You look fine… you don’t need help!


Following a few comments on our Facebook Group, about how some of us were lounging about in our PJs on a Sunday afternoon, a discussion about how women’s appearance and behaviour can affect how we are seen and treated in the mental health system. Joanna said there was potential for a conference and research on the issue of women’s appearance in Mental Health services as it impacts on diagnosis, assessment of needs and risk.
So we decided to start with a blog post based on a couple of discussions in the Facebook group.


Joanna: ‘Dishevelled/smelly (I currently qualify) required for SZC/psychosis. [Joanna is currently waiting for a plumber to fix the water supply in her flat!]. Medical student told me that during her MH placement a psychiatrist said he knew if a woman had BPD “just by looking at her” and he referred to “too much eyeliner” or skirts being “too short”.

Joanna: Some women have been refused help because they looked ‘too smart’

AE: Many women I know need to dress well when feeling bad and put on make up in order to get the strength to leave the house at all. Like putting on a costume and mask to hide behind when in public.

Joanna: for some women putting on reasonable clothes, looking clean, bit of makeup has nothing to do with ‘care’ or function even. It can be as you say the only way to face the outside world. It can also be a protection because looking dishevelled actually draws attention. It might also be the only thing a woman feels able to do for herself taking a lot of effort

Michelle B: make-up has had the thumbs up that I am well enough if I am wearing make-up — this is a sexist thing make-up hair die and so on, clothes yes angry if in red yellow or other colours

Victoria: I will never forget a comment from a nurse when I was 17 – 17-“”you silly girl, you’re pretty, there’s no need to hurt yourself”….?!?!?!?

Anon: When I was 17, my first hospitalisation… From a nurse, “but you look like a model! You shouldn’t be in here…”

Deborah: The first time I saw my psychiatrist he said in front of the ward round that I was ‘an extremely attractive young woman” and then seemed to use it to negate my description of how bad I was feeling. Sadly from then on because I hated being called that and for fear of not being believed I looked after myself less and less, doubled in weight, barely washed by hair and only wore black. At least 15 years later (after I had moved 100 miles away, still had a couple of appointments with him a year but didn’t feel under constant scrutiny) I dared to wear something brighter and put on some lipstick. And yes, you’ve guessed it, he immediately said how much better I was!

Katy: I asked my friend to buy me prison-style garb last time I was in hospital coz I was being treated like a criminal offender or a thug…a nurse in the PICU braided my hair to complete the look smile emoticon

Lydia: In my craziest days I used to test out the system. If family claimed I was ill and I had to be assessed I used to wear something slightly outrageous and it would always be picked up on by a psychiatrist. (Shows I WAS off my head to risk that). I can’t tell you the number of times my appearance has been commented on in nursing reports though, and I have spent hours changing trying to decide what to wear to give a psychiatrist or social worker the right impression e.g. not red — he already thinks I’m angry. And that’s too bright = high. Lawd what a pain!

Joanna: Assumptions are made about women who self-harm in relation to their appearance and mental state. For example, “what’s a pretty girl like you doing this for?”, and “you’ve defaced yourself”

Joanna: Through to accusations of “flaunting” of the body if any scar is visible

Joanna: Weight and assumptions. It’s always assumed that any woman with an above “normal BMI” through to “morbid obesity” has a “good appetite”. I have seen friends in hospital going doolally through lack if nutrition but staff ignoring because of their weight & assumptions. Conversely, thin women harassed endlessly about eating.

Tincey: From ignoring weight as a factor to not understanding metabolism and stress, policing the body seems to occur (at least for women, can’t speak for men) across the board in medical or other services, along with moral judgement. I was seriously ill and having a lecture on being overweight, not taking into account the various factors involved (so common to have issues in PTSD and CPTSD). So many services still espouse the idea that it’s calories in/calories out and that it’s down to our beloved ‘lifestyle choice’ so lectures along the lines of everything will be fine if you stop being a pig — miracle cure.

Joanna: Not eating, weight loss, dishevelled is the correct appearance for women SUs

Sue: I rarely leave the house without full make up /extra defence mechanism/protective layer which apparently means all is OK. And I agree with the BMI thing-still not malnourished looking enough for help apparently and if I try to lose more weight to tick their anorexia boxes I’m obviously acting out using BPD attention seeking tactics.

