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In the lead up to our Mental Health Congress on 10 October please read this article by clinical psychologist Dave Rogers, in which he talks about the relationship between equality and good mental health. 
You can book a place at the congress by clicking here.

I’m a Clinical Psychologist and my job is to talk to people about their problems with low mood, anxiety and trauma. Recently I’ve become interested in how social change and political activism are essential to promoting good mental health. This article is about Community Psychology, the movement that seeks to take psychological recovery out of the therapy room and onto the streets, to share the message that equality is the best therapy. It’s also about how we can help campaigners. If you are involved in activism for progressive social change and you’d like to talk to our group – Psychologists for Social Change – we’d love to hear from you on the contact details below.

In January 2019 I had the privilege of being invited to the launch of the #123GP Campaign in the Long Gallery at Stormont.  While some health practices have access to excellent counsellors, others lack this resource, and waiting lists can be long for people who need therapy. This initiative was an urgent call on the HSC Board to provide funds for more counsellors in GP practices, and to improve training on mental health for general practitioners. I remember the passion and the eloquence of the campaigners, many of whom spoke about their own difficulties and challenges accessing services. 

I also remember a fire alarm going off midway through the event. Politicians, civil servants, campaigners and tourists immediately took action to get outside.  It was probably the most activity our MLAs had seen since January 2017. People don’t hang about when an alarm starts ringing, especially not in Northern Ireland. But what about the silent alarm bell that brought us there, was ringing then, and rings still? What action is being taken to move us out of the way of a psychologically toxic society, a political system that fosters isolation, and an unbridled capitalism that promotes profits at the expense of everything that is of value? Thank goodness for the campaigners and activists who encourage us to take action, proclaim our rights, and to remind us - this is not a drill.  

 

Psychologists for Social Change (PSC)

PSC is a UK-wide network of psychologists, therapists, students and others interested in working towards a psychologically healthier society. We promote the idea that social and political forces have profound consequences for our mental health. Our aim is to bring therapy out onto the streets, to help communities find their voices and promote social change. That’s why our values are allied to those of PPR. PSC formed in 2014, when the London Community Psychology Network came together to develop a briefing paper to parliament on the psychological impact of austerity policies. Our central mission is to get psychologists more involved in social action, influencing public debate and lending our voices and our skills to the fight for political and social rights.

Many readers will have heard of the main schools of therapy, such as CBT (Cognitive Behavioural Therapy) and psychoanalysis. These therapies focus on internal drives, patterns of thought, defence mechanisms, avoidance behaviours and core beliefs. In other words, people’s problems are thought to reside within the individual. That is an oversimplification – for example, Freud wrote extensively about the links between our civilisation, repression, and neuroses; and most Cognitive Behavioural Therapists will take account of social and economic forces when helping people to develop a complex explanation of their problems. However both of these approaches promote individual exploration, by way of the time-honoured 50 minute therapy session behind closed doors.

 

Community Psychology

By contrast, PSC is inspired by Community Psychology. This approach focuses on individual’s relationships with the external world. It encourages us to make changes on a systemic level by putting pressure on politicians; influencing the media; exposing toxic discourses as unscientific and psychologically harmful and taking part in peaceful protests. Participation and connectedness are seen as the key to wellbeing. Poor mental health – depression, anxiety, personality disorder  – is not seen merely as an expression of genetics, neurochemistry or personal beliefs, although these factors are recognised as significant. More importantly, poor mental health is taken to be an expression of a disconnected, psychologically unhealthy society. The people who are most disconnected and most disempowered – for example minority groups, the homeless, the unemployed – are also prone to poor mental health.

Our job as Community Psychologists is to ally ourselves with citizens and groups who want change, to empower communities and to lend our voices and our clinical experience to political debate. In other words, to help challenge the status quo and make the case for a diverse, equitable, and compassionate society. Examples of how we contribute include research, contributing to a briefing paper, or working with community groups to help marginalized people find their voice.

 

Austerity Ailments

The impact of cuts to public services are clear for all to see. Food banks have increased almost 22-fold since 2010; instability and poor pay is order of the day for benefit claimants and many workers. In NI, there was a 32% increase in applications for homelessness from 2012 to 2017. Shockingly, over an 11 month period in NI, 148 people who were registered homeless died while their applications for social housing were processed (source – www.thedetail.tv/articles/homeless).

