Photo: “Northern State Hospital” by Flickr user Cindy Shebley is licensed under CC BY 2.0
by Alice McIntyre
I spent a week in a mental hospital. Most people should do the same.
I say this without condescension and with only the slightest tinge of hyperbole. My time in inpatient mental care gave me valuable tools for emotional processing that everyone, even neurotypicals, can benefit from. I began to more deeply understand how those with demonized mental conditions such as schizophrenia are human beings deserving of care and respect, just like everyone else. You, dear reader, have more in common with someone who suffers from audiovisual hallucinations than you ever will with a millionaire or politician.
Suicide is the second leading cause of death for people aged 10 to 34, according to the National Alliance on Mental Illness (NAMI). NAMI also reports that one in five U.S. adults experience mental conditions, first and foremost anxiety disorders. This begs two questions: Why are we in this situation, and what do we do about it?
We can begin to understand what’s going on by observing everyday life. More specifically, by looking at the phenomenon of what British mental health professionals have dubbed “Shit Life Syndrome,” or SLS.
Writing for the Financial Times in 2017, employment correspondent Sarah O’Connor took a close look at the town of Blackpool, on the northwest coast of England. Bucking the 21st-century trend of urban exodus, Blackpool’s low housing prices have attracted new precarious and working-class residents, driven out of major cities by austerity and rising rents. The “drop-out town” has some of the highest antidepressant prescription rates in the UK, and has suffered a decline in life expectancy (already the country’s lowest). The other nine of the UK’s most-prescribed areas are also municipalities facing economic and social decline. Inadequate funding for mental health services has resulted in doctors typically only having 10 minutes with each patient—far too little time to give them the support they need. With mental illnesses being harder to quantify on paper than physical disabilities for the purpose of gaining financial assistance, yet another source of anxiety is placed on the backs of suffering people.
What O’Connor describes in Blackpool is also true here in the U.S. Economically depressed areas have faced an epidemic of “deaths of despair” — working-class people in these communities are dying from substance abuse and suicide at ever-increasing rates. As reported by Melissa Healy for the LA Times in Nov. 2019, life expectancy in the United States has been declining over the past three years, attributed first and foremost to deaths of despair. This follows a more prolonged trend of increased drug and alcohol-related deaths since the late 1990s. The phenomenon isn’t isolated to West Virginia coal towns or the atrophied Rust Belt. Taxi drivers in New York City, our immediate mental image of the capitalist metropolis, have faced a widely-reported rash of suicides. Workers in the so-called “gig economy,” previously praised as a way to “be your own boss,” aren’t faring much better: According to a Jul. 2018 article from Vice, app-based delivery and rideshare drivers are suffering from widespread anxiety and depression. The social and economic structure of society seems to be near-universally eating away at the very people who serve as its engine.
The connection between the environment in which we live and our mental health is made clear by the bleak situations many find themselves in. Further, both inpatient care and longer-term therapy are inaccessible for those who need them the most. Writing for NPR in 2017, Samantha Raphelson conveyed how the prolonged decline in the availability of state psychiatric beds results in many who suffer from mental conditions ending up homeless or imprisoned. Neither of those outcomes involve adequate and necessary mental healthcare.
On top of this, institutional psychiatry has deep-rooted inadequacies. In part by necessity and in part by design, psychiatry and psychotherapy generally emphasize symptom management over a close examination of why those symptoms emerge. A recognition of the conditions that result in “Shit Life Syndrome” or exacerbate existing mental health problems, let alone an indication that those conditions are changeable, is almost entirely absent. Despair and disillusionment are cast as biological diseases or personal struggles, rather than a natural response to a soul-crushing existence. In the words of British critical theorist Mark Fisher in his book Capitalist Realism, “This pathologization already forecloses any possibility of politicization. By privatizing these problems—treating them as if they were caused only by chemical imbalances in the individual’s neurology and/or by their family background—any question of social systemic causation is ruled out.”
Not only is there a failure to understand “Shit Life Syndrome” and social aggravations of mental distress in a formal context and develop new methods of care, but such failure is embedded in psychiatry’s DNA. In a 2018 article for Jacobin Magazine, Columbia doctoral candidate Zola Carr details how pioneers of American psychiatry such as Adolf Meyer conceived of the discipline as an active political project to counter labor militancy and socialist agitation. Meyer’s quest to “… help people find their place in nature and the social fabric” and to counteract “ … destructive propaganda a la class consciousness and class emphasis … ” was well-funded by such archetypal capitalist “robber barons” as John D. Rockefeller, and it was due in no small part to this financial support from the ruling class that psychiatry became an accepted scientific discipline.
This is not to say the use of medication and therapy to alleviate mental distress should be dismissed. On the contrary, we must envision a radically different conception of mental health. Not only must we pursue the adjustment of individuals to everyday life, but the fundamental transformation of society in accordance with the needs of individuals. One can only imagine the profoundly positive impact on people’s mental health if the neurotic chaos of capitalism was replaced by rational economic planning for the good of all: if each and every person no longer had to worry about losing their home and could access the healthcare they desperately need.