Liz: My favourite thing I read about myself is that once in an appointment I “sat down very aggressively”

Liz: Oh I have long been told “clothing” part of my various pathologies, this is nothing new comrade……dark clothes all the same colour safer.

Lydia: I’ve always felt that my image doesn’t help. There’s some idea that I’m a quiet wallflower, which is clearly not the case, and the more I try to act in the way that’s expected the less I am me, but I’ve also tried being myself and it means a very long section. Compliance is the key.

We made the links between appearing smartly dressed and being perceived as articulate — professionals often mistake these as meaning the person is functioning and not in distress. Alternatively, articulacy can increase the risk of being diagnosed with BPD or confused with pressure of speech and hypomania.


Katy: My ‘articulacy’ was called hypomania…I told that shrink that I was not being hypomanic — it was my intelligence talking and if he could not keep up I’d talk more slowly for him !

Jane: Yeah I had pressure of speech because the psych reviews were less than 10 mins and he wouldn’t let me get a word in. So in 2 mins a week I was meant to cover everything.

My psyche has always commented on my being intelligent and articulate, and if quiet & less arsey would be more worried re mental state

Sandra: Also I think noting if had not bothered looking better dressed. GP frequently tells me her comments on my insight. Think can be misleading re how feeling

Sandra: Maybe we would all be shocked to see how we are perceived in notes by all profs

Joanna: “Insight” doesn’t = coping or not at risk. Every woman I’ve known who has died by suicide was intelligent & articulate & had “insight”. They just couldn’t get support.

Sandra: Yeah that the most scary when I have felt at real risk have been seen to be coping well.

Joanna: I’ve been considered suicidal when I haven’t & never been accurately ‘assessed’.

Sue: ”You’re obviously an intelligent woman-I don’t know why you can’t deal with your traumas in a more appropriate manner”
Joanna: Intelligence meaning that automatically means there’s no distress
Joanna: Why is this not said to Stephen Fry?
Sue: Because he’s rich and privileged
Joanna So only poorer intelligent people supposed to think their way out of distress
Sue: Yes and PD diagnosis = “at it”
Joanna: Intelligence = insight
Sue: Intelligence=insight=manipulation.

Anon: I can relate to this so much. One example I can give is phoning the (needless to say useless) CPN’s once when very distressed & suicidal, to be told “you’re an intelligent woman, you tell me: who’s in charge of your actions? Who’s in charge?” as if that would be “empowering” in some way…

Anon: Also being denied crisis care because I was “articulate” “intelligent” and “displayed good insight”… If you can describe your experiences of mentalness then you don’t need support. And if you can’t communicate them you don’t need support either, because “we’re not mind readers! ”

Anon: I came to the conclusion months ago that the only way to get support in a crisis is through actions, not words. Which obviously is incredibly risky. And “manipulative”

Sue: Being processed through the self harm team telling them I’m going to OD again without extra support and being told that’s my choice.

Sandra: Never ever be angry, because that is only behaviour of loons, don’t get angry with receptionists at CMHT who are asking bloody personal questions cos of course none of these ppl ever get angry fuck fuck

Joanna: Anger is particularly not acceptable from women & black men

Lydia: And swearing is not acceptable from “respectable” women which means I’m not. Maybe I need to clarify that with my psyche next time I see him.

Megan: I am struggling right now, asked several professionals for help and was told no as I was articulate. Spoke to Social Worker and Support Worker and they seen I was struggling and said it was completely wrong to judge my mental state on whether I am able to complete a sentence or not. AHHHH!

Michelle CM: My GP told me I was “intelligent enough” to grasp the concepts of therapy from a self help book so I didn’t need a referral anywhere.

Naomi: I have had issues with being too ‘open’ in that they thought it was part of my BPDness and I should be avoided…
Joanna: but if you had not been open you would have been failing to engage.

