Thursday 27 December 2018

Brexit and Mental Illness

Mental illness is a social phenomenon. More people are open about the difficulties they live with, and those who don't suffer mental illness will know several people who do. And it's a growing problem. Having worked for five years at my current place, the number of students coming through the doors with mental health needs and requiring support plans of some description have gone up over time. Indeed, there has been a big increase in the last 12 months alone. Compare this with when I first started teaching in 2002, and prior to that my own experience as an undergraduate and the past, even the recent past, is revealed as a foreign country.

Has Brexit got anything to do with this? Before Christmas, The Times reported that the DWP was prepping for the increased risk of suicide in the event of a chaotic Brexit and dumping hundreds of thousands onto the UK's decrepit, underfunded, and frequently vicious social security system. Last month, The Indy reported that prescriptions for anxiety medication went up in the wake of the referendum result. HuffPo and the New Statesman have run stories on the effect it has had on relationships, and exacerbating the wider climate of uncertainty. Anoosh in her NS piece picks up on research done on the spike of suicides during the Munich Crisis in 1938, which suggests concentrated political tensions can have calamitous mental health consequences for some. And when this is prolonged? As Elisabetta Zanon, the head of the NHS's European office noted shortly after the referendum, "a climate of uncertainty if perpetrated for a long period of time could impact on the mental and physical health of people, potentially leading to an increase in demand of services."

Just as Brexit is an event with many roots, the mental health crisis it is occasioning has antecedents of its own. In sum, it comes down to multiple crises in ontological security. As Mark writes, this is one of the few useful concepts to come out of Anthony Giddens's menagerie of books. This is conceptualised as a sort of a cocoon, or as Giddens puts it, "a sense of ‘unreality’ rather than a firm conviction of security: it is a bracketing, on the level of practice, of possible events which could threaten the bodily or psychological integrity of the agent. The protective barrier it offers may be pierced, temporarily or more permanently, by happenings which demonstrate as real the negative contingencies built into all risk." For example, living on the corner of a street there is always a possibility a car or lorry could crash into the side of my house. This is a potential physical threat to me every time I'm home, and is pregnant with the possibility of anxiety if you think about the financial fall out, the hassle, and the mental health toll should it unhappily come to pass. It's an ever-present risk, but one I barely ever think about - it is thoroughly bracketed by my own sense of ontological security. Similarly, think about the journey to work. Every step is dogged by risk from pedestrians, road users, public transport, or some other catastrophe, yet for most people these hardly register. Their threat is psychologically suspended. We know the risk when we stop to cross the road, but none of us ever think we'll get hit by something - until we are.

Ontological security is always conditioned by our everyday existence, but does not refer solely to it. As Durkheim noted in his classic study of suicide, one of his four types locates suicide in anomie, or normlessness. That is a combination of the social conditions we were brought up in or familiar with no longer apply, so our habits and habitus are out of sync with the way we find the world. For example, many EU citizens living here have and do experience varying levels of xenophobia, but what could previously be dismissed as the idiot prejudices of a few now presents, with the result, as something more than a minority pursuit. This not only has the consequence of putting many people on edge, to the point of second guessing acquaintances and colleagues, and perhaps avoiding situations they may have previously felt comfortable in, the continuing uncertainty over the state of Brexit is positively anxiety-inducing. Will I have a job? Can I rent a place? Take out a loan? Go to hospital if I need to? These are just some questions EU residents are having to worry about as the end game approaches. For many EU supporters something very similar is going on, and tend to fall into two overlapping sections of people. Those most apprehensive about the future, who tend to be younger, and are fearful of price rises and economic dislocation, and those for whom the EU intersects with their identity in some way. i.e. As an instantiation of liberal values and a pseudo-internationalist/post-nationalist break with Europe's imperial history. To wake up in a society in which has just rejected this and, by extension, the 'enlightened' values you hold is a profoundly jarring experience and helps explain why there is a mass movement seeking to reverse the referendum decision.

If you like then, Brexit is a suddenly imposed symbolic injury, a body blow to the ontological security of millions of people. However, what makes this into a mental health issue is not just the crisis characteristics that surround Brexit per se, but the already febrile condition of ontological security across the industrialised world. This is less a failure of social integration or the dominance of identity politics, as conservatives on the right and left maintain, but is more fundamental. It's about the kinds of human beings we are and how we are constituted as such. Neoliberalism as a concept has attracted more brickbats from establishment scribblers in proportion to its obviousness to growing numbers of people. On the one hand, in its most common usage it refers to a particular configuration of capitalist accumulation. i.e. The respective roles played by markets, states, the law, business, and labour movements. In neoliberalism, at least ideal-typically, the market is left to run riot while the state is concerned with the heavy regulation of labour and creating new markets, typically by opening up public institutions through privatisation or creating new markets or, to use the old language, new avenues for the accumulation of capital. In its less discussed form, neoliberalism is a mode of subjection, a way of how to 'be'. The notion that we are little rational actors with an instrumental orientation to the world and an entrepreneurial conception of self is less a consequence of "brainwashing", and though ideologies and stories supporting this common sense are incessantly pumped out, through design we have little choice but to relate to state institutions in a transactional fashion and abide by their attempts to discipline is as rational actors. Unemployed? You have to demonstrate your entrepreneurship by showing your job applications to the nice advisor at the Job Centre, and attend mandatory training and "clinics". Thinking of going to university? Students are invited to make their choice according to spurious notions of value-for-money, backed by a kaleidoscope of metrics and with a definite career destination in mind. Need care? You or a named person is expected to "manage" your package with the funds available, and so on. Problems and difficulties are individual problems and individual difficulties, the result of making the wrong choices or being insufficiently motivated to make the right decisions. And who is responsible? You. Just you. If you're in precarious work, have no hope of saving for a deposit, and your incomings barely cover your outgoings, there's no one else to blame.

