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Mental Health Is a Political Problem

Mental health is often framed in individual terms with individual solutions – but rising levels of depression, anxiety and stress across society make it clear that we need political answers.

Britain—like much of the rest of the world—is in the midst of a mental health crisis. The country entered its third lockdown in early January after daily Covid cases topped 60,000, and while lockdown has been an important measure to stop the virus spreading, both it and its economic consequences have also taken a psychological toll. The NHS reports that mental health services are under severe pressure; suicide rates are at a 20-year high, and moderate to severe depressive symptoms are estimated to have almost tripled for those in the 16-39 age category.

The British media has covered this secondary crisis extensively. ‘UK ‘sleepwalking’ to mental health crisis as pandemic takes its toll,’ warned the Guardian in October, following up with ‘Covid poses ‘greatest threat to mental health since second world war’ two months later. The BBC ran a segment on the mental health crisis among students at universities. Even the Daily Mail has been covering the issue, cautioning in January that ‘Lockdown is creating ‘unprecedented’ mental illness pandemic with surge in calls to helplines.’

The media’s coverage of mental health during the coronavirus crisis marks an opportunity to challenge 40 years of belief about what causes mental health problems, and how to fix them. Mental illnesses, the dominant narrative goes, are chronic health conditions caused by malfunctioning neurochemistry, and in some cases, problems within one’s family. The gold standard of treatment is some combination of therapy and medication. And seeking out that treatment is nothing to be ashamed of: after all, would you be ashamed to carry an inhaler for your asthma?

The asthma comparison is actually incredibly apt – just not for the reason most people making it might think. Asthma may be chemical at the individual level, but it is political at the population level. In the United States, for example, it occurs disproportionately in poor communities of colour, who are often forced to live near highways, waste processing facilities, and heavy industry.

People in these communities have breathing problems caused by their asthma, but their asthma is caused by the political conditions of the broader society. An inhaler can help sick people at an individual level, but a better solution would be figuring out how to create a society that doesn’t force some of its members to breathe toxic fumes.

The same patterns can be seen in mental health issues in Britain, which often follow existing inequalities. BAME people and poor people, for example, are more likely to suffer from mental ill-health than their white and wealthy counterparts. These groups have also faced the worst of the Covid crisis, both in terms of infections and mortality rates and in terms of the economic fallout.

This means that any serious attempt to address mental health issues will not be made at the individual level. The way society is organised at present creates huge amounts of stress, anxiety, and trauma. There is a pervasive sense of hopelessness and despair. People turn to drugs, alcohol, and online shopping for relief. Things were bad before, but the Covid pandemic and its social and economic effects have made everything exponentially worse.

The solutions to this situation are beyond the boundaries of what is normally considered ‘mental health treatment’. We must create a society where people can thrive: a society where people have their basic needs of food, housing, healthcare, and job security met, but also a society where people feel loved and valued, and where people have free time for pursuits that make their lives meaningful.

I am hardly the first person to make such an argument. The late theorist Mark Fisher spoke out against what he called ‘the privatisation of stress’, whereby a neoliberalising society creates more stress at the individual level and then encourages people to treat that stress individually and medically, rather than collectively and politically. And in 2019, Dr. Dainius Pūras presented a report to the United Nations stating that the best way to combat the global mental health crisis is through what amounts to social democracy.

‘Austerity measures did not contribute positively to good mental health,’ Pūras told the Guardian in an interview coinciding with the report’s release. ‘People feel insecure, they feel anxious, they do not enjoy good emotional wellbeing because of this insecurity situation. The best way to invest in the mental health of individuals is to create a supportive environment in all settings, family, the workplace.’

This is not to discourage anyone from seeking out therapy and medication at the individual level – medication and therapy can offer vital relief. But individual approaches are hardly efficient when the problem is occurring at a population level, and for many people, they don’t address the root causes of the distress.

‘Psychology talk is often a convenient means of sucking out the politics which produce the sort of despair we’re experiencing today,’ psychologist Tarik Younis tweeted on 7 January. ‘Political or economic mismanagement (i.e. a rise in neoliberal policies) will inevitably be followed by widespread suffering and despair, especially for the underprivileged. We should therefore normalise saying this is a “political/economic crisis” and understand that mental health will follow.’

We need to seriously consider how to build a society that doesn’t make people so sick – psychologically or otherwise. That discussion is a political one. It concerns what kinds of policies will allow people to thrive, and what kinds of strategies are needed to get there. I hope the media can start talking about that, and not about a mysterious, simultaneous failure of brain chemistry.