Today is World Mental Health Day, and the theme for 2018 is ‘Young People and Mental Health in a Changing World’. In reading the coverage of the event, including the official Twitter feed, it is noticeable that the framework of debate has been kept studiously apolitical. Discussion has centred on ‘breaking down stigma’, with a poll on the best way to do this showing enthusiasm for ‘awareness/education’ massively outweighing support for research, extra funding, or policy change.
When it comes to raising awareness though, it is fair to ask exactly what it is we are being made aware of, and why. And these are inherently political questions. Definitions of ‘mental health’, and the relationship between various kinds of emotional or psychological distress and ‘illness’ have been constantly contested throughout history. Particularly since the mid-twentieth century, so called ‘medical’ models of mental health and illness have increasingly been called into question.
Rather than an accident of biology, heredity or neurochemistry, voices from across the political spectrum have argued, mental ‘illness’ is best understood either as a consequence of, or a reaction to, an individual’s social circumstances.
How we define mental health matters, because the solutions we propose to the problems associated with mental illness will differ according to what we think it is. Even within ‘social models’ of mental health and illness, prescriptions for solutions will vary widely according to political persuasion.
On the right, the removal of psychological problems from the scope of medical intervention might be used to justify cutting services available to sufferers, stressing individual responsibility for one’s situation over the state’s duty of care. Liberal critics of over-medicalisation, meanwhile, are largely constrained to offering remedial measures – focused again, in their own way, on individual development – that leave the broader structures of social injustice largely intact.
In my new research project, funded by the Wellcome Trust, I look at groups for whom the solutions to the problems of mental health lay in a radical, revolutionary re-ordering of society as a whole. For these people and organisations, the psychological conditions designated as ‘illness’ by psychiatry, and regulated as such by the state, were in fact the necessary and inexorable result of capitalist social relations in an advanced industrial society. The only way to deal with the emotional distress experienced by large swathes of the population, they argued, was to empower them to resist – and eventually, to overthrow – the entire edifice of capitalism and its political institutions.
The origins of this radical strain of mental health activism, I hypothesise, can be found in two – on the face of it unrelated – developments in the mid-1950s. The first was the appointment of the Percy Commission in 1954 and the 1959 Mental Health Act which resulted from its recommendations, initiating the end of the Victorian asylum system, the expansion of community care, and the integration of psychiatric services within the NHS.
In the same period, disillusionment with Soviet-style communism following successive shocks to the international left over the course of 1956 saw the flourishing of a vibrant ‘New Left’ in Britain, opening up of new avenues of radical politics beyond the traditional domain of class struggle, embracing feminism, anti-racism, gay liberation, the peace movement and other causes.
It is in this dual context, I argue, that a radical, anti-capitalist mental health activism was able to emerge. Outside of the asylum, like-minded mental health survivors were able to meet and organise more easily, while the flourishing of left-wing politics beyond purely economist horizons opened up mental illness as a potential field of struggle that could be usefully linked to other battles.
The Mental Patients’ Union (MPU), established in 1973, is a good example. Founded at the experimental, co-operatively run Paddington Day Hospital in London, the MPU articulated a wide-ranging social model of mental health that was unambiguously anti-capitalist, putting forward a programme that linked the struggles of mental health survivors to wider issues of poverty, unemployment and housing.
An early MPU publication argued that psychiatry ‘is one of the tools that capitalism uses to ensure that frustration and anger against the oppressive system is internalised. It is time the mental patient fought back and joined other oppressed groups in the class struggle.’
The 1960s and 70s saw similar movements emerging in United States and Europe – notably in West Germany and in Italy. While never dominant within mental health organisations in Britain – and often met with scepticism, or outright hostility, from a broader organised left – these groups nonetheless had an influence that has largely been overlooked by historians of both mental health and the left.
Over the last decade, in the wake of the global financial crisis, the UK has once again seen a resurgence of activity on the radical left, while at the same time, the stresses of the recession and the cuts to services by Conservative-led governments have seen mental health issues newly politicised. Not only has the MPU’s spirit of radical self-organisation been newly reignited in groups like Speak Out Against Psychiatry, Recovery in the Bin and the Mental Health Resistance Network, but – with the leftward turn in the Labour Party leadership, and the introduction of a new Shadow Ministry for Mental Health – the radicalisation of mental health discussions within the mainstream of British politics has become a genuine (if as yet underdeveloped) possibility.
Not only – as the literature accompanying today’s event notes – are adolescence and young adulthood often associated with life changes which bring particular vulnerability to psychological or emotional distress, but in the UK, young people have also been disproportionately affected by austerity, and – from the student movement to Corbynism – a significant motor of progressive and radical politics.
If the potential of this moment is to be grasped, it will require going beyond the paradigm of awareness-raising. It will mean re-learning the lessons of activists in the past, and listening to campaigners in the present. On the left, we will need to take mental health seriously as a field of contention, while as mental health campaigners we will need to go beyond a surface critique of stigmatisation to interrogate the structures of unhappiness, distress and injustice that undergird our society.
Steffan Blayney is a Wellcome Trust Research Fellow in History at the University of Sheffield. He is a member of the editorial team at History Workshop Online and a co-organiser of History Acts. Twitter: @SteffanBlayney