Treating Oppression and Depression

In light of a further spate of suicides among young people in nationalist areas of Belfast, we present a political analysis of the issue of mental illness in the North of Ireland.

By Sean Fleming (for the Blanket)

It is known that in the north of Ireland there is a very high rate of prescription in relation to anti-depressants and tranquilliser ‘medication’. In areas where there has been serious conflict and poor economic investment this is particularly in evidence. It has been established that these drugs are often addictive, harmful, disabling and debilitating in their effects. It reflects a world-wide trend whereby psychothropic drugs are seen as the answer to severe mental distress. It is important to note that psychiatry views depression, certain states of anxiety and various forms of mental suffering as illnesses related to brain pathology. The fact is that psychiatry has never been able to prove a physical cause to any of the so-called mental illnesses. Given the symbiotic relationship between psychiatry and the drug companies it is in their interests to perpetuate the myth that ‘mental illnesses’ are the result of brain pathology and that drugs help to redress some supposed biochemical imbalance.

One of the tragedies of our time is that a social model of psychiatry has not emerged to replace the biological bias in the present model. This model views ‘mental illness’, or to use its preferred term, severe mental distress, as often being the result of poverty, unemployment, poor housing and many other social ills or interpersonal conflicts. If one looks around the world the ‘disease’ or biological model of psychiatry doesn’t stand up. It is the Irish in Britain and other ethnic minorities who are more likely to end up in psychiatric hospital, detained, given a diagnosis of ‘mental illness’. African Americans are also much more likely to suffer the same fate, Aborigines in Australia, The Maori in New Zealand and black people under the old apartheid regime in S.Africa suffered appalling psychiatric abuses. It is very often minorities and those suffering poverty and deprivation who are much more likely to be affixed with the label ‘mentally ill’.

Psychiatry argues that certain groups show a genetic vulnerability to psychosis yet no biological marker or genetic defect has ever been found in relation to any of the many and increasing number of invented psychiatric disorders. These ever expanding ‘disorders’ create new markets for the drug companies. Their drugs often have serious adverse and devastating effects.

Psychiatry is without doubt a force for social control and serves Big Pharma. George Bush’s plans to screen the entire US population for ‘mental illness’ as recently reported in the British Medical Journal, beginning at pre-school level, will provide enormous profit for these companies. This plan has grown out of a political/pharmaceutical alliance with strong drug company ties to the Bush Administration.

It is essential therefore that the issues surrounding psychiatry be politicised. The proposed Community Treatment Orders which may be introduced under the new Mental Health Bill in Britain will ensure that ‘patients’ living in the community are forced to take drugs if it is thought they are not taking their ‘medication’. It will provide no choice or availability of other ways in which the person feels they could be helped. Only presently in Britain and Ireland if someone is ‘sectioned’ can they be forced to take drugs against their will and even given electro-conlusive ‘therapy’ (ECT). The British government also intends to pre-emptively lock away some people who’ve been ‘assessed’ as being dangerous, even if they’ve never committed a crime. This is fundamentally against the spirit of human rights and a policy that panders to the prejudices of the right wing press and elements in society. It is psychiatry itself which stigmatises people. They apply a non-existent disease to them and deny them their rights when they are deemed to ‘lack capacity’. Their problems are objectified as being inside their brains and their bodies poisoned with psychiatric drugs.

Instead of telling the poor, the marginalised, the alienated and those simply ‘different’ within society that they have brain illness or disorders, we need a new radical approach to psychiatry which will help to build better societies by drawing attention to the societal and environmental factors involved in severe mental distress. Let’s take the deeply distressing and painful subject of suicide. Suicidal thinking is increasingly being seen by psychiatry as related to psychiatric comorbidity, in other words, ‘psychiatric illness’ related to alcohol/substance abuse, etc. This then provides further justification for psychiatric expansive interventions in communities where people have tragically taken their lives. They then advocate the use of drugs that paradoxically increase the likelihood of suicide as the recent scandal surrounding the drug Seroxat has shown. This drug is worth #2billion a year to GlaxoSmithKline - Britain’s biggest drugs firm which recently caved in under pressure and revealed hidden research which showed that its so called anti-depressant can cause children to attempt suicide. It has also been linked to suicide in adults and the drug regulators have now banned its use in under-18s in Britain. There is a further irony in that this same shamed drug company donated a grant of #25,000 in 2002 to the Institute for Counselling and Personal Development in Belfast which offers support to the victims of the conflict and those experiencing mental health difficulties. This group’s work tends to be concentrated in areas like North and West Belfast where there has been an alarming number of tragic deaths as a result of suicide. It is highly likely that in its work this group supports the so-called anti-depressants as being essential in treating depression despite the growing doubts about their efficacy and the corrupt activities of the drug companies involved. The behind the scenes machinations that were involved in the approval and promotion of Prozac is another case in point. It is also a fact that all the state funded ‘mental health’ organisations support the present biological psychiatric model. It is also a sad but hardly ever reported fact that there is a clear link between the heavy psychiatric or neuroleptic drugs and suicide. Many psychiatric patients in the end take their own lives after suffering the lethal ‘ side - effects’ of these drugs for many years. Psychiatry is also targeting children now with drugs for so called Attention Deficit Hyperactivity Disorder and ‘conduct disorders’.

