Wednesday, 7 September 2011

Broken System, not Broken People?

Thanks to Michael for sending us this excellent guest blog;

When the esteemed people at The Broken of Britain Blog kindly invited me to write a guest blog for them, I did something typical of a person who suffers from anxiety and depression: that is, I instantly compiled a mental list of the reasons why I was unqualified or unable to write a blog.  What made me change my mind was reading some of the other contributors to this blog and others like it and reminding myself that many people have the same exact reactions when faced with something new or difficult.  Reading the other blogs also reminded me how many people there are out there who I share things in common with and whose lives have intersected in some way with my own- the people who find themselves isolated or alienated or restricted or flattened by ill health or all of the above.  My personal experience lies in five years of mental ill health and so it is this issue that I will focus on.

Mental illness does not happen in isolation.  There are well-worn figures about 1 in 4 people suffering from a mental disorder in the UK in their lifetime or that the World Health Organization predicts depression will be second only to heart disease as the most widespread illness in the developed world.  But mental illness is not just statistics on a page or distant “others,” far removed from regular human activity.  It is all too human.  It’s dependent on how we order our own individual worlds and how we relate to other human beings.  We evolved as a social species, it was partly our ability to co-operate within small group structures that helped us to outlast other early humans and enabled us to endure the unimaginably difficult circumstances that faced hunter-gatherer tribes for thousands of years before the development of agriculture.  

Psychiatrist, Neurobiologist and author Paul Keedwell explains in his book, How Sadness Survived: The Evolutionary Basis of Depression,
‘The biology of our brains was shaped over a period of six million years, and for over 99.5 per cent of this time Homo Sapiens lived in small groups of hunter-gatherers.  Compared to this period of evolution the past few millennia or so of human civilisation- dating from the beginning of the Bronze Age- are a drop in the ocean.  Advanced civilisation- the organisation of subject peoples within a large society, with armies and division of labour- has only been possible because of the relatively recent development of agriculture and animal husbandry.  Biology takes a long time to catch up with changes in environment.  Our brain mechanisms, although malleable and adaptable to cultural changes, have limits to their capability set by our ancestral heritage.’  

Keedwell goes on to say: ‘We may be witnessing an epidemic of insecurely attached, psychologically vulnerable individuals in modern urban society.  As the extended family has been replaced by a smaller more mobile one, balanced homes have been replaced by broken ones, rearing parents have become working ones, young parents have become more stressed and isolated; and we may have failed to rear our children effectively.  Furthermore, we may have started to chase the wrong goals, or goals which are out of reach.  We have exposed ourselves to ever-increasing work and social demands while turning our backs on mutual interdependence.  In the west we have gained much more personal freedom and material wealth, but at a cost.’   

We are not built to go it alone- I know this from my own experience of an isolating episode of depression.  My family have been my loyal tribe and taken care of me.  However, my inability to engage in wider society or reconnect with the friends I used to know has left a scarring void in my life that feels as unnatural as it does paradoxically instinctive for an introspective depressive.  This is crucial: mental illness is not just a burden for the individuals or their families that suffer, it is reflective of the society we have built and the effect that it can have on us.  The social breakdown, health and wealth inequality, binge culture and the Three Cs- Consumerism, Competition and Celebrity Culture- that we see in our cities and towns and on our televisions all affect our mental health.  Social mobility had stalled and is now in reverse.  A working-class ethnic minority kid going on to become Prime Minister is about as likely as any single sperm connecting with the coveted egg- it will happen against the odds eventually, as it did with Obama, but that doesn’t mean the system is fair.  These damaging phenomena are a monument to the unfettered market that has ruled our lives for three decades and has captured the leadership of all three major political parties.

It is widely acknowledged that the policy of ‘Care in the Community,’ which has been pursued for the last thirty years, represents progress to a more humane approach compared to the large Victorian asylums.  These imposing buildings were conceived of more as quarantines where the uncomfortable truth of “madness,” an ever-present throughout human history, was sealed off as an act of segregation.  This is a rare instance where the Thatcher government should be given the credit they deserve for a progressive reform.

However, despite this change in focus and political language (which suggests a more inclusive approach to caring for the large numbers of mental health “Service Users”) the reality is still oftentimes one of isolation, stigma and neglect if not outright abuse, either within NHS services or in wider society.  By accepting that sufferers of mental illness are a part and not apart from society, we must now accept that aspects of our society are contributing factors to our dire problems with our mental health.

The glaring void across the political and media debate is some recognition that the complex and multi-layered causes of mental illness can no longer be attributed solely to the individual.  It cannot just be their burden for a dysfunctional family life or some innate weakness.  We must instead acknowledge that a significant factor leading to our higher levels of mental disorders compared to other wealthy nations is the scarring and widening inequalities that are an inevitable consequence of our “brand” of capitalism.  Equally damaging is the widespread ideal in our society that we must all fret and compete over varying states of perfection which are invariably unattainable (or undesirable) chimeras, be they the perfect house, car, job, appearance or status.  The economist Tim Jackson writes in his book, Prosperity without Growth, ‘We are persuaded to spend money we don’t have, on things we don’t need, to create impressions that won’t last, on people we don’t care about.’

