Work, mental health, and the disease of neoliberalism

Part 2

■ Part 1 of this article was published in the February issue.

What model of human does neoliberalism encourage?

Neoliberalism sees Darwinian competition as the defining characteristic of human relations. It redefines citizens as consumers, whose democratic choices are best exercised by buying and selling. It maintains that the market provides benefits that could never be achieved by planning. It runs on the illusion that we have created a meritocratic society, where the most intelligent and hardest-working rise to the top.

This ideology also assumes that those at the bottom of the social status are the most stupid or lazy.

Not surprisingly, we then internalise and reproduce this logic. The poorer classes blame themselves for their “failures,” even when they can do little to change their circumstances. Their disadvantage is the natural order of things, and they can be grateful for what they manage to get in zero-hour contracts and the kindness of those who give to food banks.

Never mind the insecure employment tenures: if you can’t keep a job it’s because you’re not applying yourself. Never mind the impossible costs of housing: if your credit card has reached its limit you’re uncontrolled and irresponsible. Never mind that you don’t get time or money for cooking proper meals: if your children get fat it’s your poor parenting that’s at fault.

In a world governed by competition, those who fall behind become defined, and self-defined, as “losers.”

“A degree of distrust and paranoia pervades relationships as we silently compare our social status with those around us, wondering where we stand and how others perceive us” (from Sami Timimi’s Insane Medicine).

The people who are not at the top or close to the top of the economic ladder feel they need to work or compete harder. To them, failure equals being a loser. This creates stress in people and families. It changes the way people think about themselves and others around them. And it certainly affects the mental health of any nation or people.

Kate Pickett and Richard Wilkinson, in their renowned book The Spirit Level (2009), state that it is not just poverty per se but the level of inequality in any society that has the biggest effect on all sorts of health and wellbeing, including the prevalence of mental disorders, stress, and unhappiness.

And they point out that inequality—the gap between rich and poor—has profound effects on people. After a decade of austerity, most families were further affected by stagnant wages, increased job insecurity, swingeing cuts, and changes to the benefits system and public services, nationally and locally, while the inequality gap grew.

A belief in meritocracy means that any failure is considered a personal failure. According to Wilkinson and Pickett, greater inequality heightens social threat and status anxiety, evoking feelings of shame, which feed into our instincts for withdrawal, submission, and subordination. When the social pyramid becomes higher and steeper, status insecurity increases, leading to widespread psychological costs.

It is clear, therefore, that because of the inequalities in society, caused by the neoliberal structure of employment and services, there is a clear knock-on effect on physical and mental health, especially of those at the lower end of the economic scale. Statistics from all over the world clearly demonstrate this. Wilkinson and Pickett report:

Scandinavian countries, although partly swept up in the neoliberal globalisation trend, have largely maintained their roots in strong welfarism and provide a viable democratic alternative to rampant neoliberalism. Levels of inequality are much lower in Scandinavian nations and they regularly top international surveys of happiness and wellness.

We are well aware of the growing epidemic of mental health issues in Ireland and in many other so-called “developed” countries. Speculation on the reasons for this have studiously avoided implicating the neoliberal nature of our society, inequality, and the resultant stress that all of this creates. Instead, mainstream mental health practitioners take the view that there is an inherent weakness in the person suffering mental distress. The treatment resorts to medical intervention: pills and a wide range of other therapies. The treatment therefore is “person-focused,” which reinforces the person’s feelings of failure. They believe they have failed to “compete” properly in the rat race as they struggle to survive.

Worse still, the treatment of mental illnesses has not escaped the commodification of people who are ill. It too is deemed a profit-making area by neoliberal thinking. It is professionalised, and shrouded in mystery—and fear. There’s a “we know what’s best for you” attitude towards the patient or client.

As long as this deliberately naïve approach to mental health in particular prevails there will be no progress in solving this health crisis. There is no doubt that many in the mental health services know only too well that their approach is not based on the main reason for the mental health crisis; but they too are trapped by the “hand that feeds and controls them,” namely neoliberal capitalism.

Will any psychiatrist, doctor or consultant ever stand up and shout out for all to hear: “It’s your neoliberal greed, competition, deluding people into thinking that they can achieve anything, no matter how extravagant. It’s your profiteering, privatising, exploitation and, above all, the rampant inequality—the widening gap between rich and poor—that is the principal cause of mental illness.”

How long would it be until they had no job and were pushed out of the elite circle of that professional class?

In summary

The one thing that the tragedy of the covid-19 pandemic has certainly achieved is the exposure and total failure of the neoliberal capitalist system of government around the world. As far as work and the availability of money are concerned, a major change was exposed. People were “furloughed”—paid for not working; though even these payments are being cut and time-limited. They can’t help themselves. Businesses too received all sorts of grants and payments. Demands for all this money to be repaid will add even more stress in society.

But that’s all right: sure a food bank or a charity will sort it all out. No consideration of the dehumanising of the people already on the bread line, or of the mental trauma that results. There is no column in any accountant’s books or spreadsheets to record the cost, or cause, of mental or physical illnesses. There is no humanity where greed and profit are concerned.

A new, post-covid pandemic awaits us, and it’s the mental health of the people who are always at the bottom: people with, potentially, no job, even poorer working terms and conditions, cuts in wages, zero-hour contracts, precarious employment—and still have the bills to pay.

To begin to change how we live, how we work, how we are to have true happiness—how our society is run—we have to understand the damage that the present system of neoliberal capitalism has done to the people most at risk from its ravages. We have to refuse to accept that no change is possible. We appreciate, above all, as happened during the covid pandemic, that community together, community looking out for each other, is an unstoppable force for real and progressive change.

If we want to solve the tsunami of health issues and inequality we need to understand that the only treatment for the health of any nation is when the people of that nation own and control the means of production and the distribution of that nation’s wealth. Our ancestors lived it, and in today’s modern world we can ensure that we live it too.