I wrote an article in March about the government plans to make the receipt of social security benefits for those with mental illnesses conditional on undergoing “state therapy.” I raised concern about ethical issues – such as consent, the inappropriateness of using behaviour modification as a form of “therapy,” and I criticised the proposed Cognitive Behaviour Therapy (CBT) programme on methodological and theoretical grounds, as well as considering wider implications.
The 2015 budget included plans to provide online CBT to 40,000 claimants and people on the Fit for Work programme, as well as putting therapists in more than 350 job centres.
Since I wrote, over 400 psychotherapists, counsellors and mental health practitioners have written an open letter, published by the Guardian, about the broader, profoundly disturbing psychological and quality-of-life implications of the coalition government’s austerity cuts and policies. However, the letter was particularly critical of the government’s benefits sanctions scheme, which has been condemned by many of us – human rights advocates across the state – as brutal, unjust, ill-conceived, ineffective and inhumane.
In particular, the letter stated that the government’s proposed policy of linking social security benefits to the receipt of “state therapy” is utterly unacceptable. The measure, casually coined “get to work therapy,” was discussed by Chancellor for the Exchequer George Osborne during his last budget.
The letter’s supporters included psychotherapist and writer Susie Orbach. She called the Conservative proposals “beyond shocking.” Echoing the concerns I raised earlier this year, she said:
“It undermines the fundamental principles of one’s right to physical and mental care – that you have to be able to consent and that the people you go to have to be highly trained and have your best interests and aren’t meeting targets.”
The letter’s signatories, all of whom are experts in the field of mental health, have said such a measure is counter-productive, “anti-therapeutic,” damaging and professionally unethical. The “intimidatory disciplinary regime” facing benefits claimants would be made even worse by further unacceptable proposals outlined in the budget.
Among the groups represented by the signatories were Psychologists Against Austerity, Britain’s Alliance for Counselling and Psychotherapy, Psychotherapists and Counsellors for Social Responsibility, the Journal of Public Mental Health, and a range of academic institutions including Goldsmiths, Birkbeck, the University of London, the University of Amsterdam, Manchester Metropolitan University, the University of Brighton, Disabled People Against the Cuts and others.
More generally, the wider reality of a society thrown completely off-balance by the emotional toxicity of social conservatism combined with economic neoliberalism (which I have argued is manifestly authoritarian) is affecting Britain in profound ways, the distressing effects of which are often most visible in therapist’s consulting rooms.
This letter sounds the starting-bell for a broadly based campaign of organisations and professionals against the damage that neoliberalism is doing to the nation’s mental health.
The letter said that for now, we call on all the parties in this election to make it clear that they will urgently review such regressive, anti-therapeutic practices, and appropriately refashion their commitment to mental health if and when they enter government.
Andrew Samuels, an Essex University professor, and immediate past chair of the UK Council for Psychotherapy, said he believed there was “a bit of a public school ethos” behind the work-capability regime introduced under the conservative-liberal democrat coalition and new conservative plans.
Characterising the government attitude as “Pull yourself together man, for heaven’s sake,” Samuels added: “It is wholly inappropriate. It symbolises a society that has lost all moral compass.”
Absolutely. Public schools are notorious for a culture of bullying. However, it’s one thing to be treated as a privileged and insulated public school boy by a peer from an elite background to “character building” rhetoric, but quite another to adopt that same bullying approach towards the ill and most vulnerable citizens. All to justify an ideological drive to “shrink the state” and remove support from the poorest.
All of this said, public schools are regarded by many as institutions that inflict a particularly British form of child abuse and social control. I also think it has to be said that soul trauma and pain don’t respect social status.
Samuels insisted the open letter was not “pro-Labour” but was aimed at getting a review of measures taken and proposed over the past five years.
He said: “If Labour decides afterwards all this is in order, it will go on. But I don’t think it will.”
The Labour Party values professional opinion and rational discourse. The Conservatives, on the other hand, are not widely recognised as a party that welcomes open debate, transparency and accountability. The tories simply exclude critical professionals and representative organisations that may challenge and disagree from the discourse.
A spokesperson for Labour said mental health “is the biggest unaddressed health challenge of our age.”
“It’s essential that we give mental health the priority it deserves if we are to thrive as a nation and ensure the NHS remains sustainable for the future,” he said.
The Labour Party have pressured the government to “write parity of esteem between physical and mental health into law,” and in the response, Labour have stated that the party is committed to implementing this policy if elected in May.
The spokesman pledged the Labour will bring an end to the “scandal of the neglect of child mental health,” indicating a welcomed return to a comprehensive preventative approach. He said: “It is simply not right that when three-quarters of adult mental illnesses begin in childhood, children’s mental health services get just six per cent of the mental health budget.”
Richard House of the Alliance for Counselling and Psychotherapy, the letter’s main organiser, said there had been a mounting groundswell of concern: “When one hears story after story of dramatic negative health impacts, psychological and physical, after people are subjected to these back-to-work practices, the time has surely come for an ‘emotional audit’ of the impact of what, to many, appear to be heartless, un-thought-through policies that are merely penalising and punishing the already disadvantaged still further.”
Yes, the time has come for a change of government. On May 7, we must ensure that the regressive, oppressive regime of the past five years is replaced by a progressive, inclusive and democratic alternative.
The Psychology of Austerity
A group of mental health professionals have come together under the banner of Psychologists Against Austerity (PAA) to highlight the psychological impact of austerity.
Now, with only a few weeks to go before the general election, PAA have started a campaign calling for a Parliamentary Inquiry into the psychological damage austerity has wreaked across the UK.
You can read more and sign our petition here: 38degrees/psychological costs of austerity inquiry