Stressing individual responsibility has the inevitable consequence of socialising anxiety, but what catalyses it further are the insidious ways in which quantification has become a measure for self-worth, and how this has invaded the everyday life of millions of people. Of course, quantification has long been a cornerstone of capitalist culture. Why, for instance, are Richard Branson and Alan Sugar taken seriously? Because they have accumulated huge piles of unearned wealth - they are paragons of success, the culmination of the best human beings can hope to be. As Bourdieu notes, the economic logic of accumulation has had a profound effect on how our cultures are configured with hierarchies of taste, gate keepers, and forms of cultural capital specific to one or a number of related fields. This has been amplified via social media, where the numbers of followers, likes, shares, notes, retweets and what have you are crude measures of one's standing in the fields that matter to you. If you're commentariat, Twitter is the platform of choice and retweets, followers, and followed/follower ratio are suggestive of one's position and seniority in the pundit field, for example. Where it is particularly pernicious is the intersection of social media and selfies, where likes and comments (or lack of them) have a direct bearing on looks and style and therefore can have a huge impact on senses of self-worth and wellbeing.

For millions of people, life is a permanent state of anxiety. Insecurity at work. Insecure relationships with public institutions. Insecure in personal relationships. It is a culture of performance, of constantly striving to meet (oft self-imposed) quantified expectations in public and in private, because we are always on display and accountable to them. Hence the fragility of ontological security. One can become habituated to an insecure life, but by letting go of the kinds of goals and hopes one was socialised into. Therefore for something to come from the outside, like Brexit, it strips away a background that was supposed to be permanent, introducing further uncertainty into an already uncertain life and loosening off a racist, nationalist id thought suppressed by official anti-racism and what Blair used to call the "progressive consensus". Such is the mental health consequences of Brexit. It has less caused the problems, but has simultaneously stressed, catalysed, and accelerated a pre-existing pathology while tipping many others into the path of the epidemic's blast wave. Dealing with is requires much greater funding to mental health services than the Tories are allowing, but this is a sticking plaster. Making Brexit go away isn't going to happen. Even if it is somehow reversed the reverberations will not stop, it's here to stay. But what can change is the perverse culture of anxiety and insecurity underpinning the mental health crisis. That means more than bleating about putting your phones down and deleting Facebook. The culture has to be tackled at source, of unpicking the institutions and relationships productive of socialised anxiety, and that requires socialist politics.


Sam said...

It doesn't undermine your argument, but I take issue with how you frame mental health in your opening paragraphs. Specifically the idea that there are more and more people with mental health issues today rather than more and more people (thanks to social liberalisation and the spread of knowledge via social media and the Internet) who are able to understand and just as importantly to *admit* to themselves that they have a mental illness.

I can think of so many middle aged men (ie the students of yesterday that you reference) who show symptoms of anxiety and depression but just can't or won't parse what's happening to them.

I'm sure the rise of neoliberalism has exacerbated mental health issues, but I get the impression you don't put enough weight on the problem being present but unrecognised in the time of your youth. The level of mental illness in today's students should be seen as indicative of how many people suffered in ignorance when you were a student.

Dialectician1 said...

Thanks, a very interesting blog. However, I am concerned that in your attempt to link mental illness to Brexit, you’ve missed the all-important class dimension. As you know, mental illness like most other chronic health problems, strongly correlate to social class; the ‘ontological insecurity’ of being working class was around a lot longer than the day after the referendum.

‘Brexit is a suddenly imposed symbolic injury, a body blow to the ontological security of millions of people’.

It is worth reading the Samaritan Report ‘Socioeconomic Disadvantage and Suicidal Behaviour. (2017), which looks at mental illness, suicide and self-harm as a class injury. Yet, what the report exposes is that while the link between cumulative socio-economic disadvantage and poor mental health/suicide/ self-harm is an unavoidable conclusion, medical research has concentrated on an individualistic/psychological approach. Most of this research avoids the grinding ontological reality of living in poverty in a capitalist society and seeks diversionary explanations (eg. genetic, personality disorders, addictive personalities, gender differences, social media, Brexit (?) etc.). As the Samaritan report shows, the mental health of the nation is in serious and continuous decline. It is now so serious it should be seen a ‘public health’ problem, which can only be solved by significant shifts in policy around housing, welfare, employment, education etc.

Let’s not get too side-tracked by Brexit. While I accept your statement:

‘Such is the mental health consequences of Brexit. It has less caused the problems, but has simultaneously stressed, catalysed, and accelerated a pre-existing pathology while tipping many others into the path of the epidemic's blast wave’.

Unregulated capitalism has had long-term consequences for the mental health of the population, particularly the epidemic proportions of self-harm in young people, but this didn’t start with Brexit. And of course you are right, the solution is ‘socialist policies’ that attack class inequality.

Howard Fuller said...

I don't think there has been any increase in mental illness simply that society has become more aware of it and especially it's minor variations over the years. Yes people are more willing to talk about these things and I have always been open about my battle with alcoholism. Having stopped drinking for 21 years I wish to encourage others that they can be do it.

However Brexit has resulted in mass boredom by most. I used to watch/listen to the news avidly but tend to be selective by switching on later and skipping the Brexit pages in The Daily Telegraph or Times whichever I get on a particular day.

Most people I know no longer give a toss or rather just wish we got it done and over with. On line it is a different matter. There are so many obsessives on both sides who drive mad but at least I can scroll past. The problem is so many don't...

But then social media probably causes more problems than the issue of Brexit. Bullying and unpleasantness that is rarely seen in face to face situations is rampant. Now that probably causes mental health problems especially amongst the perpetually offended.