By Stuart Curlett
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Politics of the Mind

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Issue 431

The crisis of mental health has become a key issue. In an era of brutal cuts to welfare and public services, levels of mental distress and suicide are rising drastically among those out of work. This is as true for low paid workers, women and young people. The World Health Organisation estimates that by 2020 depression will be the leading cause of disability. In the UK one in four people will experience mental distress of some kind. With all that in mind this book could not be timelier.

Introducing, from the outset, the Marxist method in grasping an understanding of mental health, Ferguson takes us through a history of “madness”, discussing early religious based notions right up to the development of the current, and still dominant, biomedical model.

He highlights how the dominant changes in perception and treatment of mental distress happened as a result of significant political social upheavals, such as the transition from feudalism to capitalism, the first and second world wars or the radical revolts of the late 1960s.

A section focuses on Freud’s theories of psychoanalysis, which dominated psychiatry throughout the middle of the 20th century. Ferguson discusses the engagement of these ideas by early Marxists in Russia and Germany, as well as the drawbacks that allowed its integration to the biomedical model of mental health.

The incredible period of revolts in the late 1960s precipitated another major challenge to the dominant view. Ferguson follows the advent of the “anti-psychiatry” movement, led by psychiatrist R D Laing and others. He also assesses their critique from the late revolutionary socialist Peter Sedgwick’s book Psycho Politics and comes to a conclusion of the merits and pitfalls of both sides of this debate.

The later part of the book focuses on the more recent “paradigm shift” in mental health that has emerged since the beginning of the 21st century. More progressive models that locate mental distress within the context of people’s experience of the world are challenging those that simply point to chemical imbalances or genetic deficiencies in the brain. Though is to be welcomed, Ferguson rightly argues that these models are not without their limitations.

This comes within the context of a new wave of social workers, clinical psychologists — and crucially, mental health service users — that are now part of growing campaigns that are fighting against cuts to mental health services, stigma and in many cases the very system that causes it. Ferguson gives an overview of the some of the successes and drawbacks of some of those campaigns. He also gives an insight into the politics of what is known as “mad studies” and looks at the opportunities and dangers within this field.

Ferguson ends with the emphasis on the need to move back “from worry lines to picket lines”. The book is a useful tool for those not only wishing to engage in the current debates around mental health, but for anyone fighting for a society where mental distress ceases to exist altogether.

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