Wednesday, May 17, 2017

Why Our Government Really Has No Interest In "Solving" The Kiwi Mental Health Crisis

Mental health has, over the last few years, become something of a hot-button issue in the minds of many. It's gone from being the sort of issue on the outer for which advocates have had to desperately raise awareness [think John Kirwan appearing on our screens to attempt to tell us that yes, depression and anxiety are actual things], through to one that is increasingly hard to ignore. Seemingly every citizen - and every political party - knows someone who's had a serious crisis, required hospitalization or a CAT team, or who would quite possibly still be here today if only our country did mental health treatment & support in a better, and better funded, way than is presently the case.

In train with this, this being an Election Year, there are no shortage of party-political broadcasts and press releases talking about how our elected leaders and their aspiring replacements would endeavour to seek to improve the situation. Or, in the case of the National Party, how folk demanding the proper resourcing of our mental health services sector are safely disregardable as "left-wing anti-government protesters". (which, as a matter of interest, marks something of a quantum difference from their stance in the early 2000s. Then, they held that 'talk and wait' was a totally inadequate response from the government of the day [Labour] to the country's worsening mental health situation. What a difference being in power makes.)

And, to be honest, if you've had much in the way of dealings with our mental health services over the past few years - and seen first-hand, with your own eyes the tangible effects of a $1.7 billion dollar funding-cut to these services and facilities, in a time of seemingly-exponentially increasing necessity & demand for them ... well, if you AREN'T feeling at least a little bit anti-government on the strength of that, then I really would be asking "where's your head at".

But having thought long and hard about it, it occurs to me that if we are to get serious about attempting to understand and go some ways towards ameliorating our eve-escalating mental health crisis, simply throwing more money at the problem can really only ever be a 'part' of the solution. The ambulance, or the hospital-bed at the bottom of the cliff, as it were.

And that's because the hugely increased salience of mental health issues out there in our community isn't something that's caused only by chronic underfunding of treatment services. Although obviously, this doesn't help.

Instead, the reasons why we now have more mental health issues than we did fifty or a hundred years ago are threefold.

First up, we now know a great deal more about mental health than we once did; and so are therefore better equipped to recognize it. Entire sets of conditions which were completely unknown [or, at the very least, not recognized as being mental health issues] in previous decades are now standardized and diagnosable thanks to innovations like the DSM [which I have my own issues with, for a number of reasons, but I digress]. Whereas once upon a time we regarded returned servicemen or combat veterans as simply suffering from 'cowardice', we now recognize PTSD as a serious and enduring condition, for instance. And many other examples besides.

Alongside this, increased awareness around mental health issues - both on the part of the general public, and by practitioners - has lead to reduced (although importantly, not eliminated) stigma, and therefore a greater number of people annually come forward to seek treatment for their conditions. Thanks to outreach efforts like the aforementioned John Kirwan campaign, tens of thousands of ordinary New Zealanders are now better appraised that things they've had to grapple with on a daily basis and which may have seriously disrupted the courses of their lives, are *not* simply 'the way things are' - and are instead, to varying extents, treatable or manageable with corresponding increases in quality of life.

That's something to be celebrated.

Although again, it is not the full story.

The main reason, I believe, why we are presently facing a 'mental health crisis' has rather little to do with either of these things. Although they certainly make it a little easier to gauge the scale of the harms too many of our population are currently grappling with.

Instead, what has caused such a powerful increase in people being afflicted with mental health disorders is our economic system. I am not kidding.

We already know that in cases where illnesses are not congenital or otherwise intrinsic to the individual sufferer's neurology, that particular conditions of life can cause or at the very least considerably exacerbate health conditions. Working down a coal-mine for sixteen hours a day will, almost inevitably lead to an array of negative health impacts in the lungs, and with things like Vitamin D deficiency, for instance; and lacking the money or the time to invest in proper nutrition is similarly correlated with reduced wellbeing. Labouring in constant fear of economic ruination due to parlous job-security or being unable to afford to keep your house thanks to the way the speculative market in property works ... also cannot be particularly healthy.

My contention is that the way we run our economic system - and thus, by extension, so very much of our society as a whole - is the metaphorical equivalent of consigning an almost impossibly vast segment of our population to working down that ideological coal-mine.

And therefore, that if we are seriously expecting much of our adult population to spend considerable proportions of their working week away from their families, in the absence of community, and subsisting in chasing seemingly ever-decreasing real wages lest they wind up condemned to the latter-day propertarian purgatory of finding themselves and their family forced to live in a car ... then this is quite plainly not the template for a healthy society.

If you want to find pretty much bona-fide causatory factors for the onset of mental illness, then significant stress, social isolation/atomization, and uncertainty are the de rigeur go-tos. They are also the aspects of the 'inhuman condition' living in our present economic environment. I would further add that the abrogation of an overarching sense of 'purpose' in societies which for some inexplicable reason still believe they're living after the 'end of history' have only worsened these things. We are, after all, capable of tolerating quite some suffering and discomfort in pursuit of grander and higher purpose - yet the only one of *those* which seems to be in the offing with the way things get 'done' today, is minuscule improvements in the company bottom line "curiously" never seem to 'trickle down' to the ordinary worker. Life, in other words, has no 'point'. Other than, of course, a somewhat frantic scrabble to 'survive', carried out in some of the most unnatural ways possible.

Fight Club (a fascinating exploration of mental health under late capitalism) probably puts this far more eloquently - in part at least - than I'll ever be able to, so take a brief moment to enjoy a seminal quote.

The expert evidence agrees with me. We are not living anything close to 'naturally', and therefore people are falling (mentally) sick as a result. We're simply not built nor evolved to spend so much of our time cubicle-bound and not cultivating healthy bonds with others. And the 'attempted solutions' proffered to us by the marketplace are fundamentally iniquitous in the extreme. Conspicuous consumption doesn't fix these issues (even if one could afford to do so in the first instance); squalid living conditions because that's all you can afford, and a toxic working environment because that's all you could find simply make things worse.

