Issue 175 of SOCIALIST REVIEW Published May 1994 Copyright © Socialist Review
Hazel Croft's article 'Past Caring' (April SR) was excellent and timely. However, as someone suffering from a 'psychotic' illness, I wish to add a further angle and to qualify the assertion that we are no longer 'stigmatised by society and cast aside'.
It is true that 'inadequate care' results from underfunding, but in days when more money was spent on mental health it was part and parcel of a repressive ideology of psychiatry which still predominates.
It is not simply a question of more resources but also, as Hazel suggested, of the form of treatment. More funding could still mean more people labelled 'psychotic', more people detained unnecessarily, more locks, more chemical straitjackets, more unnecessary electric shocks and more tyrannical or incompetent doctors, psychologists, social workers and occasionally, I'm afraid, nurses.
In addition to the suffering caused by illness, I have endured blatant and unredressable discrimination. I lost first my job then my home; I have been threatened with being locked up for the rest of my life; I have been detained against my wishes and, by means of subtle intimidation, without due process of law; my request for psychotherapy, instead of 'medication', has been opposed on the grounds that it wouldn't work, or would send me over the edge again (apparently I am not a person but a misfunctioning machine); my perception of truth has been denied or misinterpreted. I was first overwhelmed by, but now battle with, institutions that resemble those in a Kafka novel.
It is not just a matter of inadequate care by mental health services but also by society at large (those people who don't want to sit near you on the tube train).
We need not only care but understanding or, if we are incomprehensible, respect because we are people with potential that is thwarted and who struggle against a particularly hostile and (often to us) incomprehensible world. It is not only us that need to be cured but also the reality that has afflicted us from birth. As this is a social reality, a somewhat revolutionary treatment is called for.
Brin Price
York
The recent article by Hazel Croft, 'Past Caring', on mental health services, provides a welcome opportunity to debate progressive and socialist concepts of how to promote mental health in the 1990s. Unfortunately the article failed to do this, sticking mainly to the well worn arguments that appear in social work journals which essentially equate more resources for more psychiatry with better mental health.
I believe this is an erroneous position which in no way recognises that the problem of mental health services and their failure to deliver effective care and support is located in the services themselves. The very nature of psychiatry is biologically and genetically driven.
Secondly, there is the vested interest of transnational drug companies who make enormous profits by pushing highly addictive and physically damaging mind controlling drugs. This has led to a service that reduces human distress to symptoms that can be controlled by 'medication' and that considers increasing numbers of human behaviours dysfunctional.
This may sound polemical, but it is in fact the underlying problem and it is extending. In the US the so called 'Violence Initiative', a research programme launched by American psychiatry in 1992, seeks to find the genetic predisposition to violence in urban populations and to find suitable 'treatments' for families and children. Most of these families are black, live in circumstances of great social injustice and inequity and are being told that to rebel is to be ill. Forget social injustice as a cause of urban unrest, it's down to your genetic make up, don't change your environment for the better--we'll change you to cope with it better. Where have we heard that before?
The answer is back in the 1930s when psychiatry gave the Nazis the science to justify their 'master race' programmes against the mentally ill.
There are radical critics of psychiatry--Peter Lehmann's Against Psychiatry and Fred Newman's The Myth of Psychology, a Marxist critique of psychiatry. How about having a real political debate on the issue, rather than a well meaning but non-analytical account which perpetrates the same old myths.
Paul Baker
Manchester
I welcomed last month's article on Tory community care policy by Hazel Croft. Whilst some people with mental health problems have benefited from increased freedom and choice, for too many it means only the freedom to choose which cardboard box to live under.
However, I would like to comment further on the medication which controls the behaviour of people with severe mental health problems, and therefore allows their release into the community. These drugs are extremely powerful. Their side effects range from chronic fatigue and shaking to lack of concentration, dribbling and even brain damage or heart disease. Unsurprisingly, in some countries they are used to 'treat' political prisoners.
Since the side effects are so risky, you would think these drugs must be pretty effective in treating mental illness. Unfortunately this is not so. For example, since the 'accidental' discovery of chlorpromazine's 'anti-psychotic qualities' in the 1950s, the majority of recurrent sufferers have remained in psychiatric hospitals until recently. Research in the early 1970s showed no difference between the recovery rates of people treated with or without drugs. Even the medical theory on which the treatment is based is extremely weak. The basic idea is that mental illness is caused by biochemical abnormalities in the brain, which are corrected by drugs. But scientists are not sure how most work or which part of the brain different drugs affect. These drugs undoubtedly do affect mood, but then so does the weather.
The real reasons drugs are used to treat mental illness is that they are relatively cheap, act as a medical straitjacket for potentially dangerous people and, I'm sure not so coincidentally, provide huge profits for drug companies. There are other more effective treatments such as counselling, psychotherapy or psychodrama, but they are expensive. They also, unlike medical treatments, tend to see mental illness as something caused by society and explainable by an individual's emotional reaction to, and sensory perception of, traumatic experiences. This is something that the people who control our society would rather forget.
