Covid, capitalism and mental health
Max Bacharach, mental health worker, Hackney Socialist Party
Covid poses the "greatest threat to mental health since the second world war", according to the president of the Royal College of Psychiatrists. "As many as ten million people, including 1.5 million children, are thought to need new or additional mental health support as a direct result of the crisis".
Covid-19 has caused widespread anxiety, stress, panic and depression; reactions to the fear of the virus, conditions of life under Covid-19 restrictions, and the economic consequences of the pandemic. We see more specific traumas and effects too: Post Traumatic Stress Disorder (PTSD) in frontline staff treating patients for severe acute respiratory syndrome, the condition Covid-19 can cause; PTSD in patients admitted with this condition; grief at the loss of loved ones; and at the loss of livelihoods and of ways of life for millions.
Compounding all of this is the already existing economic and ecological crisis we're living through, which the pandemic has only highlighted and intensified, unbearably in some cases. It's no wonder a common presentation in young people today is hopelessness, overwhelm and a feeling of powerlessness and isolation in the face of the local and global situation. This often leads to self-harm, an increasingly common feature of contemporary capitalist societies, and tragically, all too often, to suicide. To this we could add addiction, substance, sexual, behavioural and a plethora of other psychosocial problems and difficulties, increasingly early in onset.
One in eight UK adults now receive a prescription for antidepressants each year according to the British Medical Journal. Stats are similarly stark elsewhere, with poverty and poor mental health closely indexed.
I have worked as a disability support worker, recovery support worker, and most recently as a wellbeing practitioner in the NHS. My role is, as part of a psychological therapies team, assessing and treating large numbers of patients for 'common mental health problems'. In my training year alone, which ended last autumn, I conducted over 400 assessments and treatment sessions - often leaving me knackered, burnt out and grasping for time at evenings and weekends.
Workers must organise
Mental health services in the NHS often overlap with those provided by third-sector and community organisations like Mind and Rethink. Sometimes these organisations are contracted to do NHS work at lower cost and because the NHS increasingly doesn't have the staff. Workers in these third-sector services should get organised in their trade unions, alongside those of us employed by the NHS, demanding a 15% pay rise. Ultimately, these outsourced services should be brought back in-house as part of a fully public, democratically planned NHS.
Hospital trusts - rocked by Labour privatisation, Tory austerity and ongoing capitalist theft from the public purse - have been overstretched and over capacity for decades. The problem of poor mental health in society has been with us for decades too. It's not rocket science: nursing shortages, now at an all-time high, especially in mental health; the steady loss of hospital beds; the increasing prevalence of pharmacological, as opposed to more expensive psychological treatments; community services shrinking and closing; social provision deteriorating; benefits tightening; and so on.
Mental health workers face a perfect storm of increased suffering and decaying provision; made worse by the sustained attacks services have faced through a decade of austerity. Mental health services, and the NHS as a whole, must get a huge increase in funding to reverse the cuts, and expand services to meet needs. This should include access to free, high-quality counselling and therapies, without being forced to wait for months or years to get treatment.
We need a mass recruitment drive of staff to provide services, offering decent pay and a decent work-life balance. This means strengthening the unions in the workplace and, as part of that process, transforming the leadership of the health unions to lead a real struggle to defend our NHS. Training bursaries for staff also need to be re-established and extended alongside a write-off of student debt.
Things are so bad that we even have Tory MPs complaining about the state of services. Ex-health minister Dan Poulter, who is also an NHS psychiatrist, said in October that "urgent action was needed to tackle the archaic state of some mental health facilities... The condition of many inpatient psychiatric wards is well below the standards that we would expect in other parts of the health service. Sometimes as many as ten patients have to share a single bathroom or toilet, and many mental health wards are in a poor state of physical repair.
"This is frankly unacceptable and needs to be urgently addressed, but a chronic lack of funding for mental health services has left many mental health providers without the funds to deal with the problem and invest in badly needed inpatient ward improvements".
What Poulter, who does not believe "striking as a doctor could ever be justified", fails to mention is that it is his party in government that has inflicted years of attacks on the NHS and the working class as a whole - increasing the social problems and suffering at the root of mental health crises.
Anxiety is a daily experience for most working, and unemployed, people in some way. Capitalism inflicts mass misery and frustration on whole populations beholden to wage slavery, debt and declining living standards; not to mention war, poverty, climate breakdown and disease.
It will be collective action, on a mass scale, that leads to the transformation of the conditions of humanity, and with it to fundamental adjustments in the human condition. It cannot be left to the somewhat futile, if occasionally successful, fire-fighting interventions of health and care workers like me, tasked with the impossible.
To end the pandemic of mental ill-health we need a fully resourced health service. But we also need to fight to materially improve the lives of the vast majority of people. This means raising the minimum wage to £12 an hour as a step to £15, with benefits increased in proportion. It means a mass council house building programme and democratically capped rents to give everyone a home they can afford. It means a transfer of wealth from the super-rich to the working class, by taking into democratic working-class control the big companies and banks as part of a democratically planned, socialist economy to meet the needs of all.