Jane: relating this to appearance/articulacy — for a woman even being polite but distant is not enough — you have to come across as ‘genuinely’ warm, respectful, deferential, of staff. Also sense that if you do behave positively/politely but staff don’t believe you share their views then you are regarded suspiciously as manipulating them somehow. I think this reflects something I once read somewhere — in psychiatry ‘compliance’ isn’t enough you have to be brainwashed too — employees/workers just need to be polite/do what they are told even if they don’t agree — psychiatric patients have to agree with what is done to them or they are asked to do — domination not just of the body but the psyche too


When women seek help from services, especially when in crisis, we are judged on what can be seen and rarely given the chance to explain our distress. Workers refuse to believe we can be as distressed as we are because we can look ok and we are not given the chance to explore what is really going on beneath the surface. We believe this is based on sexist and sanist assumptions and on the pressure on workers to refuse services to cut costs.

As Michelle said “people judge you by this idea of femininity rather than as a person”


These are excerpts from two long discussions – we have only included comments from the women who agreed to be included.
We have rearranged the order of the comments in places to make it read a bit more coherently.
The discussion also included some linked issues:

  1. sexual harassment and abuse within psychiatric services
  2. judgements on our sexuality – our sexual behaviour, relationship status and our sexual orientation
  3. the intersections between gender and race and class
  4. women’s experiences in forensic and criminal justice services

We think these deserve more discussion – look out for future blog posts on these topics.

Fuck Neoliberalism

Fuck Neoliberalism by Simon Springer, Department of Geography, University of Victoria

Email: Twitter:

Read the whole paper at


Abstract: Yep, fuck it. Neoliberalism sucks. We don’t need it. Keywords: fuck neoliberalism; fuck it to hell

Fuck neoliberalism. That’s my blunt message. I could probably end my discussion at this point and it wouldn’t really matter. My position is clear and you likely already get the gist of what I want to say. I have nothing positive to add to the discussion about neoliberalism, and to be perfectly honest, I’m quite sick of having to think about it. I’ve simply had enough. For a time I had considered calling this paper ‘Forget Neoliberalism’ instead, as in some ways that’s exactly what I wanted to do. I’ve been writing on the subject for many years (Springer 2008, 2009, 2015; Springer et al. 2016) and I came to a point where I just didn’t want to commit any more energy to this endeavor for fear that continuing to work around this idea was functioning to perpetuate its hold. On further reflection I also recognize that as a political maneuver it is potentially quite dangerous to simply stick our heads in the sand and collectively ignore a phenomenon that has had such devastating and debilitating effects on our shared world. There is an ongoing power to neoliberalism that is difficult to deny and I’m not convinced that a strategy of ignorance is actually the right approach (Springer 2016). So my exact thoughts were, ‘well fuck it then’, and while a quieter and gentler name for this paper could tone down the potential offence that might come with the title I’ve chosen, I subsequently reconsidered. Why should we be more worried about using profanity than we are about the actual vile discourse of neoliberalism itself? I decided that I wanted to transgress, to upset, and to offend, precisely because we ought to be offended by neoliberalism, it is entirely upsetting, and therefore we should ultimately be seeking to transgress it. Wouldn’t softening the title be making yet another concession to the power of neoliberalism? I initially worried what such a title might mean in terms of my reputation. Would it hinder future promotion or job offers should I want to maintain my mobility as an academic, either upwardly or to a new location? This felt like conceding personal defeat to neoliberal disciplining. Fuck that.

Read the whole paper at

Workfare Coercion In The UK

Workfare coercion in the UK: an assault on persons with disabilities and their human rights by Anne-Laure Donskoy, Survivor researcher, UK

“While there is a lot of focus on coercion organised and implemented in psychiatry, less attention is being paid to state engineered welfare measures based on libertarian paternalism, which have coercive practices at their core. Among them are policies that strongly support behavioural change using positive psychology and cognitive behavioural therapy. Freidli and Stearn (2015) call this “psychocompulsion”. These policies and measures are increasingly used to ambush and coerce persons with disabilities and the long term sick into adopting new ways of being and living conditions under the constant threat of sanctions. They have driven many to attempt to their lives. This paper builds on the work of Friedli and Stearn as an attempt to highlight current coercive welfare policies, including forcing ‘therapy’ on individuals, as human rights violation of the CRPD.”

Downloadable here:

BMJ Censorship Complaint

Recovery In The Bin complained to BMJ (details below) on 3rd November 2015. They never responded in spite of being sent four e-mail reminders.

