Mental health and welfare: a stamping manifesto

The tendency not to want to believe in mental illness festers across the Western world, and particularly in Britain, the nation that gave us Shakespeare, concentration camps and the stiff upper lip. From the friends and families of sufferers to the upper echelons of government, the suspicion that mental health difficulties are forms of weakness – simple personality flaws that could be eradicated if more of these mentalists would jolly well buck up – informs policy and influences behaviour. We need to look this institutional prejudice in the face and call it what it is: outdated, destructive and desperately unhelpful.

Over the past few months, I have interviewed a great many people suffering from mental health difficulties in the course of my work for the Independent and for One in Four magazine, and none of them are feeling optimistic about the New Year. All of them fear being forced back into work that they will not be able to cope with even if they find it; they fear government interference with benefits that they rely on for survival, and they are disappointed at the lack of positive changes the much-touted Welfare Reform Bill has brought.

In the face of what appear to be across-the-board rises in cases of serious depression, anxiety and other debilitating disorders, the response of our government in boom times has been to quietly shunt the sick onto a government poverty package and tell us to be grateful. However, as incapacity levels continue to rise, the DWP’s new Work to Welfare policy threatens to shunt us just as quickly back to the jobcentre, telling us that we’re scroungers who were actually making it up all along. This comes just as the little glut of crap menial jobs available before the stock market crash has disappeared. Nice timing, Purnell.

Many of the 40% of Britain’s 2 million IB claimants who are unable to work due to mental health difficulties already have a few problems with paranoia. But, as the noted social theorist Kurt Cobain observed, that doesn’t necessarily mean that they’re not after you. Because when any major political party talks about moving people off Incapacity Benefit, when they talk about instituting a system of interviews to ‘weed out’ benefit ‘scroungers’, we know that they’re talking about the mentally ill – those whose disabilities and challenges are most difficult to see and to quantify, often the poorest and most vulnerable members of society who have since Thatcher’s day been the first in the firing like when budget cuts needed to be made. I am, indeed, talking about Care in the Community, the policy decision also known as 'chuck the nutter in the gutter'.

Yes, there are more people receiving IB now than there were a generation ago. No, this does not mean that all of the extra people are skivers who’d rather sit around watching Trisha and drinking milkshakes. The sweeping social change that has transformed society in the past fifty years has led to an increase in the numbers of those deemed unable to work due to mental illness for many reasons. Not only has society become more treacherous and unpredictable and the working world more stressful (especially in stonkingly pro-market, anti-worker countries which exempt themselves from working time directives) but more men and women are expected to hold down full-time jobs which are increasingly focused in the service, information and fourth-sector industries, meaning that it’s more important for these employees to be entirely mentally and emotionally on the ball. Simply put: as the labour market is changing and becoming more mentally and physically stressful, the mentally ill, whose care has been successively eroded by government after neoliberal government, are being left out in the cold.

Mental illness is perhaps the subtlest and most frightening of all forms of social difference, because of its invisibility, because of the difficulty in quantifying it, and because it is not a binary condition: you’re not either mad or sane, there’s a whole spectrum involved. But the hatred and fear that the mentally ill face on a daily basis, the lack of understanding shown to them by the welfare state and criminal justice system, and the fact that they are perpetually the first targets of punitive budget cuts, adds up to a sum of institutional bias which belongs in a previous century.

Just look at Mind's recent report on mental illness within parliament itself. Twenty-seven percent of MPs, Peers and their staff have personal experience of mental health difficulty, and one in three said work-based stigma and the expectation of a hostile reaction from the media and public prevented them from being open about mental health issues. This is a problem that touches everyone, and it isn't going to go away if we collectively stick our fingers in our ears and sing a little song.

Employment law is another area where the Disability Discrimination Act has so far failed to translate into action when it comes to the mentally ill. The argument goes something like this: it’s more risky and more costly for company x to hire person y if they suffer from a mental illness – after all, how is company x to know that that employee y won’t fall behind on their work, start slicing themselves up by the water-cooler or march into the office one day spraying slugs of hot lead death into co-workers and clients? Simple ignorance is the first obstacle to greater understanding here: in fact, the mentally ill are statistically less likely to perpetrate violent crime, and far more likely to become victims of it. But a subtler prejudice against minorities is inherent to the hypercapitalist machine – because yes, it is technically less costly for a firm to hire an individual who is entirely mentally well. By the same logic, it is also better business sense to hire someone who is neither physically disabled nor a female of childbearing age. Yes, these people represent a financial risk to the company; no, this doesn’t mean that discrimination is a logical and acceptable consequence of that risk.

What happens when companies are allowed to set their own hiring policies purely on the basis of business sense is that a large amount of the nation’s talent remains untapped, and swathes of people who need to be in work more than almost anybody become dependent on the state. Individuals suffer, and the entire economic community suffers. Anti-discrimination legislation and hiring standards are not only essential for the advancement of true equality; they advance free nations both spirituality and economically.

The market, by itself, cannot deliver health, happiness and universal suffrage by treating people as commodity inputs. This is why, especially in a period of social transition like this one when our ideals and our economic and technological mores so often clash, government intervention is one of the only logical temporary solutions.

It is not enough for the Ministry of Plenty Department for Work and Pensions to demand that mentally ill recipients of incapacity benefit find themselves a job in an employment market which was highly suspicious of them in the boom times and which is now rapidly contracting. What we need if we are to avert a genuine crisis both in employment and in public health is a radical restructuring of what it means to be a worker in the information age.

It is also not enough just to whinge about current policy without suggesting viable alternatives. We’re not just holding jobs and having dinner: the point of progressive debate is to work out how to create the better world that we want our descendants to inherit. So, what would a world with fewer stigmas against the mentally ill look like?

It would be a world in which employers and businesses recognise that mental disability, like physical disability, does make it more of a challenge for an employee to carry out a job of work – and that those challenges can be surmounted with understanding and reasonable adjustments Fifty years ago, the idea of having ramps on public transport, in offices and public buildings in order to help the physically disabled participate in normal life would have sounded preposterous and wildly costly – now it is more or less accepted that the physically disabled have just as much drive to work and live as the rest of us, and should be aided in that goal. The same attitude needs to be applied across the board.

It would be a world in which flexible and part-time working is not only available but a respected and well-taken up practice required of all employers, in order to help the mentally disabled, the physically incapacitated and those with caring duties, including parents, to stay in appropriate work. It would be a world in which part-time work is supported by government benefits, allowing the hundreds of thousands of people with mental health difficulties who cannot cope with full-time work to participate more fully in the economic and cultural life of the nation.

It would be a world in which the many laudable grants, higher education places, work schemes and training projects set aside specifically for the physically disabled and other minorities are matched by similar schemes for the mentally and emotionally disadvantaged.

Last but not least, it would be a world in which, for as long as necessary, large businesses were obliged to take on a set quota of people with mental health difficulties – say one in eight, helping to reflect the one in four citizens who will experience mental health difficulty at some point in their life.

This is about socialism, but it isn’t just about socialism. It’s about creating a world that is fairer and more efficient, carrying every citizen with it. If the government really wants to leave no one behind – if it wants to move more of the mentally ill into rewarding, taxpaying work, rather than simply pare more fat from the already scrawny welfare state – we need to dare to dream of a society in which everyone can participate.

******

And with that, I'm going to go and excercise another of my dysfunctional coping mechanisms and have a little cigarette. I'd offer, but you wouldn't want one. It's fucking menthol *cackles*.