The ensuing homogenisation of the human race continues through the early
part of the new century.
The right-wing lead coalition government of the UK has increased funding
to create more automoton-like human beings. Using the latest paradigm of
well being they are effecting normalisation on vast swathes of the
population using outcome-driven psychological therapies delivered
through the Improved Access to Psychological Therapies programme.
The national program was initially conceived to keep the meat working.
What I mean is it was designed to enforce the socio-political needs of
keeping people working in the 'factories' (offices, call centres - all
places which follow the Industrial Revolution factory mode). Layard's
economic justifications for CBT were based on it's ability to treat
depression, a period where there would be an expected reduction in
productivity. He's an economist so doesn't understand that the human
condition may be more complex than psychiatry or socio-economic models
understand. People may need depression and it may not be an illness but
it does mean less productivity for some people. It can also be
associated with cognitive deficits and increased critical thinking. The
latter can be of social detriment because many workplaces function on
people agreeing a lot. The former may reduce performance.
Understanding the human race and condition is diverse is not the role of
health economists nor psychiatry. They seek methods of normalising human
beings. What is normal is not defined and I use the pejorative of
automoton as the noun I chose to describe this undefined concept to
which the psychiatric profession aims to transmute individuals who are
judged significantly different to the norm. The socio-political-economic
people just go along with the construct without questioning what is
actually being done.
I'm not sure they can understand the paradigm which sees an ill society.
These periods of depression or anxiety may serve a purpose. They may
also be a problem created by society being malformed. It is the local
society itself which can be the cause of the problems, irrespective of
the need to keep people working. That's a different variable and in
terms of health it's job satisfaction which shows the most significant
benefits for physical and mental health measures - more than most other
treatments.
Hysteria was an epidemic in the West when psychiatry was incieved. Today
the diagnosis is covered by conversion disorders and disorders related
to sex. Was it an amazing change wrought upon through psychiatry which
healed the illness (both conversion disorders and the disorders related
to lack of sex or inability to achieve orgasm are lower in prevalence
than hysteria) in which case the vibrator, one of the approved
treatments, has had a significant impact on healthcare. Or was it a
change in society's fabric which was healed by other factors, far more
complex ones than are understood with psychiatric science.
It is in examples such as the World Health Organisation International
Pilot Study of Schizophrenia where the effect of local cultures and/or
the detrimental effects of the psychiatric model of pathologisation and
treatment can be seen. The US and UK have very well funded healthcare
systems compared to the developing world nations included in this trial.
Their societies are supposedly more advanced. In all 3 of the developing
world nation sites people with schizophrenia did better on social
measures of outcome compared to the US and UK. In two of them they also
did better on clinical outcomes. The study's methods can be question as
can all studies be criticised but it is robust enough a result and has
been replicated.
Psychiatry attempts to change the individual using the paradigm of
illness and treatment. The reasons change like fashions but the answer
is usually the same: change the individual. There are exceptions. In
some countries people with gender identity disorder will have their
wishes granted, i.e. rather than using behaviour and thought
modification techniques to suppress their being or change their being
healthcare services will acquiesce and perform a sex change operation.
Even in this exception, one which fundamentally challenges the standard
paradigm because GID is associated with biological brain differences
(size of the corpus callosum), the medical profession hasn't engaged in
the undiscovered treatment.
What the fuck am I talking about? Simply this: changing society, culture
and systems to rectify the illness there could lead to significant
benefits for mental health as a broader concept. It means changing
constructs rather than individuals, a far harder challenge but one that
has been achieved by people like Gandhi (voice hearer), Luther King and
the Suffragette movement (many of whom would have had psychiatric
diagnoses applied to change their behaviour had they been born in modern
times).
It is not often considered in psychiatric practice or research into
treatments. Even the criminalisation of drugs is justified by
politicians rather than driven by psychiatrists.