Dear Editors,

Recovery in the Bin, an Internet based group with a large following, is writing to express its disappointment and concerns about your decision not to publish a piece by ‘SECTIONED’ in 7 November 2015 issue, which focused on coercion in psychiatry. The BMJ effectively implemented a policy of censorship by demanding a number of deletions of what is regarded as legally sensitive content, as a condition for publication.

These deletions included key testimonies of service user experiences of coercion and force in psychiatric hospitals. We believe it is essential that your readership hears about the nature of this coercion, especially as detainment under the Mental Health Act has risen by 10% in England, data collected by Health and Social Care Information Centre (HSCIC).

This Group profoundly objects to the author being told that they could not mention their personal experiences of forced treatment unless the staff involved had been prosecuted. This represents a disproportionately high threshold for submission, thus preventing genuine exposure of unethical practice being aired in a spirit of openness and learning. We believe on the contrary that the BMJ should be leading the way by drawing attention to these experiences, in a truthful fashion, and we perceive the risks of being sued for doing so is very doubtful. It is in fact more likely that such testimonies would be dismissed as the expression of someone’s ‘paranoia’, ‘illness’ and ‘delusion’.

While this Group has always believed that the BMJ’s vocation was to disseminate robust research findings and experiences of shared learning, with a view to modify and improve clinical practice, it appears to us that in this instance the BMJ’s judgement is at odds with its own principles and objectives. This raises the following questions: Is the BMJ lacking foresight in its refusal to support difficult experiences that show up the failings of the mental health system? Would it act in the same way had the author of the piece been a mental health practitioner?

We look forward to reading your response.

Yours Sincerely,

Recovery In The Bin (Mental Health Group)

Recovery In The Bin: Welfare Rights Training for ESA/ PIP

The government has allocated £22 million towards recruiting presenting officers at benefit claims tribunals over the next two years. The detail was buried in the Budget announced on 16th March. They claim this is to support the department in personal independent payments and employment and support allowance tribunals. The money will pay for 180 new presenting officers.
Personal independence payments (PIPs) are gradually replacing disability living allowance (DLA), which is supposed to help with the extra costs that come with living with a disability. In January next year, the formula used to calculate PIP’s daily living component will change. 290,000 disabled people will lose the payment completely and 80,000 will have their benefit cut. The government clearly expects to be fighting more claims over reduced disability benefits in the coming years.
A DWP spokesperson said: “Presenting Officers assist tribunals by giving both the legal case for the appeal, the Department’s case for upholding the original decision but also by drawing attention to any new and relevant evidence. By increasing the number of Presenting Officers, we will help ensure the right decision is achieved at each appeal.”

But there’s a problem

In its consultation paper; Proposals for the Reform of Legal Aid, the Ministry of Justice proposes to save £22 million by removing welfare benefits matters from the scope of legal aid funding. This is part of a plan to cut a quarter of the legal aid budget, with social welfare law the main target. Social security is the largest subject area being removed from the scope of legal aid after families. From 1st April 2013 legal aid was no longer available for advice on how to challenge benefits decisions.
People with mental health diagnoses often find it hard to fill out ESA/ PIP forms let alone represent themselves at tribunals. Especially those with more severe conditions such as schizophrenia. It doesn’t take much to figure that people in these situations are going to find it harder to get the representation they need.
On top of this there is evidence that the tests themselves are leading to greater stress, either exacerbating preexisting conditions or negatively impacting on the mental health of people with other disabilities. A study published by the Journal of Epidemiology and Community Health in November 2015, showed a correlation between worsening mental health and assessments under the WCA, published last week, that linked the WCA tests with a possible additional 590 suicides, increased mental health problems and hundreds of thousands of antidepressant prescriptions. Volunteers such as ours could help lessen that distress.

Here’s what we’re doing about it

We have asked Welfare trainer Tom Messere, author of the Big Book of Benefits, if he would train 20 volunteers in the basics that they will support people up to these tribunals to give them a bit more of a fighting chance. And whilst we have Tom at our disposal we are also we will be training the volunteers to help fill out the often complex and confusing forms, so that less have to go to tribunal in the first place. The training will be on ESA and PIP, form filling, getting any available medical and informal evidence correctly pitched (what the person needs to ask for), possible calls, key pointers for accompanying, and up to tribunals.