The public realm and, in my opinion, the public good have been systematically dismantled and undermined by a cross-party consensus of government economic policy.  The neoliberal mantra of ‘private: good, public: bad’ has ring-fenced large swathes of the economy as beyond regulation.  If the supreme aim of every country is to create an amenable environment in which to do business then the wellbeing of the citizens of those countries can never be more than an afterthought.  This leaves us with government measures in health, crime, education, immigration and environmental policy being largely a thankless task of trying to clean up a mess predominantly wrought by an economic system that fosters inequality, promotes greed and narcissism and propagates that all human meaning resides in the relentless pursuit of material wealth.  I prefer the argument for helping people to lead healthy and meaningful lives but even those with the reductive and wholly economic view of human affairs must deduce that it costs much more to deal with the effects of these problems than it would to begin to tackle them at root. What kind of mixed message do we send to children when the Health Secretary meets with fast food corporations to draw up policy and the England Football Team are sponsored by Mars chocolate bars?  And how will we explain to our grandchildren why we have a national carbon footprint three times the size of our country’s foot?  It is time that politicians were honest that their own ideological dogma is the straitjacket preventing real change from breaking through instead of conducting debates on the margins over minutiae.

Exhaustive research by eminent epidemiologists Kate Pickett and Richard Wilkinson for their fantastic book, The Spirit Level, reveals that more individualistic and unequal societies have higher rates of mental illness as well as crime and prison rates, overall health, gender inequality and social mobility.  They write, ‘There are big differences in the proportion of people with mental illness between countries.  In Germany, Italy, Japan and Spain, fewer than 1 in 10 had been mentally ill within the previous year; in Australia Canada, New Zealand and the UK the numbers are more than 1 in 5; and in the USA more than 1 in 4.’  These rates correlate accurately with how wide the gap is between rich and poor in the countries named.  Their contention is that mental illness is closely related to status and more particularly status anxiety within society and therefore more unequal and callous countries leave more people marginalised, more ‘losers.’  

Such high levels of mental illness mean that it is no longer an issue that can be brushed under the carpet.  Is there anything else which affects 1 in 4 people and touches nearly everyone’s lives which is so ignored or misunderstood by politics or media?  I think that those are the kinds of ratios which demand that we as a culture begin to re-examine our attitudes and language towards the concept of madness or insanity.

  The fact that there is a cross-party consensus over draconian welfare cuts shows us how politically acceptable it is to attack the most vulnerable and voiceless.  When a company like Atos Origin is allowed to undertake its outrageous assessments of the physically and mentally disabled with impunity it shows a culture that has lost its compassion, its humanity and its priorities.  

Sufferers of mental and physical disabilities can be forgiven for believing that whoever we vote for, we always lose as the choice is between three shades of the same ideological dogma.  This is why websites like The Broken of Britain are so important, so that a group of people who have been consistently ignored and discriminated against can join together, exchange stories and speak as one.


Visually Impaired said...

I have to agree with you about all your comments.

I am visually impaired and suffering from severe depression. Almost suicidal in nature. I am currently going through the mental health system. An im surprised by how little compassion there is especially for mental health.

So what helped me get worse you ask. The dwp and it's idiotic way in that it allots contracts to people like A4E who failed to help me as they were clueless. The fact that they still provided me with small print documents despite me asking for large print documents. It shows they ignore the person and just see the person as pound signs.

The DWP stopped me from seeing a specialist advisor who was with a charity that was looking after me and my needs for free and sent me first to a4e and then beacon who were well meaning amatures but it really upset my routine. They tried having me sanctioned but this failed.

On 1st of september saw a specialist mental health person who instantly refered me onto a full blown psychiatrist, she said you have enough on your plate without having to look for a job.. Im so lost and despite me b eing open with the dwp they have ignored me and my needs.

Michael Richmond said...

Thanks Visually Impaired. I'm sorry to hear about your health problems. I know how tough severe depression is but I can't imagine how your visual impairment must impact you on top of it. To pressurise people who are having to cope with so much into finding work as if that's the cure to all things is inhumane but sadly indicative of our culture.

Someone, a single individual, should be continuously co-ordinating your care and helping you to navigate the DWP and save you some of the stress. DWP, A4E, ATOS and all those other accursed acronyms see no humans, only numbers because public services have been financialised across the board. The principles of The City have seeped into our entire society so that human wellbeing is expendable and seeking profit is the only goal.

I can only hope that you get the help you deserve and that things start to improve for you.

Iti said...

Mental health is often underestimated to be nothing but mental weakness.

It is such a disgrace that people of similar biology fail to understand the complexity and sensitivity of human brain; and its capacity. The one and only reason for the existence of non-sufferers of this severe disease is that their lives have, not yet, been touched with suicidal circumstances and the triggers they bear.

It is high time people realise the seriousness of this illness and the effects it has on its victims, who by the way, are mostly unaware of its intensity and as a result surrender to the belief that it is a mental incapability, rather than a disease, as dangerous as a heart failure.

Barbara Kirk said...

I was under A4e in Wakefield and now I realise it wasn't leading me anywhere. All I got out of it was updating my ECDL through Dove Employment & Training.

Recently I was seen by an ATOS assessor and have been told I'm fit to work. The assessor saw my physical capabilities and not my mental health problems.