People are living through a mental health crisis. There are 1.6 million people on waiting lists for mental health services and another 8 million who need help but can't get it. Children want to die at A&E.
There is a way to look at the crisis that doesn't place it in the medical system. It makes sense that so many of us are hurting. We are living in a world of uncertainty and trauma. The climate is breaking down, we're trying to stay on top of rising living costs, while revelations about the police murdering women and strip-searching children shatter our faith in those who are supposed to protect us
As a clinical psychologist who has worked in the National Health Service for a decade, I have seen how we are failing people by placing their problems within them as some kind of mental disorder or psychological issue, and therefore depoliticising their distress. Can six sessions of CBT help someone who doesn't know how to feed their family for another week? In a world where two women a week are murdered in their own home, branding people who are enduring sexual violence with a mental illness does nothing to keep them safe. Children who are navigating poverty, peer pressure and competitive exam-driven school conditions are more likely to be helped by the practice of meditation.
We wouldn't diagnose a plant with "wilting-plant-syndrome" We are told something is wrong with us when we suffer under unliveable conditions. Without acknowledging our hurt, to work and produce.
Mental illness is framed as an "illness like any other" in attempts to destigmatise it. Recent research shows that depression isn't caused by a chemical imbalance of the brain. Stigma and disempowerment are increased by suggesting we have a broken brain. The myth is so bad that it distracts us from the environment that causes our distress.
Individual therapy is great for a lot of people. I worry that a purely medicalised, individualised understanding of mental health puts plasters over gaping wounds and ignores the source of violence. We are encouraged to adapt to systems in order to protect the status quo. Black people living in a racist society are too often medicalised, labelled dangerous and met with violence under the guise of "care". Black people are more likely to be sectioned, restrained and over-medicated than any other group.
A lot could be learned from liberation psychology by the UK. It was founded in the 1980s by an activist and psychologist named Ignacio Martn Bar. People's experiences of oppression lead to suffering. Liberation psychology sees potential social actors in the project of freedom, rather than being forced into a white, eurocentric and individualism idea of therapy. Collective social action is used to challenge the causes of distress.
Poor people's mental health has been affected the most by the Pandemic in the UK. Is it true that wealthy white men don't suffer? It's true that they do. Structural issues affect our everyday lives and we are still learning about them. How the pressures of individualism and capitalism may lead to isolation and substance abuse, or how colonial violence towards immigrant families plays out within homes and on bodies are examples.
I don't think people in distress should be on the picket line. It's possible that pain can be disabling. Mental health workers have a key role to play in social transformation. Social action alleviates people's distress.
The housing and economic system need to be changed instead of trying to change mind sets. Recent studies show how universal basic income improves the wellbeing of people. Some of my most powerful work as a clinical psychologist has not been in the therapy room, but in advocating for secure housing for, or working in the community with, queer, black and brown people, to prevent gender-based violence. The network Psychologists for Social Change shows us how it can be done. We need social change that is preventative, such as investing in young people and community-led services. They work to shift trauma in marginalized communities through social action and creativity.
One-on-one therapy is part of my job. Therapy should be a place where oppression is examined, where the focus isn't to simply reduce distress, but to see it as a survival response to an oppressive world I would like to see a world where therapists aren't needed. The culture embraces each other's madness. It's where we take the risk of turning to each other in our pain.
Big changes can happen pretty quickly despite the fact that structural transformation won't happen overnight. The structures that are hurting so many of us will not be changed without us.
We need to look at our conditions. The sun safe, affordable housing, and easy access to nature are all possibilities for the water. Food can be community or social support services. Transforming the oppressive aspects of society would be the most effective therapy. Whatever support is available, we need it. It is difficult. If we were able to transform the soil, access sunlight, nurture our roots and have room for our leaves to unfurl, life would be a lot better.
Dr. Sanah Ahsan is a clinical psychologist.
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