So as welcome as it is that we're FINALLY having a more strident conversation about beginning to more properly resource our mental health sector ... it is unlikely to ever be enough. Even presuming National somehow miraculously grew a conscience at some point between now and their next Budgetary announcement and put the full $1.85 billion being asked for into this part of our healthcare system, we'd STILL find ourselves with ever more New Zealanders winding up having to make use of those services. Because it wouldn't address the underlying causes behind the mental health crisis.

The economic ones derived from the choices which successive governments - whether Labour or National - have chosen to make over the last thirty years.

Ted Kaczynski - better known as The Unabomber - covered this topic in his Manifesto document. I do not endorse his eventual actions, and an array of elements in his published analysis are potentially somewhat askew; but in light of the notion advanced above, the following quote represents an interesting perspective:

" Imagine a society that subjects people to conditions that make them terribly unhappy, then gives them drugs to take away their unhappiness. Science fiction? It is already happening to some extent in our own society. It is well known that the rate of clinical depression has been greatly increasing in recent decades. We believe that this is due to disruption of the power process, as explained in paragraphs 59-76. But even if we are wrong, the increasing rate of depression is certainly the result of SOME conditions that exist in today's society. Instead of removing the conditions that make people depressed, modern society gives them antidepressant drugs. In effect, antidepressants are a means of modifying an individual's internal state in such a way as to enable him to tolerate social conditions that he would otherwise find intolerable. (Yes, we know that depression is often of purely genetic origin. We are referring here to those cases in which environment plays the predominant role.)"

Now, I have my own thoughts about anti-depressants. One of which is that for some people they can be pretty invaluable - quite literally life-saving, even. But the core kernel of the above is in accord with what I am saying. Namely, that our Government has very little interest in actually addressing what's behind many people's increasing experience of mental illness; and instead, is now talking seriously about investing SOME modicum of money in ameliorating some of the worse manifestations of these natural human consequences of neoliberalism, because it's easier to have a 'conversation' phrased in impenetrable bureaucratese [which, according to noted mental health campaigner Mike King, is pretty much what our Government seems intent on doing] than it is to engage in serious dialogue as to why they're not more open to reforming our economic system.

It's as simple as that.

Once again: I have absolutely ZERO issue with National, Labour, or any other party putting more money into our already-overburdened mental health services. This is vital, and it is to be welcomed and applauded as and when it actually turns up. [subject to whether further neoliberal idiocy is forcibly injected alongside it, of course...; and, for that matter, the seemingly-inevitable gap between the pittance which politicians are often keen to put in, and how much is actually required to deal with the present case-load let alone increases]

But unless we go past the issue of underfunding of our treatment services - start to have the serious conversation about what ACTUALLY constitutes prevention [which, as the old adage enjoins us to remember, is almost invariably better [particularly in these situations of mental health illness] than 'cure'], then we are only going to wind up having this exact same conversation once more in a few years' time, when the NEXT round of folk needing to use mental health services turn out to be so much vaster in scope and numbers than those whomst we've budgeted for.

Jiddu Krishnamurti once wrote that it was "no measure of health to be well adjusted to a profoundly sick society". At this stage, folk aren't even managing to do that, and so we've really started to lose sight of the important conversation of how to live /healthily/. Part of this is, arguably, by design. Because the path to 'health' - whether physical or more especially, mental/emotional/psychological - inevitably entails turning away from the trajectory down which our political-economy seems hell-bound to move as if in the grips of a teleological rapture. And therefore, if people are beset & riddled by health issues, and enervated from overwork or stress, with the organic bonds of community and solidarity riven asunder by the 'natural' pressures ... then they are considerably less likely to bother thinking about 'overturning the apple-cart'. Because they're quite understandably far more interested in seeking to scrape together the pittance required to purchase even a cast-off core from same.

I suppose all of this calls to mind - appropriately enough - a quotation from One Flew Over The Cuckoo's Nest.

"Have you ever speculated, Mr Harding, that perhaps your are impatient with your wife because she doesn't meet your mental requirements?"
"Perhaps, but you see the only thing I can really speculate on, Nurse Ratched, is the very existence of my life - with or without my wife - in terms of the human relationships, the juxtaposition of one person to another: the form, the content."
"Harding, why don't you knock off the bullshit and get to the point?"
"This is the point. This IS the point, Taber. It's not bullshit. I'm not just talking about my wife; I'm talking about my LIFE!
I can't seem to get that through to you!
I'm not just talking about one person - I'm talking about everybody!
I'm talking about form! I'm talking about content!
I'm talking about interrelationships!
I'm talking about God, the Devil; Hell, Heaven!
Do you understand?! Finally?!!"

That's pretty much where we're at here. I'm not just talking about an overhaul of the mental health system here - still much less simply twiddling around the edges a bit.

I'm talking about the very nature of our society. Its "form", its "content", and most ESPECIALLY its "interrelationships".

I will be genuinely surprised [and inestimably pleased] if any of our political class dare - as part of what's set to become this year's election debates - to name the specter whose rapacious possessionary antics have fed so perniciously into the mental health crisis of today.

But it is called "Neoliberalism".

And until we banish it utterly; it remains highly, regrettably unlikely that our peoples' conditions will seriously improve.

The Government, therefore, has absolutely no interest in "solving" [as opposed to "managing", I guess] the Mental Health Crisis for one very simple reason.

Because to do so - to really, truly, meaningfully do so - would be tantamount to abolishing themselves and all they stand for as part and parcel of the process.

It's as simple - and as complexly insidious - as that.

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