Dave's Progress. Chapter 97: Mental Health and Social and Economic Deprivation.

It's been quite a while since my last blog, so I'm sure you're all waiting in eager anticipation for whatever crumbs of wisdom and insight you may pick up from my abundant intellectual table. OK, so maybe I exaggerate. Maybe I even "big myself up" to ludicrous and grandiose proportions, as during my illness I was wont to do. But the theme of time running by has lately been of interest to me as I have just passed my 39th birthday. So, given my propensity for being both mentally and physically unwell, I feel it is good to bear in mind that, to use that over-used phrase, "time waits for no man". In consideration of that, here is yet another blog for your delectation.
As this is a blog primarily about mental health, then, it is fitting that my subject be, erm, mental health. And, as you may have gleaned from the somewhat sober title, it is about the link between social and economic deprivation and mental ill health.
Being from Stoke-on-Trent, we at the Pathways Group are no strangers to a little social and economic deprivation, as, it seems, Stoke is often near the top of the list in terms of these criteria. Indeed, in a recent document by the Royal College of Psychiatrists, entitled "No Health without Public Mental Health: The Case for Action", the link between social and economic deprivation and mental ill health was made clear, it stating that mental ill health "is consistently associated with deprivation, low income, unemployment, poor education, poorer physical health and increased health risk behaviour." And, Stoke-on-Trent scores consistently highly on this list of criteria, with 14% of the area's populace being unemployed or unable to work, 23% lacking any educational qualifications, and a massive 46% of private households classified as being in fuel poverty. The risk, therefore, of an increased number of people facing mental ill health in my own locality would appear to be significant.
Perhaps significantly, also, the Royal College of Psychiatrist's document would seem to fly in the face of the purely medical model of psychiatry, stating, as it does, that such environmental factors have a great deal of impact on mental ill health. It has always been my belief that environmental factors should be taken into consideration when accounting for any one's mental ill health, as well as the purely genetic or biochemical factors. To be fair to mental health services, this is usually the approach taken, but in the treatment of psychoses, at least in this country, the purely medical model seems to prevail. The prescribing of anti-psychotic medication seems always, then, to be the first option explored, assuaging, as it does, the chemical imbalances in the brain which the medical model sees as the major cause of illness. However, in a recent book, "Psychotherapeutic Approaches to Schizophrenic Psychoses: Past, Present and Future", it is shown how psychotherapy has been and is being used to treat psychosis, ranging from traditional Freudian approaches to cognitive behavioral therapy and indeed, almost any other human intervention. Indeed, the book shows that in other countries, such as Finland, psychological approaches have become far more established than in the UK, with neuroleptic medication being used cautiously, for shorter periods and in lower doses than in most industrialised countries. This is a refreshing approach to my mind, as it would appear to take away the risk of the often harmful and physically unhealthy side-effects of such medication.
Ideed, it would seem that many have seen the potentially damaging effects of social and economic deprivation on our health. Even as far back as the writing of Engels, as the newly industrialised cities began to appear, he remarked that there was "something in the turmoil of (their) streets against which human nature rebels."
Further to this, the one-time celebrity psychiatrist Oliver James seems to have constructed, in various books, a whole thesis that mental ill health is not just affected by environmental factors, but more specifically by the very system of advanced Capitalism itself. Citing such things as the endless competitiveness and the inducement of "status anxiety" which the system promotes, he believes that our way of life is an inherently unhealthy one.
So, when speaking of mental ill health, it is perhaps always apt to remember environmental factors such as social and economic deprivation, as it seems that they are just as important as biochemical or genetic factors in inducing mental illness. And only by doing something in these areas, which some suggest may mean a whole re-evaluation of our current way of life, can we hope to begin to redress the increased risk of mental ill health in areas like my own beloved Stoke.
That's all for now from your normal, average, delusional and paranoid man.