“The mode of production of material life conditions the general process of social, political and intellectual life. It is not the consciousness of men that determines their existence, but their social existence that determines their consciousness.” (Marx 1859)
In what way is health, in particular mental health a highly political and potential radical issue? In my Self Care video I touched on the flawed, capitalistic idea that a person’s worth is dependent upon their economic value. This idea is pervasive in how it reinforces a sense that people must be “useful” or “productive” in order to be seen as functioning adults. This can be harmful not only in how it stresses capitalistic goals, placing strain on those still exploring what they wish to do, but also in how it contributes massively to ableism (the discrimination faced by disabled, neuroatypical and mental ill people). The link between “maturity” and “production” is one that leads society to treat people with mental or physical disabilities like children regardless of their age. It limits what we see as productive or valuable.
There is an important balance to be stuck between self-care, nurturing and providing for your own needs, and contributing towards a common good. This is not a revolutionary idea. But self-care and contributing to a good beyond yourself are not necessarily opposite ends of an important spectrum but rather overlapping aspects of positive action.
This relates to Marxism is so far as Marx and Engels noted how capitalism “has resolved personal worth into exchange value” (Communist Manifesto). The idea that people should have to work for a living is pernicious in that it appears reasonable until followed to its logical conclusion that people who cannot or will not work deserve to die.
Two recent books, Oliver James’s The Selfish Capitalist and Mark Fisher’s Capitalist Realism address the emotional and social impacts of modern capitalism. In the United Kingdom for example depression is now the number one illness treated by public health services. Significantly Fisher refers to the “privatisation of stress” that creates a culture where it is “incumbent on individuals to resolve their own psychological distress” (Fisher 2009). This individualism is a trademark of neo-liberalism. Fisher goes on to note this individualism in the organisation of Live Aid and Bono’s following ‘Product Red’ brand which existed for the idea that poverty could be ended directly by individuals without any political solution or systemic reorganisation.
“The fantasy being that western consumerism, far from being intrinsically implicated in systemic global inequalities could itself solve them.” (Fisher 2009: 15)
And it should definitely be noted that I used the word Marxist somewhat loosely, though I am not alone in that. Marx wrote very little on health care or non-economic forms of community so Marxian academics throughout history have just filled in the gaps in Marx’s ideas based on his general intent and updated others for greater relevance to the present day. That is what I seek to do. I don’t always aligned myself to academic Marxism because it comes with a great deal of baggage but there are times when it is the appropriate school of thought to credit with what I am thinking.
The Oxford Online dictionary defines Marxism as: “the political and economic theories of Karl Marx and Friedrich Engels, later developed by their followers to form the basis of communism. Central to Marxist theory is an explanation of social change in terms of economic factors, according to which the means of production provide the economic base which influences or determines the political and ideological superstructure” and Merriam-Webster as: “the political, economic, and social principles and policies advocated by Marx; especially a theory and practice of socialism including the labor theory of value, dialectical materialism, the class struggle, and dictatorship of the proletariat until the establishment of a classless society”.
These are true though in reality Marxism, particular academic Marxism, is hugely diverse in its methodology and praxis as there is lots of room to interpret and reinterpret in the 150 years since Marx and Engels were writing.
If mental health reform were to come hand in hand with societal reform then it would involve some re-evaluations of individualism and community.
Let us accept a few basic conclusions as a foundation. People have inherent value beyond their beauty, usefulness or identity. Despite this many people’s actions actively harm themselves, the common good, or both. So everyone has value to the common good and yet many people harm it, which might appear to be a contradiction of sorts, however not so if part of the common good is the wellbeing of individuals as well as the wider community.
So perhaps the most pertinent questions that would arise from these conclusions, is what is the common good? The common good, in my perspective, is the advancement of the health, welfare and innovation of communities. I also use the word communities a bit loosely. It could mean small social communities like a co-op, families, towns, nations, continents or even the world. In an abstract sense the human race does operate as a global community insofar as events effecting one area or set of people will have knock on effects, however small and for better or worse, everywhere else.
So I talk about communities. Humans are social animals. We thrive together as much as we have the capacity to tear each other down. We are not the strongest or fastest animals out there but we evolved and survived because of group-action. Therefore problems which affect the individual (mental health, crime, poverty) cannot truly be understood in an asocial vacuum.
So my argument is that, like poverty, mental health reform needs a collective, community wide approach not a greater focus on the actions of individuals.
Fisher, Mark Capitalist Realism (2009)
Goodman, Benny ‘Marxism and Health Care’ (2013)