Welfare Reforms and Mental Health – Denise McKenna

A speech by Denise McKenna from the Mental Health Resistance Network (MHRN) at the “Welfare Reforms and Mental Health – Resisting Sanctions, Assessments and Psychological Coercion” conference on Saturday 5 March 2016, organised by MHRN, Disabled People Against Cuts and Alliance for Psychotherapy

I’m so pleased we are having this day to talk about, and to plan, our resistance to the neoliberal Welfare Reforms that are being imposed on us. We all know how much suffering they are causing. As well as planning strategies we want to explore how mental health service users, or survivors as we call ourselves, can campaign most effectively with psychologists, therapists and other mental health professionals. This might include how we interact together and how we best use our unique experiences, skills and positions to strategise our resistance. Perhaps we can explore how we cope individually with having this repugnant ideology forced on us in what is fast becoming a totalitarian society. For some benefit claimants coping can literally be about staying alive.

To set the ball in motion for this conference I want to say something about how the campaigning issues of survivors have changed in the past decade or more. I am speaking from the perspective of a survivor and a benefit claimant. I want to take you back to the early 1990s when I first became involved in the survivor movement after a few unhelpful admissions to psychiatric wards. As you might know, the survivor movement opposes the medical model of mental distress and has been campaigning for decades for care to be provided from the perspective of a social model. We have also been fighting the power imbalance between healthcare provider and service user, an imbalance that is enshrined in law; I’m referring to the Mental Health Act. This imbalance was compounded for me by the fact that I am working class and many psychiatrists and psychologists are middle class. Anyway, whatever our backgrounds, survivors who rely on benefits are usually living in poverty.

I was a member of the hospital user group then and had become an expert in the minutiae of inpatient life. In about 2004 I went to a Labour Party meeting with a fellow survivor to ask the councillors to visit the acute psychiatric units which were in their constituency to see how bad they were. One councillor was sympathetic so we arranged to meet her in the hospital user room and show her around. When she arrived she wasn’t alone; she was with a senior hospital manager. The councillor’s attitude towards us had changed; she no longer wanted to see the wards. She was hostile and told us we should be out working instead of, I quote, “sitting around smoking and drinking coffee all day”. As it is, I have never smoked and don’t drink much coffee, although it’s commonplace for survivors to be accused of excessive smoking and caffeine consumption. There is some truth in that accusation; I think it’s called self-medication. Anyway, from her behaviour I knew that something significant had changed.

Soon we were being bombarded with back to work propaganda from the New Labour government. Our local MP, Harriet Harman, even came to the hospital to give us a lecture on it.

I had worked in the past but in recent years had been a revolving door psychiatric patient. No one at the hospital was suggesting that I return to work; on the contrary they were busy sectioning me and giving me drugs and ECT. Anyway, I knew that I was now in a predicament; unable to work and uncertain that my benefits would continue. I wasn’t the only one in this predicament. In the mad community people come and go, some leave the system and move on, some kill themselves and others stay for a long time.

There was soon widespread panic about the back to work sword of Damocles hanging over our heads. The survivor movement had been looking inwards, preoccupied with psychiatry. We were suddenly confronted with the outside world and it seemed at the time that the fight against organised psychiatry had to be put on the back burner.

Soon, the user group was closed down and user involvement was controlled by managers at the hospital which was now a Foundation Trust. Over time day centres closed while the press were going crazy demonising us for being scroungers and liars and we were still being pumped full of powerful drugs. Loads of people were discharged from secondary care and left without support. People were isolated and in 2008 many started losing their benefits.

In 2010 the Tory/Lib Dem coalition came into power and we knew things were set to get much worse. That December a couple of us called a meeting with other survivors and we formed the Mental Health Resistance Network. At first we were just campaigning to have the Work Capability Assessment (WCA) scrapped, thinking this was our main problem. We took the DWP to court in a judicial review which was about them taking responsibility for obtaining further medical evidence for mental health ESA claimants. We won the case, although not in its entirety. The WCA was found to “substantially disadvantage people with mental health problems” but there was only a recommendation for the DWP to remedy this disadvantage, not an order to do so. The DWP agreed to set up a pilot to test the suggested reasonable adjustment to remedy this disadvantage. Two years later we are still waiting for this pilot to start.

During the court case the DWP fought hard against us but at the same time they did passport loads of people into the support group of ESA. All the indicators are that this happened for two reasons, one, because Atos was struggling to keep up with its workload and two, because questions were being raised in court about the low numbers of people being put into the support group, so even though we haven’t yet changed the WCA lots of people did benefit from the case. It was a strike against the enemy that hit two important targets at the same time, one we were aiming at and another unexpected one!

Eventually we linked up with campaigners with physical disabilities, however we felt like phoneys; many of us didn’t identify as disabled. Also, we had slightly different issues with developing our own social model. Nonetheless it was one good thing to come out of all this; we were finally out of the isolation of the psychiatric system, at least as campaigners.

I mention this history because I want to emphasise the enormity of the shift we have already made in campaigning. We are now out in the world standing side by side with other oppressed people. We always knew that the medical model of what they called mental illness was based on denial of the social context of our distress and that that denial served a political ideology. We knew that mental distress was caused by social factors, poverty, discrimination, domestic abuse, bullying, and so on and we weren’t convinced that the chemical imbalance in the brain story was the whole story or even any part of it. We also knew that the big pharmaceutical companies were behind a lot of the drug pushing. We were arguing for our pain and madness to be contextualised.

