The Covid response exemplifies how solving complex public health problems requires both individual and collective efforts. People have protected themselves individually by washing their hands, socially distancing and wearing masks, but none of this would have been achievable without a coordinated social effort from our communities, the NHS, the government, and the media.
The creation and delivery of a vaccine within a year, a miracle of international cooperation and one of the greatest scientific triumphs in history, is another example of how collective efforts are needed to promote well-being. A collective global mindset is also required to distribute vaccination to poorer countries and thus reduce cross-border infections.
The counterpoint to all this – and one that runs through the DoH’s Mental Health Strategy – is that success and well-being come principally through individual efforts and individual responsibility. “The fault, dear Brutus, is not in our stars but in ourselves, that we are underlings”. If people could only pull themselves up by the bootstraps, this position claims, they could have good mental health, good wages, a good life. As Margaret Thatcher put it: “There’s no such thing as society. There are individual men and women and there are families.”
Offering to improve mental health services in such a climate is akin to hosting AA meetings in the Guinness Brewery.
This political philosophy leads to under-investment in the welfare state, schools and hospitals. Handouts, bank rescues and tax-breaks to the wealthy expose the hypocrisy of this position – some of us are more individual than others. Worse still, this philosophy promotes isolation, inequality and insecurity, “austerity ills”. Governments that promote such policies are actively legislating for poor mental health. Offering to improve mental health services in such a climate is akin to hosting AA meetings in the Guinness Brewery.
Better funding and better organisation for mental health services is greatly welcomed. Under the right circumstances timely, prompt access to high quality interventions can make profound changes and improvements to people’s lives. For some clients therapy will be enough to promote individual change and lead to a better quality of life.
But for many disadvantaged clients, therapy is a sticking plaster for a gangrenous wound. No amount of therapy can reduce the very real anxieties of living below the poverty line, or the fear of losing one’s house or job. Individual effort is not always enough to produce lasting improvements in well-being. All of us, politicians included, must commit to changing our society and its unhealthy fixation with the excesses of individualism, rampant free-market capitalism and an addiction to economic growth at all costs.
Psychologists for Social Change recognises that we need to create a society that causes less emotional harm to its citizens. There are five qualities to a psychologically healthy society: agency, security, connection, meaning and trust. While it is positive that the DoH’s Mental Health Strategy emphasises the need for “promotion, early intervention, prevention and family-focused recovery”, therapeutic services can only form one piece of the jigsaw of recovery.
Case study examples of greenway development, investment in Sport Well-being Hubs and Employment Support are a good start towards investment in social programmes. However the strategy fails to address government policies that actively damage our collective mental health. “Promoting Wellbeing and Resilience”, the first theme, needs to begin with failed governmental policies of austerity and other toxic approaches in education, healthcare and housing.
Consideration must be given to:
- Addressing insecurity in the benefits system – poverty, loss of benefits and the draconian insensitivities of PIP tribunals are linked to poor mental health. Universal Basic services and Universal Basic Income should be investigated as a psychologically and economically healthier model than our current system.
- Addressing young people’s emotional well-being in schools – high-pressure testing in schools, both through GCSEs and the current Transfer Test situation in NI, are damaging both to mental health and future career prospects. Real learning should be promoted instead of fear.
- Addressing housing insecurity and the impact of the housing crisis – laws enabling councils to build affordable housing directly, protections for tenants and rent controls.
- Addressing precarious employment – ensuring all jobs pay a living wage, and ending the uncertainty of living wage contracts.
- Addressing loneliness – investment in community-owned and community-led activities.
- Promote our connection with nature – encouragement and subsidising of outdoor activities and more green spaces.
- Promoting the importance of the climate crisis, investing in green technologies and weaning our country off fossil fuels.
- An emphasis on marginalised communities and how they are unequally affected by problems with mental health.
Dave Rogers is a member of Psychologists for Social Change, a network of applied psychologists, academics, therapists, psychology graduates and others who are interested in applying psychology to policy and political action. We believe that people's social, political and material contexts are central to their experiences as individuals. We aim to encourage more psychologists to draw on our shared experience and knowledge to engage in public and policy debates.