The Politics of Madness

When community mental health care was first ‘sold’ to the public, it was packaged as a democratic, liberal, modern idea, which naturally suited a civilised, progressive society like our own. Dissenting voices at the time warned people that governments usually favoured policies which supported their own interests rather than anything else, and that ’community’ mental health care policy would prove to be no exception.

And they were right.

Discharging people into the community was in theory less expensive than maintaining the old Victorian hospitals which, by the 1980’s, often needed major renovation works. Under the Community Care Act (1990) government agencies were intended to have a much lower (and cheaper) profile, leaving families, charities, neighbours and friends to play a more prominent part in helping the unwell person ‘recover’ in familiar, homely surroundings. In reality, community mental health services have expanded into legions and their harassed members are still having to run around like plate balancers at a circus, striving to keep the myth of social integration half-alive.

It was expected that ‘self-reliant’ service users would help to support themselves practically and financially, even to the extent of contributing to the inland revenue and providing a little bit of extra demand in the market place. They were pictured as happy, successful capitalist citizens, leaving behind the backward communal worlds they had previously inhabited and the unwanted socialist ideas on which they were based. In reality, the financial burden has simply passed straight across to Local Authorities and state welfare agencies, who distribute millions in aid to masses of largely dependent service users, living on open-ended benefits, demonstrating socialism at its worst.

It was assumed that individualized care would prove to be the most effective therapeutic approach, because it emphasised the idea of self-improvement, dovetailing nicely with the individualism of modern society. This would stop policy-makers and clinicians wasting time on the fictitious social and cultural causes of mental disorder, such as inadequate socialization, gender/class/culture conflicts, secularity, materialism, alienation and community disintegration. Instead, there would be cohorts of beautifully rebuilt ex-patients coming off therapists’ couches, achieving their challenging personal ambitions in a perfectly conducive social world. In reality, the social fabric has rotted away to threads, many ex-patients can’t cope with their individual isolation, there is more recorded mental disorder than ever before, and now even the policy-makers can sense it.

There was certainly method in the government’s madness.
But madness in the method……


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