As the attacks on the welfare state started to come fast and furiously, the wider political context of psychiatric abuse came into view more clearly. Now the causes of all our problems were deemed to be due to something within us as individuals, not just the biochemistry of our brains but our rotten genes, our stinking thinking, our moral failures, our bad attitudes, our laziness, and our choices, above all it was about our choices. Bear in mind that this refers to many people who have suffered sometimes horrendous abuse and misfortune as children; to talk about choices is the ultimate insult.

Psychiatry had been unable to bring an end to much mental distress. It wasn’t curing us. Survivors came up with a Recovery Model which was about finding fulfilment in our lives on our own terms. However this model was stolen from us, transformed, and used against us. It is re-presented to us as being about changing our attitudes and all the other negative things we are guilty of. The sole purpose of the Recovery Model now is to move us away from the benefits system and pretend we are moving towards work. It has no therapeutic purpose.

Recovery could now be interpreted as a drive for conformity which means being compliant in our own subservience to neoliberalism, to be grateful to our oppressors, submission and humiliation being built into this notion of recovery. There’s a Mickey Mouse Recovery Star used to measure the areas of our lives that we have to work on to get better, apparently it measures our progress. People are resisting this twisted version of Recovery, I’m thinking of the Recovery in the Bin group, and there is a growing Mad Studies movement now. RiTB has come up with a brilliant Unrecovery Star that measures all the social causes of mental distress.

I am not an academic or a political expert. I am just one of the people that the neoliberals have little need for other than as part of a reserve workforce to be used to drive down wages and working conditions, and as a possible example of what can happen to you if you don’t submit to the demands of their preferred society. I am fighting for my life and for the lives of my friends. But I hope it doesn’t sound too dramatic if I say that I am also fighting for what it means to be human and to be civilised, for how we value ourselves and each other. I am fighting against the lie that the only value to be found in our lives is as workers making the rich even richer. We have higher purpose than that.

So let’s just recap on the position we find ourselves in. Conditionality means that if we don’t perform impossible tasks we are sanctioned and face destitution. And the benefits system is now conflated with healthcare. First our distress is decontextualised, it always has been, and then we are then told that one of the consequences of our distress, our unemployment and need of benefits, is the source of our distress and not a consequence of it. Our unemployment is now the context that affects our mental health, so having first been removed from its social context, our distress is now being re-contextualised into a false social context. It is our unemployment that now needs to be cured. When we see our healthcare professionals we are guarded in everything we say and do; we are walking a tightrope. We have to pretend we believe in something we know to be a lie. We have to fake feeling positive even when we are suicidal; pretend all we want to do is work when what’s really on our minds are terrifying thoughts, voices and strange experiences. On the one hand we have to show a positive attitude not to be sanctioned while on the other we have to talk about how bad we feel in order to try to get the money we need to survive. And all the time we have to make a show of loving our abuser who we really hate. It’s a complete head-fuck! We are being driven mad.

By turning psychology and the caring professions into weapons of abuse the government is trying to destroy the institutions that help to uphold our values, our empathy and respect, and even our love for each other. As though it’s not enough that they want to abuse us, they want to delegate the abusing so that we abuse each other. We have to fight to save the integrity of these professional and academic disciplines. I don’t think it’s too extreme to say they are trying to annihilate our humanity.

Anyway, back to the here and now! It is an honour to have the opportunity to work with psychologists, therapists and other professionals. In the past, for many of us, our dealings with professionals have often taken place within the power imbalance I mentioned earlier, with us as the weaker partner. We must remind ourselves that we are now working together as equals with professionals while at the same time remembering that society still sees us as lesser. Our views don’t seem to hold as much weight. The professionals’ area of expertise is still deemed more valuable than ours. Sometimes the system has even tried to infantilise us and society has only been interested in our lives as sensationalism, a kind of prurience. Part of the battle for us sometimes is just being able to hold our heads up high.

I know the professionals here today do not want a power imbalance, you want a true partnership and we welcome that. We are all harmed by the systems that support capitalism. It is not just benefit claimants who have something to lose if we fail to jump through degrading hoops; professionals are at risk too, we need to be aware that there are many people who feel they can’t put their head above the parapet for fear of losing their livelihood. It would be too easy for those of us who are unemployed to feel that our suffering is worse. We may be closer to the edge than those who are able to work, but we are all vulnerable.

Neoliberalism has been proven to be a failure for the majority of people and the idea of personal culpability, decontextualising everything in our lives, is central to forcing people to accept something that is harmful to them.

We can continue to speak up to try to bring about the mind set changes that we all want and that is an ongoing activity that we are all engaged in. I still like the old fashioned term, “consciousness raising”. We can also make the imposition of their ideology on us impossible to manage. We need to become impossible to manage. Finally we need to be realistic, live in the day and try to help those at risk to survive the assaults.

Today is a day to begin planning our strategies of resistance and I know there are loads of great people with brilliant ideas here in this room. I think it’s going to be a fantastic conference, I’m really excited. Thank you.

Denise McKenna
Mental Health Resistance Network (MHRN)

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