
Marjorie Wallace (Saneline) has joined the foray into the latest discussion regarding mental health services in Britain today. This after the new president of the Royal College of Psychiatrists, Professor Dinesh Bhugra will deliver a damning indictment of the services in his inauguration speech on Wednesday.
Wallace reiterates the same old myopic argument she has been using for years about how it was wrong to close psychiatric hospitals and instead focus on community mental health teams. I have always thoroughly disagreed with Wallace and the politics of Sane and this latest from her makes no difference. Mental health has always been at the bottom of the financial pile and a Cinderella service. Yet what kind of mental health system do we want? Wallace always harps on about on about the old days (would she really mean it with the good old days?) of the psychiatric system where it meant those who would relapse had the knowledge that they could admit themselves to hospital whenever things became intolerable, and return home when they felt ready.
But were these hospitals or the political ideology of the mechanisms of these places something that ought to be championed? A sense of loss and a desperation to reclaim these old asylums? My own view is that the psychiatry, then and now is still rooted in a need for social control, conformity and coercion (the changes to the Mental Health Act, for example). Is the mental health user at the centre of the treatment, is her/his needs understood when vocalised? Or is it based on a very paternalistic notion that shrink knows best? And indeed the over emphasis of medication that acts like a panacea for all society’s ills. The commodification of mental distress under this society means any old pill is chucked at us as a quick fix. A bio-chemical and deterministic understanding ever presence in mental health and psychiatry. Science has advanced in many ways yet psychiatry is still wedded in a type of medievalism. A kind of taking a sledge- hammer -to -the -television- when- it -isn’t- working -to -fix -it mentality (a case in point is the use of ECT).
Psychiatry rarely treats people as human beings instead we are reduced to specific criterion, behaviour, eventual diagnoses and labels. And as psychologist Lucy Johnstone argues psychiatric diagnoses are social judgement lacking scientific objectivity. The psychiatric system is fraught with power relationships and is ingrained with institutional racism, sexism and homophobia. The system reflects the oppression that exists within this society. Mental distress is on the increase due to the fragile and precariousness of life that includes debt, misery, job insecurity, pressures, oppression, poverty and so on yet psychiatry sees this increase in a social vacuum.
I believe in asylums, but my interpretation is different to Wallace’s understanding of the term. I believe there should be safe places people can go to which isn’t based on social control but based on the needs of the mh user who is able to define his/her needs on their own terms and a equal relationship between staff and user not this imbalance of power that exists between staff and user. That leads to mistrust. RD Laing was right when he said psychiatrists observe as opposed to listen.
I believe in a system that treats people with respect and understanding as opposed to vilification, social control and stigmatisation. And to go beyond a bio-medical understanding of mental distress (I don’t totally rule out medication because I do think there is a dialectical relationship between the social and the biological). There is a hell of a number of people out there who will experience mental distress but it is still hidden. It is not something people feel able to be vocal about. And a system, contradictorily, that desperately tries to “normalise” vulnerable people yet only too happy to turn a blind eye to what the powerful in society get away with.