Yes we need more resources in mental health but not the same old ‘diseased’ bio-psychiatric medical model of mental ‘illness’ and mechanistic Cognitive Behavioural Therapy, but a social-social public health preventive model of mental distress/health, health workers who firstly tackle the social determinants of health and work amongst the people where the social is not forgotten.
No one is denying the reality of mental distress, also mental distress needs twenty times more resources than at present, but the question is “what type of resources and interventions?” Does anyone ever stop to analysis why mental health issues are occurring. What is the cause that causes the cause to become a cause? Is it diagnosis which is so wide e.g. DSM5, that everyone is now mentally ill? Is it iatrogenesis? Is it the ideology of austerity? Is it the treatments with so called anti psychotics and anti – depressants? Is it coercive mental health laws? Is it unfairness, poverty, inequalities? Is it abuse and discrimination? Is it a cruel state, poor working conditions, deregulation and privatization? is it individualising, psychiatrising, psychologising existence so that the social, political, economic, materiality and broad environmental issues conveniently disappear? Is it capitalism, society, which causes so much mental distress? Why are so many people internalising their own oppression, harming themselves? Why not externalise their distress come to voice. There are many people who would like to work in mental health but not one dominated by psychiatry and mechanistic CBT.
Psychiatry is a pseudoscience with a faulty epistemology and wrong, very wrong, ontology. What is a human being – not just DNA or neurochemical selves. Humans are social beings and how society is socially, economically politically and environmentally (SEPE) arranged influence much including mental health and distress.
Many people who go into the psychiatric system have just normal emotions, reactions to situations, e.g. bullying, all forms of abuse, power-over, lack of autonomy and control, alienation, homelessness, trauma, unfairness and poverty. Many have been drugged (iatrogenesis doctor induced illness) into psychiatric services as Whitaker (2010), clearly and with evidence illustrates over the last sixty years people have been medicalised and damaged. Psycho-trophic drug giving has ‘sky rocketed’ leading to an explosion of chronic mental health and physical disabling conditions. Q if the drugs are so good why has chronic mental health conditions increased so much in the last 40 years – madness. No one is denying the reality of mental distress. People suffer suffering is not an illness. Psychiatry is a marriage of convenience with neo-liberalism, big pharm, corporations, governance (control of the populace) – a form of ideological hegemonic power.
Surely all the children in USA/UK now medicalised with toxic drugs aren’t all mad? Did the children ask for these drugs? Do all women and the poor placed in institutions by husbands, families consider themselves mad, are all the Jews exterminated by German psychiatrists in T4 camps did they consider themselves mad? Are all BME groups labelled and tortured by psychiatry would they consider themselves mad? The Soviet dissidents tortured in Russian and sent to gulags would they consider themselves mad? Are all the people getting on in years and particularly women given electric shock at alarming increasing rates are these people mad?
When you listen to people who have experienced abuse, rape, power-over, poverty, trauma including psychiatric trauma and psychiatric rape, experienced a cruel state, would they consider themselves mad? Maybe nearly driven mad but that’s another issue.
What can be called mad is a biological and genetical, nonsense aetiology which still prevails. When in the 21 st century today’s scientists are aware of epi-genetics and that genes get switched on and off and are influenced by social economic political broad environmental issues including poor diet. The genome studies again have found no conclusive findings for biological explanations for mental distress. Mad is the four ideological myths of psychiatry (chemical imbalance, 1960’s marketed drug ‘illness model of drug action, pseudoscience of diagnosis, biological biomarker myth) and the reality of coercion and iatrogenic mad practices. Another madness is the invention of illness DSM and all classifications, fabrications of psychiatry. Thinking that psycho-trophic drugs will cure mental distress is another madness. Nor providing the social determinants and the prerequisites for health and wellbeing is mad also really a crime against humanity. Psychiatry is a crime an industry of death.