You can join us

We are hoping you can donate to help pay for the training, the venue, transport and accommodation for Tom, and as we are recruiting volunteers, many on low incomes themselves, and as we will need to have representatives in as many places as we can (sorry, we wish we could provide for everywhere) then we are trying to raise as much help for their travel as well.

As such we are looking to raise £2250.

RITB co-sign letter on therapists in job centres plans


This is the Mental Wealth Foundation (coalition of professional, grassroots, academic and survivor campaigns and movements) letter on ‘therapists in job centres’ plans co-signed by RITB

Mental Wealth Foundation is a broad, inclusive coalition of professional, grassroots, academic and survivor campaigns and movements.  We bear collective witness and support collective action in response to the destructive impact of the new paradigm in health, social care, welfare and employment. We oppose the individualisation and medicalisation of the social, political and material causes of hardship and distress, which are increasing as a result of austerity cuts to services and welfare and the unjust shift of responsibility onto people on low incomes and welfare benefits.  Our recent conference focused on Welfare Reforms and Mental Health, Resisting the Impact of Sanctions, Assessments and Psychological Coercion.


Date                21 March 2016

From:              Mental Wealth Foundation

Mental Health Resistance Network
Disabled People Against Cuts
Recovery in the Bin
Boycott Workfare
The Survivors Trust
Alliance for Counselling and Psychotherapy
College of Psychoanalysts
Psychotherapists and Counsellors for Social Responsibility
Psychologists Against Austerity
Free Psychotherapy Network
Psychotherapists and Counsellors Union
Social Work Action Network (Mental Health Charter)
National Unemployed Workers Combine
Merseyside County Association of Trades Union Councils
Scottish Unemployed Workers’ Network
Critical Mental Health Nurses Network

British Association for Behavioural and Cognitive Psychotherapies
British Association for Counselling and Psychotherapy
British Psychoanalytic Council
British Psychological Society
United Kingdom Council for Psychotherapy

Professional bodies scrutinise Government therapists in job centresplans

We write in response to your joint public statement of 7 March 2016 outlining the outcome of your meetings with the Government’s new Joint Health and Work Unit and your scrutiny of the Government’s plans to place therapists in job centres [1].

There is no indication that any consultation has taken place with members of your organisations with knowledge of these matters nor with service users, clients and their representative organisations.  This lack of consultation and opportunity for wider reflection has contributed to your organisations departing from your own ethical structures and frameworks, and being seen as agents of harmful government policy [2]. It is by now generally accepted that the consequences of the DWP and government policy in this area are far reaching for physically and mentally disabled people on social security benefits.  Inexplicably your organisations’ scrutiny of government plans has failed to recognise this.

The joining of Government Health and Work Departments is not helpful, and current DWP policy intended to reduce the socio-economic causes of mental illness to the one simple fact of unemployment is clinically and intellectually ridiculous.  The resulting policy promoting work as cure, which your organisations are now supporting, is offensive and dangerous. It is wrong for therapy organisations to buy into the unthinking praise for ‘work’ that often forms part of the rhetoric of governments.

While for some clients improving employment prospects may be an objective, for many others this is not the case and may be profoundly damaging.  Indeed, for some people, their mental health problems may have begun because of work e.g. through experiences of bullying in the workplace.  This one size fits all approach is simplistic.  Premature return to work can result in loss of confidence and relapses affecting future ability to get back to work. This can also lead to prolonged periods without benefits and no income [3].

You state that plans must be aimed at improving mental health and wellbeing rather than as a means of getting people back to work.  These are not the aims and objectives being expressed by the people who are implementing the programme right now, involving targeting ‘hard to help’ clients who are likely to be people with enduring physical or mental health difficulties. For example in the Islington pilot project Councillor Richard Watts has stated, “We think there is much more that health services can do to promote the idea of employment for people with health conditions.” In the Islington CCG Commissioners’ report in November calling for employment services in GP surgeries to reach ‘hard to help’ claimants, they state that, “to improve the system we need to…maximise the contribution of all local services to boost employment, making it a priority for health, housing, social care and training.  We need to open up how we talk to people about employment, including asking healthcare professionals to have conversations about work with patients, as part of their recovery. We need to give professionals the information and tools to help them to do this.” [4]. For all clients, establishing a trusting relationship is the first priority, involving respecting their current needs, perspectives and autonomy.

