1979 Great Britain elected Margaret Thatcher as the first ever British female Prime Minister. From that point onwards she began to implement a new philosophy and change society as we know it today.
This philosophy comes in many forms and has many different labels such as individualism, neoliberalism, Thatcherism and some people just referred to as common sense. It’s safe to say they were probably idiots.
It was seen as progressive and modern back in the 80s and early 90s yet since moving on from this philosophy the world has suffered many woes.
The philosophy is that everybody has it in their power to determine their future. This style of thinking also advocates a small government state with minimal government intervention into peoples lives. This is ideal for people that have a lot of money and resources but what about the rest of the population? The people that have a hard time reaching the same goals that a person with money takes for granted.
We are not equal
Society is not equal therefore someone must do something to ensure that everybody has the same opportunity as everybody else. It is not equal because we are not all born, and cannot be, born in to a wealthy white middle-class family with access to savings, good education and good healthcare.
In reality people are born into different social classes, into council houses or homes that are on under threat of eviction, areas with overcrowded schools and long waiting lists for operations and appointments for specialist doctors. Some people are born gay, female, Asian, Muslim, Jewish, black, with learning difficulties and with many other things such as dyslexia, depression or autism. These are things that cause people to face problems that others do not. Everyone can face some inequality at some point in their life and others for their whole lives.
Obviously these groups are mixed and just because you are born into one of these groups or several of them does not mean that you will be facing inequality. Yet, people are born into these groups are more likely to face injustices than a white male. Discrimination because of your race, religion, disability, gender or sexual orientation. It’s all inequality.
So how do you overcome some of these injustices?
You provide good schools, police and healthcare services for all.
But, this hasn’t happened. Since Margaret Thatcher became Prime Minister successive governments have continued her mantra of privatising public services. These services are then run for profit not for people. They become businesses.
If businesses or services don’t make a profit then shareholders and managers demand payback for their investment. To make a profit in a recession they decide to cut, cut and cut more. The 2008 financial crisis was the perfect excuse for businesses and governments to do this. That is why profits have risen for the shareholders and wages have stagnated for the workers. This has caused greater financial inequality between the richest and poorest.
How does this relate to mental health?
Along with privatising services neo liberalism encourages people to take ownership and become independent self-serving individuals. It believes there is no such thing as society.
This is how it feeds into mental health. With this philosophy society teaches you that you need to take ownership for your own mental health and that your mental health is within your control. You are responsible for your future. This is where I fundamentally disagree.
The government and society have seen great leaps and bounds in mental health field of science. Low levels of serotonin and dopamine and other irregular levels of neurotransmitters are blamed for depression. Whilst this is true it is not the cause of personal debt, evictions, benefit sanctions or lack of social care. These are the injustices causing higher rates of depression. It’s obvious!
Blaming neurotransmitter levels is utilising the medical model of the western world to diagnose mental disorders. It plays a part but it’s ignoring some of the biggest causes. High financial inequality and the breaking up of society
The government spout better services and more money for the NHS. All this with the hope that chucking a few antidepressants, and systematic one size fits cognitive behavioural therapy at it, they think that everything will be okay and they can cure the individual. Unfortunately it does not work like that.
Why do we have higher rates of depression in the United States of America and the UK if it’s only neurotransmitters to blame for depression? It’s something in society as well as the chemicals in your brain.
I’m not disputing the use of cognitive behavioural therapy and antidepressants, I have seen them do great things and I will continue to advocate for their use in the correct circumstances. However, I feel that the government, and neoliberalism itself, have done very little to address the causes of depression which is now one of the biggest reasons for being sick in the western world.
By placing onus on a person to take responsibility for the mental health society tries to back off. However, if someone does not have family or friends to take responsibility for them then they are left with skeleton like mental health services. Mental health services have been cut ever since they closed the asylums in the late 80s. It’s often called the Cinderella service of the NHS.
Society is broke
So the Thatcherites and neoliberals want people to take responsibility and be individuals. But they broke the family, they broke industrial society. Ask anyone from an ex-mining town or old industrial town and they will tell you that the sense of community has left ever since these industries were dismantled.
As you can probably see in your town or city people live more individual and secluded lifestyles. With this people become isolated, depressed and unable to reach out for help. They also don’t notice when others need help. Or when they do it’s too late.