The system discriminates - we need democratic public ownership of mental health services
Simon Horn, Cardiff West Socialist Party
I've got ten years' experience working in the supported living care sector. We support people for 18 months to two years once they are released from mental health units with the prospect of entering back into the community.
The people we work with have been diagnosed with various conditions, usually have complex needs, and often have a criminal history. I've been doing this type of highly skilled work for ten years. We deal with medication and have to restrain clients, but are only paid minimum wage.
Like me, a majority of the care workers in the sector are BAME, but I look after very few people of colour. Mental health can often be viewed as a family issue and help not sought. Still, black people are four times more likely to be detained under the mental health act than white people. In February, Moyied Bashir, a young black man in Newport, was killed in his own home after his family called the police looking for assistance as Moyied was experiencing a mental health crisis.
Many police officers have negative stereotypes of young black people, made worse by negative portrayals in the media. For the police officers called to Moyied's home, it is likely they already had a racist bias. This means they were less likely to see a black man having a mental health crisis, and more likely to see a young black man acting aggressively - compounding their prejudice.
In my experience, when the police respond to a mental health call, regardless of the person's race, they are heavy-handed with their approach. I have seen clients being tasered unnecessarily. And with regards to BAME people, the approach of the police is already heavy-handed regardless of mental health.
When I worked in Splott, a diverse working-class area of Cardiff, I worked with a black gentleman with complex mental health needs, and on one occasion we had to call the police. The client was behaving in an intimidating way. The moment the police arrived, they were ready to take him down. They tried shouting at him to lie down on the floor but he wouldn't listen. If it wasn't for my colleague's intervention they would have taken him down - and this was a man in his late 60s.
I've seen in other situations, where the circumstances were exactly the same and the only difference was that it was a white client, that the police are happy for us as mental health professionals to take the lead dealing with the situation.
Apart from me, none of my workplace is unionised, so there is no workers' representation to challenge management. I see people from all over the world in agency work, abused financially with zero-hour contracts, losing their shifts at the drop of a hat.
In the past, people receiving mental health care experienced institutionalisation, now it is corporatisation. It's now not a government that abuses the system, it's the corporations doing it. The system needs an overhaul. It needs to be taken out of disgraceful bidding wars between local authorities. It needs to be back in public ownership with democratic oversight.
We need investment for a generation of trauma-affected children
Rachel Lyon, Primary School Support Worker, Waltham Forest Socialist Party
The pandemic has had a significant effect on the health and wellbeing of children. Working as a school support worker I have seen this first hand. Children in my class repeatedly ask me things like: "Do you have Covid?" and "Will my Nan die?"
Children of keyworkers have attended school withdrawn, quiet and emotionally shaky, with a lot of questions that need to be addressed, as well as the stress experienced by being separated from many of their peers. The effects of extended social isolation for those children who have not been attending school will become increasingly apparent in the next months.
At the start of my career I was trained to implement the Every Child Matters (ECM) framework. Following this document is supposed to ensure children are safe and healthy, manage to enjoy and achieve, and can obtain economic wellbeing. These aspirations are ingrained in my practice, but have been at odds with reality during the pandemic.
The ECM looks to make parents and caregivers responsible for the ultimate wellbeing of the child. But I believe that, through the pandemic, the negligence now lands firmly at the feet of the government. Children are being driven with a constant focus on attainment, in underfunded schools, and without a plan to address their mental wellbeing.
During the period of lockdown our school timetable has a work-camp mentality and a structure that fails to consider the needs of children under stress. Without appropriate release, or means to process this stress, children can suffer long-term trauma.
The government and education secretary Gavin Williamson seem hell bent on driving children to 'catch up' academically. How can they insist on high levels of attainment, at the expense of all else, in a shell-shocked Britain? How will this government, that has let us down in so many ways, begin to address the healing that needs to take place in schools?
I believe we need to see a change in the curriculum now, to put our kids' health over assessment. I believe we need shorter core lessons, workshop approaches, positive behavioural interventions, Personal Social Education sessions, counselling opportunities, mindfulness and yoga, if we are to begin to educate what will undoubtedly be a generation of trauma-affected children.
Union pressure works
Under pressure from Marcus Rashford and the National Education Union, the government caved in and provided some funding for laptops for children, and free school meals during the holidays. We need to push now more than ever for initiatives to address our children's fragile mental health.
We need investment to increase staffing and resources. We need smaller class sizes. We need high-quality, low-rent, social housing that really gives children the chance to grow in a happy, thriving environment.
We need a new party of the working class to fight for this. As a working class we are deprived even before we leave the womb. From there we are then sent to the front line whether as a worker or a child, because the capitalist economic wheel can't stop spinning! We need a socialist society that puts children's wellbeing before the interests of the super-rich making profits.
In The Socialist 5 May 2021:
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