CPN co-chairs, Hugh Middleton and Joanna Moncrieff, went to meet Luciana Berger MP (the shadow minister for Mental Health) to convey the importance of a Critical Psychiatry perspective in developing the Labour Party’s mental health policy.

After his victory in the Labour Party leadership last year, one of Jeremy Corbyn’s early moves was to appoint the first dedicated Shadow Minister for Mental Health. Luciana Berger, MP holds the post. Even before her appointment, the Labour Party had made mental health one of its priority areas. The following is a report of a meeting with Luciana Berger at Portcullis House on 14^th June.

We explained that Critical Psychiatry offers a critique of the now widely accepted view that mental illness is a brain disease, consisting of a chemical imbalance or other specific abnormality, and that this abnormality can be effectively treated with prescribed drugs. This view has become established through the efforts of the pharmaceutical industry, sometimes with support from the psychiatric profession. However, it is not supported by scientific evidence. There is no evidence that people with depression have any specific abnormality of their serotonin system, or any other system. There is no evidence that antidepressants ‘work’ by correcting this hypothetical abnormality.

The problem with looking at mental disorders as if they were a sub-species of physical illness is that it renders the problems people have meaningless, and it obscures the role that social problems such as poverty, insecure employment, precarious housing, social isolation and loneliness play in the genesis and perpetuation of mental health difficulties. Locating the problem in an individual’s brain encourages passivity and dependence and discourages people from playing an active role in their own recovery. Although thankfully we no longer chop out bits of brains, and only rarely subject people to electric currents, it is this idea that mental disorders are brain diseases that need to be eradicated that allows pointless, harmful and sometimes downright cruel things to be done to people under the rubric of ‘treatment.’

So, Luciana rightly asked, what should be done? We agreed that one of the most important long-term solutions to mental health problems is the creation of a fairer and more integrated society. Support for families and children, decent jobs, secure housing, educational opportunities, and community centres and activities will help reduce the difficulties that lead to mental health problems in the first place. Moreover, some basic social interventions such as befriending schemes, social support during a crisis and basic counselling or therapy can help address the sort of social difficulties that most people with mental health problems face. Luciana emphasised how she has been working across departments to achieve the social conditions that would promote better mental health for all.

Critical Psychiatry suggests we need a radical change of perspective, however; an alternative to conceiving of mental distress as a form of sickness. As a society we need a mechanism to provide help and support to people who are struggling with one aspect of life or another that doesn’t involve designating them as ill. Such provision could be embedded within social services, for example, and could help to empower people to identify their own solutions to their particular problems. It could relieve the pressure on GPs who are confronted daily with a tidal wave of misery that medicine has no answers to, and avoid the huge levels of prescribing that this situation creates, and that Luciana indicated she too was worried about.

We also expressed concern about the care of people with serious and long-term mental disorders. There seems to be an increasing view that a mental breakdown is like the flu, and that people should recover in a matter of weeks. But mental disorder is rarely this short-lived, and some people need care for months and some for years. Since the closure of the old asylums, provision for this group of people has been whittled down, and handed to the private sector, which is costly and of variable quality. Luciana was also concerned about child and adolescent inpatient services being largely run by the private sector.

It is heartening that the Labour Party is taking mental health policy seriously, and Luciana appears to be thoughtfully considering different positions and solutions. Let’s hope the Party will put some genuinely radical ideas into its new mental health policy.

Hugh Middleton and Joanna Moncrieff