Covid-19 poses not just an acute threat to the physical health of many people but also to their mental wellbeing.
The pressures piled on people during this crisis can seem endless.
Across the globe, people face stringent restrictions, the fear that their loved ones will fall ill, and mass deaths.
Millions of people have suddenly been sacked, or are still working in challenging, dangerous conditions.
An economic slump that some economists describe as being worse than The Great Depression of the 1930s and the 2008 financial crash is coming.
This threatens to thrust millions of people into deep poverty.
And for those already experiencing mental health problems, the fallout from Covid-19 will almost certainly intensify them.
For instance, a study from the Young Minds Trust showed that for 83 percent of people with mental health problems, the pandemic was already making it worse.
Author and activist Iain Ferguson told Socialist Worker that coronavirus has opened up an “unprecedented” mental health crisis.
More than a third of the planet’s population is under some form of lockdown—with catastrophic health impacts.
“Many will be experiencing heightened feelings of loneliness, anxiety and depression,” said Iain.
In addition, “Many working class people will face going to work without the Personal Protective Equipment needed to keep them safe.
Some will worry about being sacked, or face sharing a house with too many other people.
“These pressure are clearly in a different league from the rich.
“Yet prince William and Kate are broadcasting from inside Kensington Palace dishing out advice on how we should handle our mental health,” said Iain.
The royals front the Heads Together charity which claims to try to battle mental health stigma to “ensure that people feel comfortable with their everyday mental wellbeing”.
But it’s not just stigma that means people struggle to stay healthy.
The Tories have spent a decade gutting mental health services and slashing benefits.
Now Boris Johnson’s failures to stem the rise of Covid-19 mean that those already hit by austerity are finding it harder than ever to get the support they need.
“As with every other aspect of this crisis, we’re quite clearly not all in it together,” said Iain.
It’s not true that mental distress indiscriminately affects everyone equally—whether you’re a duke or a bus driver, a duchess or a hospital porter.
Mental health problems both reflect and compound existing inequalities and oppressions in society.
Racism, sexism, homophobia and other oppressions shape our everyday life experience, so it’s not surprising that they have implications for our mental health.
“Across Britain, the rates of schizophrenia and psychosis are notably higher in people from a Caribbean background—but this not the case in Caribbean countries,” explains Iain.
So it’s not simply a question of biological predisposition to certain mental health problems—but one rooted in wider social conditions.
“The roots of the mental health epidemic is not genes or biology but life experience under capitalism,” he said.
Being black and working class makes it more likely that someone will suffer mental distress—and it makes it even less likely that they will be properly diagnosed.
Seeing mental distress as flowing from biology rather than wider social conditions has implications for how people will be treated during and after the pandemic.
“The dominant model, the psycho-scientific model, primarily sees these conditions as a result of a faulty brain,” said Iain.
“This is the model that is promoted by psychiatry and by big pharma, but we should not medicalise people’s reaction to coronavirus.”
The dominant model, the psycho-scientific model, primarily sees these conditions as a result of a faulty brain
A useful example to look at is the Diagnostics and Statistical Manual of Mental Disorder (DSM)—a book that provides psychiatrists with a list of mental illnesses.
The DSM makes it easier for clinicians to make a diagnosis based on how many symptoms a person is displaying.
This “medical model” of understanding mental distress has an ideological impact.
It rests on the idea that much of the human experience can be broken down, compartmentalised and translated into diagnosable disorders and then medicalised.
Over five decades, the DSM has swollen to include more entries than ever before.
The DSM 5, released in 2013, indicated that if someone was grieving for longer than two weeks, they should be considered to be suffering from a major depressive episode.
Medical intervention forms a critical element of treatment for mental distress.
For some people, antidepressants and other drugs are lifesaving and contribute to a continued sense of mental wellbeing.
But this focus on medicalising normal, if upsetting, parts of human life—such as grief—risks overlooking other methods of treatment, such as talking therapies.
“Feeling sad or angry or confused is not a sign of mental illness—if you’re not feeling anxious now then you’re not watching the news,” said Iain.
“Of course some people will need medical help or support to get through this crisis. People who are currently using medicine and find it helpful shouldn’t stop.”
And Iain said that pharmaceutical companies—which have financial links to half of DSM’s authors—will want to get in on the market created by the increased rates of mental distress experienced during the pandemic.
“We need to resist attempts by big pharma to turn a normal reaction simply into a diagnosis,” he said.
The full extent of the mental health crisis exposed by the pandemic will only be understood in the years to come. But there remains some possibility for a collective response to the virus, that could help those feeling vulnerable or anxious.
“There needs to be a collective response to collective trauma,” argues Iain.
“A key feature of trauma and mental distress generally is isolation and powerlessness.
“But acting collectively is important in developing a sense of agency and challenging powerlessness.”
Times of crisis don’t just provoke feelings of despair in people—but can fuel a desire to act too.
Being part of organising action together can in some cases combat feelings of isolation or anxiety.
Over 750,000 people offered to be “NHS Volunteers” to help with the coronavirus effort.
And dozens of grassroots-organised neighbourhood support networks have sprung up so working class people help each other to survive the crisis.
“Although we need to go beyond self-help and Mutual Aid groups, hundreds of thousands of people are volunteering and disproving the lie that there’s no such thing as society,” said Iain.
Fighting for mental health services now has to be twinned with the struggle for a world without mass health emergencies—mental or physical.
The task of fighting for better mental health services is an urgent one. It will mean rolling back the decade of austerity that has slashed hospital beds, cut community support and closed GP practices.
But it means also fighting for an understanding of the mental health crisis that locates it in the context of an unequal society that crushes people in the pursuit of profit.
The high levels of chronic unhappiness under capitalism is a direct product of class society built on inequality, competition and accumulation.
Capitalism is a system where the vast majority are denied any real choices about how to live their lives.
And workers are forced to compete with each other for the resources made scarce under capitalism, such as jobs and housing. So it’s no wonder that in everyday life, feelings of powerlessness can contribute to widespread anxiety or depression.
Karl Marx spoke about how people’s experience of work left them unfulfilled and alienated.
He said the worker “does not confirm himself in his work, but denies himself, feels miserable and not happy, does not develop free mental and physical energy, but mortifies his flesh and ruins his mind.
“Finally, the external character of labour for the worker is demonstrated by the fact that it belongs not to him but to another, and that in it he belongs not to himself but to another.”
So any response to the crisis should include fighting for a world that isn’t based on exploitation and oppression.
It needs a vision for a socialist society where ordinary people are treated with respect and have control over themselves and their lives.
Iain called on socialists to put forward a “political explanation of the crisis and use it to channel people’s anger.”
“We need to win the argument that it’s the political-economic system of capitalism that’s produced this crisis.”
“It’s up to us to prove another world is possible.”