Sedated—How Capitalism Created Our Mental Health Crisis by James Davies
Why is it that over the last 40 years many areas of medicine have improved with the exception of psychiatry and mental health? That is the question author Dr James Davies asks in Sedated—How Capitalism Created Our Mental Health Crisis.
He argues capitalism systemically depoliticises, over medicalises and individualises our approach and understanding of mental health
Sedated argues our current mental health crisis stems from neoliberal reforms of the 1980s. Using academic studies, interviews with experts and detailed analysis, Davies weaves an intricate and engaging story.
He looks at former Tory prime minister Margret Thatcher and how subsequent governments remained committed to neoliberalism. They pushed policies such as privatisation, stripping the welfare state, running public services like a business and clamping down on trade unions.
Each chapter showcases how Thatcher and other champions of neoliberalism tried to use economics to change the very “hearts and souls of people”.
The first half of Sedated is an expose of the drivers of our mental health crisis, and the interventions that perpetuate it. “Interventions” range from Improving Access to Psychological Therapies (IAPT) services to mental health first aiders in workplaces. They’re supposed to spot signs of mental distress and refer people to services, but without dealing with the workplace problems that are causing it.
Davies brings politics back into the discussion and says economics shapes these interventions, with the aim of getting people back to work.
These interventions reinforce the idea that individuals are to blame for their own joblessness, recasting unemployment as a “psychological deficit”. They purposely bypass the structural issues, such as lack of jobs, discrimination and stigma, that can hinder job opportunities.
Davies explores the role of debt as a tool used to mask deeper structural issues in the system. He claims that the deregulation of credit normalised borrowing as a way to make ends meet while wages stagnated. By deregulating credit, Thatcher helped to lock people into debt and all the pressures that come with it.
Similarly, Davies argues that the prevalence of prescription drugs is another plaster, masking systematic problems. He says the avid promotion of drugs, such as anti-depressants and anti-psychotics, serve the economic interest of big pharma. Yet evidence shows that long term use of these drugs lowers rates of recovery.
In the early 20th century psychiatric treatments, such as lobotomies, insulin-induced comas and fever therapies, were heralded as highly effective. But ultimately these therapies proved extremely harmful to patients.
Is it not then reasonable to question whether the same hype applied to previous psychiatric remedies can be applied to current treatments? And that this leads to the over prescription of anti-depressants and anti-psychotics.
This is strongly contested by those in psychiatry with economic links to big pharma. But the findings in the book challenge the long cultivated belief, perpetuated by big pharma, that mental health issues have a biomedical base.
Davies is correct that mental health interventions depend too much on a chemical cure. But his claims about the ineffectiveness of drugs are too black and white. Many people rely on drugs because they need to—which Sedated doesn’t touch on. Rather, if interventions were shaped by the voices of patients, it could help a holistic approach which combines the prescription of medication and talking therapies.
Davies proposes that a more effective approach to the mental health crisis would require policies which tackle the social roots of distress. They include, he says, more progressive taxation, strengthening of trade unions and better social welfare.
The second half of Sedated drives home how we got here. It looks at the way society teaches us to accept the chemical cure over and above addressing the social causes of mental distress.
Davies broadly touches on the inequalities that were exposed by the pandemic. He acknowledges how those on lower incomes and black people were disproportionately affected by Covid 19. Unfortunately, Davies doesn’t really explore the relationship between racism, sexism or disabled people’s oppression and mental health.
He makes a nod to the explosion of grassroots anger as the system throws us into crisis after crisis.
Davies pieces together an illuminating polemical, which debunks and re-politicises the mainstream understanding of mental distress. While painting a grim picture, Sedated offers a sense that change can happen.
Interventions that tackle the social roots of distress and centre human’s needs are possible. But only with system change.
Interviews with RAR organisers 50 years on
Hadestown is a damning condemnation of capitalism
Exhibition seems to revel in making histories and events obscure
Artist Mike warns, 'This is what you’ll lose'
