The Political Economy of the Mental Health System: A Marxist Analysis

The present paper analyses the functions of the mental health system in relation to the economic organisation of society, using concepts derived from Marx’s work on political economy and building on previous critiques. The analysis starts from the position that mental health problems are not equivalent to physical, medical conditions and are more fruitfully viewed as problems of communities or societies. Using the example of the United Kingdom, it traces how a public mental health system evolved alongside capitalism in order to manage the problems posed by people whose behaviour was too chaotic, disruptive or inefficient to participate in a labour market based on exploitation. The system provided a mixture of care and control, and under recent, Neoliberal regimes, these functions have been increasingly transferred to the private sector and provided in a capitalistic manner. Welfare payments are also part of the system and support those less seriously affected but unable to work productively enough to generate surplus value and profit. The increased intensity and precarity of work under Neoliberalism has driven up benefit claims at the same time as the Neoliberal state is trying to reduce them. These social responses are legitimised by the idea that mental disorders are medical conditions, and this idea also has a hegemonic function by construing the adverse consequences of social and economic structures as individual problems, an approach that has been particularly important during the rise of Neoliberalism. The concept of mental illness has a strategic role in modern societies, therefore, enabling certain contentious social activities by obscuring their political nature, and diverting attention from the failings of the underlying economic system. The analysis suggests the medical view is driven by political imperatives rather than science and reveals the need for a system that is more transparent and democratic. While the mental health system has some consistent functions across all modern societies, this account highlights one of the endemic contradictions of the capitalist system in the way that it marginalises large groups of people by narrowing the opportunities to make an economic contribution to society.

Recovery college features and context: advancing a recovery and well-being policy agenda

Purpose Internationally, there has been a move towards more recovery-oriented mental health policies for people living with mental illness, and some countries have included well-being as a population-level objective. In practice, these policy objectives can be difficult to achieve because of deeply rooted policy legacies, including a biomedical approach to care and the stigma associated with mental illness. The purpose of this paper is to investigate how interventions that operate outside the formal mental health system, such as recovery colleges (RCs), may advance these policy objectives more easily than efforts at broader system reform. Design/methodology/approach This study conducted a scoping review to explore the features and context of RCs that make the model an attractive and feasible opportunity to advance a recovery and well-being agenda. Our research is motivated by the initial and growing adoption of RCs by the Canadian Mental Health Association. This paper applies the consolidated framework for implementation research to analyse features of the model and the context of its implementation in Canada. Findings The RC’s educational approach, adaptability, coproduced nature and positioning outside the formal mental health system are key features that facilitate implementation without disrupting deeply entrenched policy legacies. Other facilitators in the Canadian context include the implementing organisation’s independence from government, its federated structure and the model’s alignment with national policy objectives. Originality/value This paper highlights how interventions outside the formal mental healthcare system can promote stated recovery and well-being policy goals.

Societal Labels, Maslows Hierarchy and Care within the Mental Health System

This article deals with how social attitudes and the consequent labelling in the society and prevent climbing the maslow tree and the kinds of therapy personal growth can offer to those living with schizophrenia. The way this works is illustrated in the article and how the various parts of the mental health system including hospitals, day centres and sheltered accommodation can help with this based on my own experiences.

Resilience in 2021: Descriptive analysis of individuals accessing virtual mental health services (Preprint)

BACKGROUND Although resilience has been extensively studied by developmental researchers, it has received less attention in the psychiatry and psychopathology research and practice, which is more focused on disease and pathology, and associated symptom-based measures like PHQ-9 and GAD-7. OBJECTIVE This study aims to describe resilience levels in individuals accessing Ginger, a virtual mental health system in addition to its association with demographic characteristics, baseline depression and anxiety symptoms. METHODS We conducted a retrospective observational study of 9,165 members who accessed Ginger, an on-demand mental health system, and completed a baseline survey between January 1, 2021 to August 5, 2021. We used multivariate regression models to test for associations between baseline resilience and other member characteristics. RESULTS Baseline scores centered on a mean and median of 24 (out of 40), with 81% of the sample having low resilience at baseline. Despite having relatively higher resilience scores, members with no or mild depression or anxiety still had low resilience scores on average. CONCLUSIONS Overall, members had low baseline resilience, in line with prior studies of trauma survivors. Findings suggest a need for mental health support among individuals who might not typically be recommended for treatment based on traditional clinical assessments like PHQ-9 and GAD-7. Future research could focus on the interaction between resilience levels and symptom-based outcomes measures like PHQ-9 and GAD-7.

The importance of motivational postures to mental health regulators: Lessons for Victoria’s mental health system in reducing the use of force

Objective: To consider whether research into “motivational postures” can assist the Victorian Government and the forthcoming Mental Health and Wellbeing Commission to regulate and implement forthcoming mental health laws. Conclusion: Although no research explicitly uses a motivational postures framework, there is evidence of a diverse set of postures amongst the mental health workforce. Some practitioners and disciplines reflect positive motivational postures towards mental health laws and consumer rights, while others show resistance, and others disengagement altogether. More research explicitly built on motivational postures is required to inform appropriate regulatory responses.

Alberta not criminally responsible project: Rates of persons found NCRMD and absolute discharges in Alberta following the Not Criminally Responsible Reform Act

In 2014, then-Canadian Prime Minister Stephen Harper passed the Not Criminally Responsible Reform Act into law, which gave Canadian courts and Review Boards new powers to protect the public from particularly dangerous mentally ill offenders. The most controversial change to the law included the designation of the High-Risk Accused. Once designated by the courts as a High-Risk Accused, that individual is barred from leaving a forensic hospital except for urgent medical reasons. In this article, the authors assess the impact of the Not Criminally Responsible Reform Act on the forensic mental health system in Alberta, Canada. The findings indicate that the legislation did not lead to any meaningful changes in the Alberta forensic mental health system in terms of absolute discharges and incoming persons found not criminally responsible.