Instead of masking problems with drugs we need to understand how oppressive structures in society affect people and cause disharmony, stress and tension which can then precipitate severe mental distress and even suicide. There needs to be a much clearer focus on these economic, social and class structures and the effects they have on mental well being. It is becoming increasing clear that in the future people and communities may have to find a way of managing their own mental health by not leaving it to psychiatric propaganda eager for ‘cash cows’ in a system that would collapse if it actually made efforts towards truly helping others. A new social or holistic psychiatry would therefore seek to understand and explore’life experience’ and the ‘problems of living’. The north of Ireland could take a leading role here. We know that the levels of mental distress are greater here than in other parts of Ireland or in Britain. Instead of a system inextricably linked to pharmaceutical companies, which supports delusional projects like the Genetic Epidemiology of Mental Illness In Northern Ireland (GEMINI) in its search for the elusive defective gene in ‘mental illness’, why not put money into projects that help people to rebuild their lives and deal with the root causes of their mental suffering. Forums could be established whereby people could make their voice heard and their mental/emotional distress understood. For psychiatric ‘patients’ therapeutic housing could be set up where they are helped to withdraw from neuroleptic drugs and to get their lives back again. The Soteria therapeutic housing project founded by radical American psychiatrist, Loren Mosher, who sadly just died (12 July 2004) proved to be a great success for many psychiatric patients and yet was totally ignored and arrogantly dismissed by the psychiatric establishment. This is a model for the future and a common-sense alternative run by ordinary caring people that actually worked.

Instead of creating depressed and alienated communities awash with addictive benzodiazepines,’anti-depressant’ and other psychiatric drugs, activists for a radical or holistic approach to mental health should seek to build supportive communities. In this model strong social ties and inclusive networks would bind communities and ensure that people are not left isolated, disempowered and impoverished by a system driven by pharmaceutical interests. The great radical psychiatrist, R D Laing recognised the need for this wider social change if the psychiatric establishment was to be overthrown. Biological psychiatry is also seen today in the current fashion for Western medical and mental health agencies to develop projects for victims of war in other countries, often wars provoked by Western governments. They seek to objectify mental suffering as an entity apart. They make it into a clinical problem to which they apply Western ‘treatments’. They often dismiss indigenous knowledge or ways of treatment. Often they ignore the fact that what people really want is not to look inwards at their own mental lives but help in rebuilding their devastated social, economic or cultural ways of life. It is this exclusion of the wider context that makes the present system so reprehensible. This is in clear contrast to the innovative work of the British Inter-war years psychiatrist, Harry Stack Sullivan, who for a period helped to steer the traditional psychiatric focus away from the individual to the interpersonal and who highlighted the need for more socially orientated and holistic therapies.

A social model of psychiatry better serves societies and communities that have suffered conflict, war and economic deprivation. Those labelled mentally ill or are seen as suffering from one or other ‘psychiatric disorder’ are being demeaned and harmed by the present practice. It seems to me that by building therapeutic housing projects and communities those who have been targeted with psychiatric drugs could draw attention to the societal, environmental and political causes of severe mental distress and thereby help to effect real and radical change in society by exposing biological psychiatry for what it is - pseudo science and psycho babble that serves Big Pharma. A new radical psychiatry would work with people in a non- pathologising way and help to understand the real origins of their mental pain. The way forward is through self-determination for those who suffer severe mental distress and a new social and healing model of psychiatry that understands and relates to the experience of the person in context with others and the wider society. This clearly calls for a strong and active movement not afraid to challenge and end the present oppressive psychiatric system.

Urgent Appeal