Mental health and other fables

I drive a lot. And when I drive I listen to podcasts. I’ve been listening to ABC’s The Health Report for a very long time. It’s always good, and often covers things that I wouldn’t encounter elsewhere.

Yesterday as I drove through the gathering dusk of a rainy Tuesday evening, I heard Norman Swan interview a woman called Christine Morgan. 

Christine Morgan has found herself, quite willingly, at the intersection of a multi-faceted political shit-storm. Bushfires and now Covid-19 are, quite predictably wreaking economic havoc on regional communities, many of which are already the poorest areas in Australia.

Quite naturally, the usual cabal of self interest carpet baggers have rolled up with their grab-bag of expected demands – MORE FUNDING FOR MENTAL HEALTH. Apparently we’re on the precipice of a suicide crisis.

Public health funding for interventions is so hard to come by, and usually requires robust proof of efficacy. In mental health though, evidence is often optional.

And yet, in light of no evidence of efficacy, the government announced 19 million dollars for some kind of regional mental health thingo. I say that, because, under sustained, direct questioning from Norman Swan, a medical practitioner who, no doubt, is acutely aware of the punishing requirements of funding, Ms Morgan could not tell him what the plan would actually do.

Morgan emitted some garbled fuck-speak about connectedness and resilience and intersectional community based oriented interpersonal directed tailored appropriate interventions. 

‘Social determinants’ got wedged in there, but as an afterthought.

She was pressed again, and again, spent five minutes wittering on about the same key jargon terms above.

Swan was magnanimous in defeat.

I live in post-bushfire regional Australia. It’s obvious that the mental health that Morgan is talking about is actually social ‘health’ – insecure housing, no money and poor physical health. 

Solving that problem is very expensive. So instead, people like Morgan label people mentally unwell, eagerly ‘treated’ by an ever increasing number of graduating psychologists who talk about ‘connectedness’. Connected to what? A job? Enough money to live on? A course of ivermectin for scabies so everyone can get some sleep? A trip to the dentist to treat an abscess?

No. It connects them to a psychologist. Economists call this ‘supply side market manipulation’. If you ask a psychologist if you need government funded psychological help, what are they going to say? No thanks, we hate money?

Every morning I take my dog to the beach, early. We park in the carpark and walk the track to the beach. About a month after the fires I pulled up and saw a guy getting out of his car, with some difficulty. His leg was in a full cast, up to the thigh. He managed to manoevre himself out of the car, across the carpark and down to the toilet block. He was sleeping in his car, with a broken leg.

I saw him most mornings for about a month. Then there was another guy with a clapped out green Hyundai. He usually put the bonnet up during the day so people wouldn’t call the Council. Then there was another guy in an old Mazda Astina. He gave me a fright, because his face was pressed up against the window as he slept. In the dim dawn light he looked as if he was dead.

These are the ‘traumatised people’ that these mental health practitioners are ‘helping’. They meet with them in a warm office and offer them instant coffee and biscuits. They make suggestions and ‘develop strategies’. They ‘put them in touch with local services’ – as Christine Morgan outlined for us. These local services are organisations like Campbell Page, a company that exists to operationalise the punitive end of the Centrelink system.

Does this assist their mental health? Of course it doesn’t.

So how is it that people like Christine Morgan manage to extract literally millions of dollars out of the public purse to employ an ever increasing cohort of graduate psychologists? Who wins?

Well, obviously the psychologists. After all, this is corporate welfare, no different than the ‘Employment Agencies’ who also happen to be generous donors to the Liberal Party.

The big winner though is the government.

Convincing people their problems are caused by mental illness, rather than social inequality individualises the blame & undermines their sense of personal strength. It tells them, ‘Your misery is your fault. It’s because you’re mentally unwell’. It enfeebles and depoliticises them. In individualises them and makes them feel like they’re unusual.

‘Mental health’ is an effective strategy for defusing real social change. 

And who are the losers in this game? Well, obviously those who’re suffering from real social disadvantage, those who could do with secure tenure in a rental property and a trip to the dentist.

But there’s another set of losers, those with real mental health issues. We never hear about these people until it all goes wrong – the young man who murdered Eurydice Dixon in Melbourne, for instance.

Reallocating finding into ‘lifestyle’ mental health instead of ‘real’ mental health services for people who have illnesses like schizophrenia and bi-polar is bloody criminal. And yet these are the people who’re least able to advocate for themselves. Psychologists won’t advocate for them because these people actually need real help, and that’s not something they’re in the business of providing. Once again, it falls upon real medical professionals to try to secure funding for a pressing and serious group of illnesses.

The mental health gravy train is also an artefact of middle class, professional psychologists, who’ve seldom experienced real, grinding poverty. For them, it’s inconceivable that a person might find their circumstances so bleak that they would consider suicide as an ‘out’. For these psychologists, suicide is, by definition, a mental health issue.

It’s not.

We could halve the suicide rate in Australia in six months. We would ensure people’s social health. We would give them secure housing, healthcare, dentistry, access to work, education, good food. We could stop denigrating and humiliating them through the Centrelink/workfare model. We could address homelessness. Some suicides are undoubtedly caused by very real mental health problems, but most are caused by social problems. This is indisputable and reflected in the real rise of suicides with every economic reversal.

We should stop lining the pockets of career carpet-baggers whose mandate is little more than;

– Convince this person they’re mentally unwell so they don’t feel like they can organise collectively against the conditions they find themselves in

– Potentially help them adjust emotionally to being homeless and completely without hope of an improvement in their circumstances.

This new government initiative is meant to be rolled out to address ‘poor mental health’ in regional Australia. It’s insulting. Imagine you lose your job and your home in the pandemic shutdowns.

Is the nice lady with the dangley earrings going to buy you a new house? Or even help you find and pay for a rental? Nope.

But she can try to make you feel happier about being at the pointy end of nature’s climate change catastrophe, and if you’re lucky you’ll get a couple of Wagon Wheels.

 

 

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