Of Course Mental Health Is Political

Last last month, professor of health history Matthew Smith writing for Psyche wasted no time and put it right in the title: mental health is not an individual matter, but a political one. It’s a brief(ish) look at social psychology.

In recent years, experts have turned once again to social factors in mental health. The financial crunch of the late 2000s and the COVID-19 pandemic, along with dissatisfaction with psychopharmacology, have once again made social psychiatry relevant, though rather than speaking about ‘social psychiatry’ as a discipline, we tend to refer to research on the ‘social determinants of mental health’.

Mental health researchers today are much less likely to respond judgmentally to their research subjects. Yet they are still often reluctant to stress the political implications of their findings. The temptation might be to simply conduct more research. But there is already more than enough evidence to know that socioeconomic deprivation is bad for mental health. In addition to the classic studies, subsequent research – such as that conducted and disseminated by Richard Wilkinson and Kate Pickett – has further cemented this link. What mental health researchers, clinicians and activists need to do now is what social psychiatrists failed to do: to tackle poverty, inequality, racism, community disintegration and social isolation head-on.

I’ve said much the same, back in 2019, when I argued that psychotherapy either can be social work or social control. The context at the time was in therapists who, for autistic people, focus on “coping skills” or “social skills” entirely based upon normative standards of behavior and expectations.

If we’re talking about developing “skills”, isn’t the necessary skill here maybe more about developing a better sense of how many spoons you think you might have for any given day, adding some wiggle room, and then laying out your day accordingly? But then also recognizing that sometimes the world is going to overwhelm you and when it does you should feel neither shame nor guilt about it?

(As a side note: recently I made the mistake of engaging someone on r/AutisticAdults who said that if you practice things like eye contact, “correct” posture, and “controls” on stimming it isn’t masking it’s just training your brain to do things differently. (Spoiler: it is masking.) They also they “don’t think of autism as anything other than an STD”. This is a person who in fact is thinking about their own mental health politically, but has chosen the wrong side.)

It came up again when I shared Sonny Hallett’s thoughts on trans visibility day in which they cite Kai Cheng Thom.

She goes on to say, “the ultimate question of social justice somatics is not ‘how can we cure the traumatized body so it can return to productive society?’ — the question of dominant psychology. our question is: ‘how can heal our traumatized bodies so that we may love each other & fight together?’”

“If we are not thinking about mental health in political terms,” writes Smith in the Psyche piece, “we are hardly thinking about it at all.”

Mental health professionals have not just the opportunity but the responsibility to side with building solidarity and capacity against the social and political structures which cause debilitation.

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