Jobs advertised on the BACP website in November 2015 have the explicit aim of getting clients back to work and engaging with employment services e.g. “your role will include: producing tailored health action plans for each client, focusing on improving their health and moving them closer to work…generate health and wellbeing referrals to ensure continued engagement with employment advisers” [5]. Similarly G4S advertise jobs for BABCP accredited CBT practitioners with job roles including: “Targeted on the level, number and effectiveness of interventions in re-engaging Customers and Customer progression into work” [6].

We respectfully submit that information about these jobs was known to all of your organisations when you issued your joint statement. This inconsistency is seriously misleading.

We are glad that you oppose conditionality, coercion and sanctions.  Clearly such punitive measures have no place in the therapeutic relationship. We fail to share your reassurance from the government that these measures will not be pursued against clients. DWP have repeatedly claimed that sanctions are a last resort and only happen in a tiny minority of cases. The reality is that millions of people have been sanctioned. In the twelve months to September 2015 alone, over 350,000 ESA and JSA claimants were sanctioned [7].  In the Employment Support Allowance Work Related Activity Group the majority of sanctions were of people who have been placed in the group specifically because they are experiencing mental health issues and research shows that benefit sanctions on people with mental health problems has increased by 600% [8].

It is not possible to consider this issue without considering the context of sanctions, cuts and persecution which is endemic in the current system. You fail to acknowledge that attending this proposed therapy may not be explicitly linked to conditions/sanctions but will feel so for many of its prospective clients who are on benefits. There is a structural power imbalance between job centre employees and those on benefits. With their income under threat, those on benefits will be especially susceptible to cues, suggestibility and positive reinforcement when attending job centres.  Many on benefits have experienced oppressive power relations for much of their lives. Saying no in relation to an apparent free choice in this context is hugely difficult, especially when saying no has uncertain consequences [9] .

Attempts to coerce people into work are detrimental not only to their health but to their safety and, in many cases, present a risk to life.  The extreme fear and distress caused by the current welfare reforms, including changes in disability benefits and the new Work Capability Assessments, is widely reported including instances that have led to suicide [10]. Therapy alongside this coercive system breaches the ethical principle of non-maleficence.

You state that there must be choice as to location of therapy. There is a clear danger in putting DWP representatives into GP surgeries, community centres and food banks that are seen as safe havens for people on low incomes and benefits. The presence of DWP compromises this. DWP/Maximus workers in the GP surgery, with access to medical records, will serve as a deterrent to people visiting their family doctor. The model currently in use in Islington allows Remploy/Maximus workers to access and write into GP records; this jeopardises any commitment to client privacy and confidentiality [11].

The choice of method of therapy is an illusion and therapists of all modalities are subject to the stresses of an unjust target driven culture [12]. We are concerned that under-qualified and inexperienced staff, such as job centre coaches, will be in a position to make referrals to Health and Work programs.  This is exacerbated by the fact that referrals are likely to be to IAPT workers, many of whom themselves lack in-depth training and experience of severe mental health issues. Inappropriate referrals are increasingly likely in a target-driven culture.

We are not reassured that the feasibility trials planned by the government will contribute to knowledge and understanding and are not reassured by your echoing what government is saying.  Instead you and government must listen to the voices of survivors who describe the reality of government plans on their lives and are fighting for services with a vision of humanity beyond work [13].

It is clear from your public statement that you have failed to critically examine and scrutinise the ongoing activities of the Government Joint Work and Health Unit.  We call on you to cease your engagement with this unit and instead hold a national stakeholder event which is guaranteed to involve the participation of representative organisations for service users and therapists with direct knowledge of the area, as well as professional bodies like yours. There should be no government involvement in such an event.  From it, a representative group can be selected that will adequately represent the views of service users and therapists to the appropriate government departments as well as to the opposition.


  5. ‘Mental Health Advisor – Job Details’ Retrieved from November 21st, 2015. Available at
  6. crisis
  9. For a fuller discussion of these issues, see
  11. Para 4.3 also

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)