Changing society to heal the deficits as a requirement of psychiatry and
mental health opens up a new challenge. After the what there is always
the question of how?
The simple answer is it is already happening through the independently
funded Time to Change campaign. This was started by a coalition using
funding from the National Lottery and Comic Relief. Mind and Rethink
were members. I'm not sure if the Royal College of Psychiatry or NICE
were. They were sticking to methods which work on the individual. Little
did they know the future of mental healthcare and real progress for
patients was being commissioned independently of the medical profession.
Mind and Rethink were also on the coalition which got the IAPT scheme
started. They're very strongly in favour of psychological therapies. I'm
un favour of psychological therapies as an alternative and a
preventative to medication but I think the modern way it is used isn't
correct. People can be the right people for other people's journey in
life but not everyone follows the medical model of the human condition.
Though there is evidence to support it there is also evidence to support
a different argument, that the system isn't working and the whole idea
of mental health is misaligned and misused.
Medication is my greatest bugbear. It must always be about choice and
informed choice by the individual. Informed choice means informing
people that antidepressants little different from slow acting narcotics
and antipsychotics don't treat the delusions and hallucinations, they
just sedate people. Regardless it still attempts to treat the individual
and billions is spent on this as well as hundreds of millions a year on
psychological therapies to normalise the individual through psychiatry.
Time to Change is one answer. It has had a fraction the funding of the
psychiatric system which seeks to normalise individuals to their dogma
of not mentally ill or distressed. Those are subjective judgements and
there is sufficent evidence to challenge the validity of the model in
practice. There's also sufficient evidence to show alternative routes
may be worth considering. This sort of progressive thinking is not seen
in the Royal College which chooses to use the motto "Let wisdom guide."
They'd rather stick to removing human behaviours and creating a
homogoneised race which is untrue to who we really are.
1 in 4 people in the UK suffer mental health problems every year.
Psychiatry clearly isn't working. This figure is reliable (as a ball
park estimate) across a number of decades. It was originally publised in
a book in the early 1980s by Huxley and Goldberg and is considered a
figure with authority in academia. In the 1990s the wrote another book
and re-estimated the multiplying figure to go from a prevalence to an
incidence figure and quoted 3 in 10 in a year. Using the shorter
sampling prevalence estimate from the Adult Psychiatric Morbidity
Survey, one of the UK's highest regarded regular reports, which also
uses a slightly different measure from the one used in the 3 in 10
figure the estimated incidence is in the same area as 1 in 4 - pretty
high basically.
Some might say it's gotten worse because more people are being treated.
Diagnoses may have also spread to milder cases. As extremes of behaviour
get removed by medication lesser extremes become the extreme and become
pathologised. It takes a generation or two (with the nuclear family) to
forget what the human condition is like. This is less of a problem in
developing world nations where the Great Confinement, the period where
the mad were removed from sight to the asylums, hasn't happened though
it is happening in a different way: psychiatric medication used to
modify behaviour, emotion and experience of consciousness.
Billions of pounds every year are put into normalising human beings
through psychological therapies (which can have other purposes than be
used to normalise people) and medication as well as the remaining
psychiatric hospitals and the nefarious treatments used there.
I think Time to Change gets just over 5 million pounds a year on
average. It's better funded than any antistigma or social change
programme from any of the professional medical bodies or the UK
government. It may be getting more funding from the government to
continue. Compared to what they're offering for ways to normalise the
individual it's a pitiful pittance. Mind are campaigning about stigma
and discrimination in the workplace but they're an independent charity.
Time to Change's methods are not the only way. There is significant
social change in a number of areas required to rectify the illness in
society which is responsible for the suffering and poor lives of the
mentally ill.
Rather than fund more behavioural modification driven by socio-economic
conditions or drugging of individuals to hide their symptoms we need to
remake a society where the unmedicated mad can exist alongside the
unmedicated automoton as equals walking the journey of life together and
without those perjorative concepts.
I have a dream.
