Can we all please stop complaining about being miserable and just get on with it? That seemed to be the gist of Mel Stride’s recent remarks on the state of the nation’s ongoing mental health crisis. According to the work and pensions secretary, the mainstream conversation around mental health may have gone “too far”, leading to people self-diagnosing what are, in his mind, the “normal ups and downs of life”.
To add material insult to injury for those of us who experience mental health problems, in the same interview, the minister unveiled a new and dangerous plan to push 150,000 people with “mild” conditions back into work. It’s really very good for our wellbeing, he argued.
There’s virtually no evidence to back Stride’s sweeping claims, which scapegoat disabled people and thinly veil a cold-hearted government cost-cutting measure. While we might all be able to describe elements of work that help us feel well – for example, camaraderie with co-workers, or feeling we have a sense of purpose – work is also responsible for much of our suffering in contemporary life.
In 2022-23, 822,000 British workers reported work-related stress, depression and anxiety. Currently, one in four UK workers are in “low-quality employment”, or, put less euphemistically, a “bad job”. Given these conditions, it is particularly harmful to people’s wellbeing to push them into work when they are not ready or able.
As a result, mental health service user groups have been protesting about back-to-work initiatives for decades. Take the Mental Health Resistance Network, which in 2015 resisted a government pilot that would station therapists at jobcentres, describing the move as “forced treatment” for benefits claimants. The group wrote: “We should not be put under pressure to look for work unless we feel capable. The competitive, profit-driven and exploitative nature of the modern workplace is not suitable for people whose mental health is fragile.”
And yet, there is an intimate historic relationship between mental health and the economy, with the state deciding who is considered “legitimately unwell”, and moving people in and out of that category, in line with economic demands. In 2009, after the economic crisis, “workfare” came to the UK, a Victorian workhouse-like scheme that sent benefits claimants on a compulsory (and, of course, unpaid) “journey back to work”.
When it comes to “treating” our mental health, again, money has long been the main consideration. We can see this in the government’s emphasis on the mental health crisis as primarily a financial burden, and the NHS’s ever-increasing focus on cost-effective treatments, such as medication and cognitive behavioural therapy, that quickly get people back on the production line.
As a result, we should be highly critical of the ways that economically motivated ministers choose to diagnose and treat the problem of widespread suffering. This also applies to Stride’s comments about people “self-diagnosing” with mental health problems. This is something that young people, in particular, are frequently lambasted for, with critics suggesting that we are overpathologising ourselves. Millennials and generation Z are often framed as work-shy, or as falling out of employment due to a failure to pull ourselves up by our bootstraps or accept the demands of modern life, rather than any “real” illness.
But in the sphere of mental health, the definition of “illness” has always been highly contested, and shaped by the political world – most crucially, the extent to which our distress affects our productivity. The word “work” appears in the Diagnostic and Statistical Manual of Mental Disorders (a tool frequently used for psychiatric diagnosis) almost 400 times, reiterating the extent to which mental illness is defined by its impact on the market. Considering this, we should be supportive of attempts to reassert agency over how we define our own mental distress, as well as how we choose to respond to it.
With regards to the latter, people with lived experience of mental ill-health and distress can tell you what they need. It is certainly not more demonisation of disabled people, who have for decades endured allegations of “scrounging” and “malingering” in order to get state support in a failing system. Nor is it the removal of these benefits, which are a crucial lifeline for many people who experience mental distress. As a friend who has supported disabled people through benefits applications told me: “It’s so hard for people to get everything in order … the evidence, support, applications, appeals … it’s a complete insult to say it’s too easy to get benefits. So many people are suffering and dying because of the system.”
Rather than taking away life-saving support, there is an urgent need to address the drivers of mental illness. According to mental health service user collective Recovery in the Bin, “intolerable social and economic conditions”, which include poor housing, poverty, deteriorating working conditions, discrimination, racist social institutions, rising rates of homelessness, strained public services and, of course, a punishing benefits system, all demonstrably harm people’s mental health.
The work and pensions secretary refers to the “normal ups and downs of life”, but there is nothing normal about the decades of neoliberal austerity that have decimated communities and left many people to fend for themselves. The conditions we currently live in are maddening, and being stripped of benefits and pushed into low-paid, precarious work will offer no respite from this. It is not the conversation around mental health that has gone “too far”, but more than a decade of policies that harm the most marginalised, and then punish us for suffering.
Micha Frazer-Carroll is the author of Mad World: the Politics of Mental Health, available via Pluto Press
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