You might ask, wouldn't we be better protected by simply locking up the dangerously insane and the permanently baffled? Absolutely. The sooner we lock up the Tory government the safer we'll all be. Better still, let them choose which cardboard boxes to live in.
Daran McFarland
North London
Having been through the psychiatric system myself, I was very interested to read Hazel Croft's article on mental health and community care.
Informative as it was, the article failed to point out the difference in life experience between psychiatrists and their patients. This often leads to a harsher diagnosis for people who are working class, women or black. In my experience these people are also more likely to be detained for compulsory treatment under the Mental Health Act.
Also overlooked was the oppressive nature of the psychiatric system itself. This is not a problem of the recent past, but one of the present, and those doctors and nurses within the system are acting (however good their intentions) as agents of social control for the ruling class.
Finally, with the Tories' new 'objective' health test are we to see people living in the community forced into pitifully paid and meaningless jobs purely for the sake of saving money?
Dileep Bagnall
Blackburn
Richard Purdy writes (April SR) to reject the idea that an age of consent is 'of no use'. But his arguments are confused. Richard rejects the idea that individual cases need to be dealt with by looking at the circumstances of each case. To do so, he implies, would give greater discretion to judges and other agencies. However true this is, it does not amount to a defence of a legal age of consent. Who exactly enforces that? Is it not precisely the same people Richard is concerned about?
Secondly Richard insists (correctly, but abstractly) about the differences in power between adults and children and that the law has backed physical assaults on children. Precisely: the age of consent has done nothing to 'protect' children in this sense.
Thirdly Richard uses a traditional ploy of child protectionism by citing the extreme example of an adult and an 18 month old. In what way has a legal age of consent made this more or less likely to happen? Richard's example fails totally to give any arguments for an age of consent. He should look at the history of child protectionism and how it developed as a class measure of control.
As he says, and where we can agree, socialism is necessary for the young to develop in human freedom. Laws provide no protection, and will be used to penalise the young themselves.
Derek Howl
Leeds
It is obvious that no socialist would advocate the abolition of all laws ostensibly designed to protect children from physical and/or sexual abuse. Children and young people are oppressed in a variety of ways under capitalism, and they need protection.
However, Richard Purdie (Letters, April SR) seems to be saying that socialists are doing no favours to children and young people by advocating the abolition of the arbitrary age of consent laws. These laws are apparently needed to safeguard children from the specific threat of sexual abuse by adults.
No doubt they can be used to prosecute child sex abusers, but that is not their purpose. Richard is right to point to the inequalities in power between adults and children under capitalism, but fails to recognise that the age of consent laws are an expression of this inequality rather than its antidote.
Youth oppression is structured largely through the nuclear family. Ruling class morality baulks at the idea that young people can be sexually active outside of marriage. Criminalising sex involving those under 16--and now 18 for gay men--is but one more buttress for an increasingly unstable family structure.
The moral hypocrisy of the ruling class knows no bounds: they argue that teenagers are not in a position to make informed choices about their sexuality, and then deny them the right to proper health and sex education and contraception on demand. They believe that the age of consent laws protect young people from 'harm' when what is really harmful is not sex itself but sexual oppression, and the ignorance and confusion it often leads to.
Of course, the issue can never be clear cut--precisely why socialists must oppose an age of consent.
Rather than criminalising young people, we fight for a society where people can enter into sexual relationships on a free and equal basis, without fear of the consequences. Sex which is not equal and freely consensual--and that includes child sex abuse and adult rape--cannot and should not be dealt with by prescribing a blanket ban on sexual activity under 18 or 16, both at present and in any future socialist society. We can point to the example of the Bolsheviks two months after the successful workers' revolution in Russia in 1917. They abolished the age of consent.
James Drummond
North London
Stack on the Back has always been one of the highlights of Socialist Review. April's issue was no exception. Because Pat made so many excellent points, and did so wittily, it seems churlish to criticise. Yet the conclusion of Pat's article was, for once, a bit of an anti-climax.
Pat approaches, but then draws back from, the most important point. Contrasting the 'bludgeoning' David Blunkett is complaining about (pickets of his surgery, 'nasty' letters!) with the bludgeoning of gays which he voted for was the right thing to do. But imprisonment of some men whose 'crime' is to have sex with other men is only part of this bludgeoning--and not the most important part.
This threat has been a cause of anxiety for many gays and one consequence of Blunkett's vote is that it will continue. And, although large numbers have had this threat lifted, due to the lowering of the age of consent from 21 to 18, Tory backbenchers are demanding the law be enforced more vigorously.
Blunkett and the other closet bigots in the parliamentary Labour Party have thrown away an invaluable opportunity for millions of gays to gain the confidence to proclaim their sexuality.
So long as the law discriminates against gays people will stay in the closet--not just until they are 21 (or now 18), but for the whole of their lives.
If Blunkett and the rest of his cronies had shown an ounce of principle, they could have created the conditions for gays of all ages to take a stand against a tide of hostile public opinion.
Blunkett and co have not 'just' voted to make the lives of millions of gay people a misery; they have also thrown a lifeline to the Tory Party.
Tom Delargy
Paisley
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