Some people state it is naïve to want to abolish psychiatry without putting something in its place – to abolish psychiatry is a necessary prerequisite for change and it is naïve not to want to do this. Replace it with more doctors of medicine MD’s, they are trained to deal with health problems – adopt a new approach to mental health, a public health approach, adopt community preventative medicine, not dualistic but holistic including changes in SEPE – increase resources for mental distress twenty times fold – not less resources but more. Have a 100% state funded NHS, have no private provision in NHS, have a national work occupation health service in all organisations to promote health and reduce mental distress. But don’t have a national sickness service have a health service. More up – stream public health measures preventing and enhancing health, a more just society, reduce relative income differences, introduce a universal wage. There are numerous alternatives – open dialogue, exercise, social solidarity, Hearing Voices Network, peer groups, Sorteria houses, dial house in Leeds, activity for life, retreats, safe spaces, quiet spaces, night cafes, more social engagement, better healthy workplaces promoting autonomy control and income and so on. Adopt a social model of health and mental distress tackle alienation. Just stop abuse. Maybe social transformative change has to occur before psychiatry is abolished? Just think if annoyed, angry, discontented, irritable, unhappy, grief stricken, miserable people, put upon people, people disadvantaged, ‘down depressed’ people, agitated people, traumatised people, abused people, decided to use this energy as a catalyst joining alliances to change things, demand a less abusive fairer society, that would upset the status quo.
This author acknowledges the reality of serious mental distress which needs resources but the crucial question is what type of resources. It also acknowledges that some people are happy with present day mental health services and drugs but others are not. Many people are trapped and damaged by the drug regime.
If you get rid of the ideology of psychiatry and psychiatry itself, there will be less stigma more possibilities. One can easily make a case that capitalist society makes you mad – isn’t education mad, testing children, pressurising children, labelling children – too much I.T and social media pressure, too much computer time, sedentary children inducing future public health ‘time-bombs’- isn’t this madness?
These are not just issues of the past. They are happening now and will happen in the future if psychiatry isn’t abolished. We are drugging people and damaging them, some drug use will still be required, there is a role but use the correct drug induced model of drug action, be truthful with people and use drugs with extreme caution and only mainly short term. Electric shock, psycho-prisons, Community Treatment Orders, harmful mental health laws are still used. Human rights violations are very much still rampant. So who is mad? Surely not the people, surely not children and the poor, not the politically constructed ‘race’ people. It isn’t psychiatric neglect but SEPE neglect, social justice neglect, materiality, power and resources neglect and psychiatric abuse. It is also an abuse that there is very little resources for mental distress but these are decisions made by people in power with vested interests in the status quo. Just think how much money we could save without a pill for ever ill. Just think how many people could be saved from chronic disabling mental health conditions, how many children could be saved. This money could be used in mental health on alternative schemes and up –stream public health to prevent health problems.
Here is the crux many people have a vested interest in psychiatry, and the psych industry unfortunately they are also very powerful in a neo-liberal state and the ideology of individualism, a form of social control and it’s an ideal way to make profits.
One person with a similar aim and viewpoint – Bonny Burstow (2015) her latest excellent book Psychiatry the Business of Madness: an epistemological and ethical audit advocates an abolitionist approach.
Revision after consulting the public in four workshops and 14 discussion groups have recently come up with a manifesto for change which will be launched in 2017
Revisions Manifesto’s seven visions for change:
- To move from a ‘diseased’ bio-psychiatric model of ‘mental illness’ to a social model of mental distress/health. We need for a different approach ‘grounded’ in social fairness, listening, equity and social justice.
- To stop using all psychiatric diagnostic and classification systems
- To recognise what we need to achieve good mental health :
- Income, family, friendships, a safe home, opportunity, work, leisure, the arts, spirituality – plus many more which should be defined by individuals and communities themselves.
- Recognise oppression in all its forms and develop strategies to combat these at the individual and structural level.
- To understand that medication does not and cannot ‘cure’ mental distress.
- To work towards socially orientated and democratically accountable types of mental health service provision.
- To stop coercion – abolish Community Treatment Orders, ban electroconvulsive therapy and urgently review all mental health laws.
- To challenge the current crude neo-liberal economic system that creates a fertile environment for ever increasing mental distress.