more context in the realities of people’s lived experience, happiness feels like a sort of social soporific. Happiness becomes a rather insipid goal in life, rather like a drug – soma in Huxley’s Brave New World.

Since Margaret Thatcher’s premiership, and revitalised with a vengeance by this Coalition government, neoliberal political policy has propagated a devastating increase in most of the socio-economic, cultural, ethical and political conditions that nurture psychological distress and suffering. Current political policy-making manufactures depression and anxiety, if you like.

It seems perverse to me for happiness campaigns like Action for Happiness to want to influence government policy towards reducing levels of anxiety and depression without coming out very strongly against current government policies that are having a devastating effect on the nation’s ‘mental health’.

So, while Thrive devotes space to the social side of mental ill-health, it is careful to say little about social class, adult and child poverty, waged poverty, the cuts in social security – including disability allowances for the mentally ill, policies like the bedroom tax, the consistent fall in real wages, the growth of zero-hour contracts, the growing shortage of affordable homes, the crazy rise in private rents in London, policies forcing families out of central London, food banks, the cuts in mental health budgets (20% higher than cuts for physical health budgets over the next five years, despite “Parity of Esteem”), the stigmatisation of asylum seekers and more.

And here is a final thought on this particular issue.

According to Jack Carney’s piece in Mad in America (2012)[17], before the 1980s, academic studies of the relationship between social deprivation and mental illness concluded that the former was the primary cause of the latter. With the rise of neoliberalism, studies have generally concluded the opposite – that mental illness causes social deprivation. The implications for neoliberal governmental policy are obvious. Define the problem as one of mental illness, treat it as an individual affliction, and carry on creating a society that celebrates inequality, social injustice and environmental devastation, in the interests of the global market.

[1] 2014 Penguin

[2] Not to be confused, of course, with Coca-Cola’s “Happiness is Movement” campaign in 2014 – http://www.coca-colacompany.com/videos/happiness-is-movement-ytbn3bc63pz38

[3] Robert and Edward Skidelsky (2013) How much is enough? Money and the good life Penguin, chap.4

[4] For more, see https://freepsychotherapynetwork.files.wordpress.com/2014/11/blank-9.pdf

[5] See an NHS review of the issue here http://www.nhs.uk/news/2013/08august/pages/controversy-mental-health-diagnosis-and-treatment-dsm5.aspx

[6] For example, http://dxsummit.org/archives/2032

[7] http://www.actionforhappiness.org

[8] http://b.3cdn.net/nefoundation/bb8366694aa033e578_vvm6bfv3t.pdf

[9] See for example, http://www.ncbi.nlm.nih.gov/pubmed/23290196

[10] David Harper argues a similar case regarding Action for Happiness in the Guardian here http://www.theguardian.com/society/2012/feb/21/sad-truth-action-for-happiness-movement

[11] http://www.instituteofhealthequity.org/projects/social-determinants-of-mental-health/social-determinants-of-mental-health-full-report.pdf

[12] http://www.instituteofhealthequity.org/projects/demographics-finance-and-policy-london-2011-15-effects-on-housing-employment-and-income-and-strategies-to-reduce-health-inequalities/the-impact-of-the-economic-downturn-and-policy-changes-on-health-inequalities-in-london-full-report

[13] http://www.apa.org/about/policy/poverty-resolution.aspx

[14] http://apt.rcpsych.org/content/10/3/216.full

[15] http://www.mentalhealth.org.uk/content/assets/PDF/publications/starting-today-background-paper-3.pdf.

[16] Pagination from the Kindle edition.

[17]  http://www.madinamerica.com/2012/03/poverty-mental-illness-you-cant-have-one-without-the-other

Other resources:

William Davies The corruption of happiness 18 May 2015  in OpenDemocracy

A fascinating article. The comments on happiness as a choice put me in mind of the fantastic (and often misrepresented) film ‘No’ by Pablo Larrain (2012). The film documents the overthrow of General Pinochet in Chile by a campaign using the tagline ‘happiness is coming’ (which the film frequently equates with Cola adverts). It offers a fascinating and deeply cynical perspective on the seamless persistence of neoliberal ideology despite the overt change in the head of state.

The Free Psychotherapy Network

We are a group of psychotherapists offering free psychotherapy to people on low incomes. We are currently developing our own ways of doing no-fee work and we are supporting each other in the experience. We would like other qualified psychotherapists and counsellors to join us in building a network.

We envisage a loose, mutually supportive, network of practitioners offering their time, experience and energy to their local communities in whatever settings work for them. This might be through individual or group sessions, through facilitating peer-support groups or by working with existing community groups.

We are not talking about charity, nor are we interested in this government’s bogus vision of ‘the big society’. We see ourselves as contributing to a broad movement of activism, pressing for social justice and community values in response to the social injustice and cynical market values that seem to have a tightening grip on our society.

We support the provision of psychological therapies by the NHS. But, for the moment, we see little hope of a turnaround in the recent cuts to NHS services – in particular, cuts to the open-ended talking therapies.

We believe that the state of our emotional and psychological lives is as fundamental as our material standard of living – our incomes, our physical health, our working conditions, our education and housing. They are clearly inseparable, though not necessarily in a simple way. We know that money doesn’t buy happiness any more than poverty destroys the possibility of love and a creative life. But we do live in a society whose dominant political and cultural messages seem to us to overvalue money, profit, property and consumption, while at the same time undervaluing the quality of our emotional lives and relationships with our families, friends, co-workers, neighbours and wider communities.

Inequality of wealth, income and power are growing in the UK. In some respects, they are becoming more deeply and subtly entrenched in the way we think about ourselves and the meaning of our lives. We believe that it is as essential to a decent life to feel that we have the power to influence the way we live and can find the courage to live well with ourselves and each other, as it is to have basic material security. Gross inequalities of social, economic and political power corrode mental as well as physical health for everyone.

Most people find the rapport and understanding they need to live well in their everyday network of friends, relatives, colleagues and community. A significant minority, however, find themselves struggling in relative isolation with painful and debilitating experiences of anxiety, fear, depression or self-doubt. Usually, the sources of such psychological difficulties are environmental – poverty, early trauma or abuse, family breakdown. All too often the people struggling with psychological insecurity are also struggling with financial and social insecurity.

We want to work with local communities by supporting people who would benefit from the experience of practitioners, who cannot get the kind of support they need from their GPs or from voluntary services, and who do not have the money to pay for psychotherapy. We want to work, as far as possible, from local bases in communities we are connected to. We want to encourage people to collaborate, support each other and share experience and understanding of psychological difficulties. We will work with people as psychotherapists, but also as equals in the common experience of wanting to understand ourselves and others better, and to live our lives with more freedom, more creativity and more responsibility toward the common good.

How you can get involved with the network:

*  If you are already involved in free and/or low-fee work as a qualified practitioner and you support the ethos of the network, you could join us by sending a short statement about what you are doing, its setting and the social/political perspective you hold about the work. With your permission, we could add your statement to the website and connect you with other therapists interested in developing support for each other.

*  If you are interested in starting a project or you want some support for an existing project, get in touch with us and we will think about how we might be able to help.

*  If you want to support the network in some way – by getting involved in existing work, offering ideas for community projects, thinking about the clinical implications of working for free, setting up support groups for no-fee practitioners, or simply by endorsing the philosophy of the network – get in touch with us.

Email us at paulwilliamatkinson@gmail.com

 

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