The services are left with picking up the pieces. Many people are lucky to have friends and family that help care for them or just want to listen to them talk, however, these people are also feeling the squeeze with cut benefits, increased personal debt and fading services.
There is evidence, by Wilkinson and Pickett discussed in their book The Spirit Level (2009), the more unequal a society the less empathetic they are and they are more individualistic. These societies are also more materialistic in their nature and have higher rates of mental health issues, murder, prisoners, obesity, personal debt, solitary lifestyles and depression.
Number one of this ranking is the United States of America. The UK is not far behind… Do we really want a society to emulate the inequalities of the United States of America?
Even though some countries are poorer they rank higher when it comes to lower financial inequality and higher quality of life. These are countries such as Spain, Portugal, Japan, Sweden and Germany. While these countries’ societies may not be perfect, they are a lot more equal than the UK.
So what are we left with?
When I was working in the Emergency department, as a mental health nurse, I saw many people coming following a night of heavy drinking. They had taken an overdose to try and kill themselves because they were drunk and feeling desperate. But there was normally more to it than just drink and desperation.
Every day was the same for me. 5 or more people daily to assess; for many it was a one off, for others it was a regular thing.
I would be sitting in that small side room waiting as they entered; they rolled in their drip stand along which doubled up as a crutch. Sat across from me with my pile of papers in my lap. Staring through me at the wall as I explain the assessment. The smell of chemicals in the air from the ward outside. Beeps and noises going off every 2 minutes. Nurses shoes tapping and relatives shouting for attention just to find out what is going on.
After a while, sometimes with gentle encouragement, everything would come out. All the pressure. All of it. The person would just let go… sometimes that’s all they needed.
There is more to it than neurotransmitters and break ups with partners. It may seem like just that but when you dig a little deeper you find out there’s more at play.
The main cause of these episodes were family arguments, money problems, social issues or work related issues. However, many of these were rooted in problems with benefits sanctions; lack of communication or contact with society and family; issues with discrimination in the community or at work; lack of services available; poor education; lack of youth and social services and problems with finding steady and secure work.
These people weren’t ‘clinically depressed’ at the time but if their situation got worse then they certainly would be.
People were tired of fighting and arguing trying to achieve life’s standards on their own. After the episode they would find that they had friends and family willing to help. Just a shame they had to get that desperate before they realised they were not alone. Remember these people thought, and many people do you think this way, that they have to achieve everything on their own and if they don’t: they are a failure. Well it’s not true.
Some people are unfortunate not to have friends and family to help them and we would forward them on to charities and other services run within the health care system. However nowadays, since the cuts and austerity imposed upon us by the Conservative government, these charities and services no longer exist or they are hanging on by a thread.
Secondary mental health services, specialists in treating people with severe and enduring mental health issues, cannot cope with the weight of the population suffering from mild to moderate depression. This weight has been shifted to primary care psychology services and they are taking on more and more severe cases by the day. The services were never designed to cope with this. This is also why anti depressant prescription rates have gone through the roof.
The society we have at the moment, that is aimed at making profits and letting people look out for themselves, is making people feel unwell. Their wellbeing is shot to pieces.
In short, we have medicalised neoliberalism’s problem which is making people feel terrible. And then we have created a society that blames people for feeling shit. It’s your fault.
Then to top it all off we have made people believe that they have to stop feeling shit on their own. I bet self help books and apps have made a mint.
Some people even try to profit off this. £50 for a mindfulness app. Jog on.
So how do we fix it?
Of course, people should take responsibility for their own health but having a shit society doesn’t help, does it?
It makes it harder to look after yourself if you have benefit sanctions, personal debt or eviction hanging over your head.
So, maybe to start:
We need to start reversing the individualism in society. We are on this planet together. What use is it just living in a little bubble. You may need help someday.
We need to embrace our differences and demand better universal basic services for all. People have recently been talking about universal basic income. We don’t even have basic services for all; we need to accomplish this first. Access for all to good healthcare, housing, social care, education, financial, training and transport.
We need to distinguish between businesses and services. Health and education are not there to make money for the rich. They are there for everyone. They are services not a business opportunities.
We need to look out for family and friends. They may not always be here and you never know when you might need help.
Lastly we need to reverse the ‘it is your problem’ mentality. We can start by being just a little bit kinder to people in states that they don’t want to be in.
We need to build a society we can all live in. Not only the luck few.
Don’t vote Conservative
P.p.s if you like this I have more material coming out on this.