Australia leads the world in debates surrounding mental health funding, a precedent that was partially followed in the UK election by Ed Miliband advocating for greater funding towards early psychological interventions. The local debate was spearheaded by former Australian of the Year, Professor Patrick McGorry, when he was appointed several years ago.
There is no question it is a worthy debate, particularly given our proportion of spending within the total health budget is below OECD norms. Another esteemed colleague, Professor Gordon Parker, says no Western country in the world has done more to destigmatise mood disorders, particularly depression.
Few clinicians can see a downside to such advocacy. It is better some people with milder illness are encouraged to seek treatment when perhaps they would improve anyway, rather than those with serious disorders not present at all.
But in parallel to the debates around destigmatising mental illness and appropriate resource allocation to the sector has been another debate surrounding psychological harm and human vulnerability. This is most pronounced in the heated discussions surrounding domestic violence, free speech and racial discrimination, the mental health of asylum seekers and to some extent workplace bullying in the realm of industrial relations.
The British sociologist Professor Frank Furedi, a long time critic of the medicalisation of human distress, argues that the Left increasingly paints the human being as lacking agency. ‘The very idea of human autonomy is becoming a dirty word amongst the Left.’ he says. This has become a new political fault line, particularly as the economic argument against markets and the porous flow of capital has become harder to pierce.
In the UK, conservative media personalities stepped in to counter Miliband’s advocacy. Jeremy Clarkson went as far as referring to ‘Johnny suicides’ and Daily Mail columnist Janet Street-Porter wrote that ‘depression was the latest must-have accessory for the misery movement.’ While their comments were insensitive, it is a pointer that destigmatisation can arouse its own blowback.
Local criticism has been led by former Labor leader and Australian Financial Review columnist Mark Latham. In several opinion pieces this year, he has hit out at what he sees as fashionable mental health advocacy.
In one infamous article several months ago that led to defamation action, he suggested author and medical student Lisa Pryor’s use of anti-depressants was an example of inner-city mothers feeling ambivalent about their children. More recently, he wrote that the Labor Party rushing on to the band wagon of domestic violence advocacy and its characterisation as a sudden epidemic was part of the labour movement having lost its way.
But behind the bluster is a key point. Recent decades have seen a fundamental recasting of human vulnerability in the Western world, away from a view of people being fundamentally resilient to one where we are seen as innately vulnerable. It has occurred in parallel, and arguably in direct opposition, with the dominance of market economics with man’s rationality and autonomy at its centre. The greater emphasis on psychological weakness may also be a pointer to the rise of the Greens and their outsized reflex towards care and compassion.
British military psychiatrist Professor Simon Wessley has long argued that more technical arguments about trauma and depression have filtered down to the populace to weaken our relationship to adversity. Its intellectual roots lie in the Vietnam war, after which the notion of post-traumatic stress disorder arose despite no new scientific knowledge. Prior to Vietnam, the belief was that there was a tiny percentage of soldiers that might develop a trauma disorder and it was more likely to be due to their own pre-existing vulnerabilities. But since the notion of PTSD evolved, the growing view is that exposure to trauma is the primary cause. This is one of the roots of the growth in political arguments surrounding human vulnerability.
The local political examples are many and varied. In arguments about free speech and race, the case against Brandis’s law changes posited that so called hate speech psychologically harmed the affected minority, so much so that the Australian Psychological Association supported the forces against any change fearing offence may be the precursor to mental illness. This is a total corruption of the John Stuart Mill concept of freedom’s limits being the point at where it causes harm to others.
In debates about asylum seekers, the criticism of offshore detention is less about its effectiveness as part of a robust immigration program and more about the psychological harm detention may or may not cause the migration aspirants.
News Limited and Speccie columnist, and former union official, Grace Collier says ‘bullying is the thing’ in relation to disgruntled workers unable to find resolutions to workplace disputes and resorting instead to psychological claims. Collier compares the trend to the dubious diagnosis of repetitive strain injury in the 1980s. Bullying claims can act as a counter hampering attempts to make workplaces more flexible.
Mental illness remains a neglected segment within the health system, particularly in its treatment of the most serious disorders like schizophrenia, anorexia or bipolar disorder. Its advocates may, however, be unwittingly trivialising the experience of serious mental illness. For example, Beyond Blue spokesman Jeff Kennett quite openly says he uses the term mental health as a synonym for all emotional distress.
But while the psychological science surrounding trauma and mood disorders continues to evolve, there is an ascendancy of an even more significant and sinister politics around human frailty. It is a critical plank in health and safety serving as a new kind of morality and an organising principle for progressives justifying non-economic outlets towards regulation and government intervention. Important thinkers like Furedi believe that conservatives are yet to grapple meaningfully with such a challenge.
Dr Tanveer Ahmed is a psychiatrist, media commentator and author.
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