You don’t need a psychologist to tell you the effect of relying on food banks, or the effect of having your disability challenged by an empathy-deficient PIP tribunal, or the psychological consequences of being homeless. The evidence of a connection between socioeconomic status and mental health is robust, with a review from the Mental Health Foundation recognising the “impact of stigma and discrimination on people experiencing mental health problems and those living in poverty” (Elliot 2016, Mental Health Foundation).  The psychological impacts of living in an unjust, economically unfair society are also detailed here , but can be summarised as:

• Humiliation and shame

• Fear and distrust

• Instability and insecurity

• Isolation and loneliness

• Being trapped and powerless

On the other hand, a psychologically healthy society is one that values people, aims to reduce distress and empowers citizens to speak out and to participate in improving their society. What would it take to make our society look like this? A good example is the work done by the #123GPCampaign.

 

#123GPCampaign

Lower numbers of inhouse GP counsellors is a direct consequence of austerity politics. Stormont’s 2019-2020 budget allocated a mere 2% increase in spending for health services in NI. The Department of Health concedes that our health service “can’t continue the way we are”. Our spending policy in Stormont is closely aligned to NHS budgeting in England, where 10 years of austerity have seen budgets rise by an inadequate yearly average of 1.5% between 2009/10 to 2018/19. This is in comparison to a previous average of 3.7 per cent (source – The King’s Fund). Fewer funds means fewer counsellors, and longer waiting times for appointments. 

What is the psychological impact of having to wait for an appointment? A report by Mind, the mental health charity, notes that overly long waiting times “can exacerbate mental distress and cause relationships to break down, jobs to be lost, people to be isolated and, in extreme cases, lead to suicide attempts”. There is a powerful ethical and moral case for the State to increase funding for mental health services. Besides this, there is a compelling economic argument – psychologically healthy people are better able to flourish in work, paying more taxes and reducing welfare benefits. 

It is hard to promote this type of rational debate, especially as a golden rule of psychology is that we are all heavily prone to biases, prejudice and irrationality. As long as we have a psychologically unhealthy society where profit maximisation is paramount, the case for redistribution of wealth to spend on public services will be ridiculed in certain quarters. But rational, evidence-based debate, making your voice heard, and using the legal rights available to us are a valuable tool in creating a healthier society, one that recognises it is important for people to have speedy access to services. Campaigners from PPR and the #123GP Campaign are crucial in keeping up the pressure for a psychologically healthy society.

 

Standing Up for Your Rights

Human Rights movements have made all our lives better and created a society that, while imperfect, is in many ways psychologically healthier than in the past - more connected, less tolerant of abuse and discrimination, and more respectful and compassionate to people’s differences. That is why the continuing work of the PPR is so important. It’s a happy side effect that the active, assertive pursuit of one’s rights is in itself a psychologically healthy activity. Research suggests that social activism is connected to wellbeing; therapies such as ACT (Acceptance and Commitment Therapy) emphasise the need to take meaningful action in accordance with one’s values.  Schema therapy, an approach that examines early life experiences, begins with the premise that people’s problems are often caused because one or more essential rights was denied to them in childhood – the right for affection, or autonomy, for example. Sometimes therapists will give clients copies of the UN Convention on the Rights of the Child (UNCRC) to reinforce the idea that they had a right to a happy, contented childhood. If you didn’t learn your rights in childhood, you might not be capable of recognising or protecting them as an adult. A good outcome in therapy is when someone recognises their rights and starts to assert them, to speak up against injustices in relationships, or in work. 


 

How We Can Help

If you are currently working on a project or campaign and you think it would be helpful to get a psychological slant on things, we’d be delighted to hear from you. There is a small group of core members in Psychologists for Social Change in Belfast, with a wider group of 50 or 60 who provide occasional support. We can contribute to research, interviewing, project development and lending our professional perspective to reinforcing your views in debates or media discussions. We also like to protest so keep us in mind if you have a demonstration coming up. We don’t pretend to have easy solutions to the problems of austerity. But our job, inside and outside the therapy room, is to help people find their voice and take control of their own stories, and feel empowered to speak out against injustice.

 

If you’re interested, drop us a line at http://www.psychchange.org/northern-ireland.html, or get in touch by get in touch by emailtwitter, or facebook

 

Please book your place at PPR's Mental Health Congress, 10 Ocotber 2019.