As the State Shrinks, Is Society Really Becoming Bigger?

"... in terms of opportunity, this would mean mental health professionals perhaps becoming involved in helping people achieve a life beyond mental health services by, for example, aiding them in gaining some form of employment or just engaging them in some form of meaningful activity. This may also have implications in terms of stigma and discrimination, a major barrier to opportunity, as service users would, perhaps, be able to rely on psychiatrists and others of professional capacity to join the fight against stigma."

From my blog post, "Dave's Progress. Chapter 100: The Road to Recovery."

Looking over my blog the other day, I came across the above, now apparently rather optimistic comment, and I was struck by just how much things have changed since I wrote those words. The post concentrated on the transition in mental health services to a more recovery oriented model, where the social rehabilitation of a service user would be seen as perhaps just as important as ameliorating illness. With cuts to services, though, such things now seem like so many fine words, and I have outlined in these pages how the promise of opportunity for those with long-term problems post illness has faded through a lack of any meaningful or appropriate support. Indeed, as statutory provision of care recedes through a lack of proper funding, just where does one go to try to find a life beyond mental health services?

It seems that the government's big idea with regard to such things was the creation of what David Cameron termed, "The Big Society". But just what did "The Big Society" mean for those in a situation where, like myself, after years of illness, they found themselves floundering? Well, as far as I'm aware, the "big" society was seen as an answer to the massive cuts to public expenditure that we were told had to be made after the economic collapse of 2008. As the public sector then receded, there would be a greater reliance on the third sector, with things like charitable organisations and social enterprise schemes taking up the slack.

Indeed, one might be forgiven for thinking that "The Big Society" was not really a new idea for the Tories, given that they adhered to the Neoliberal philosophy of creating a small state and increasing privatisation, an economic underpinning to their policies which can be traced back to Milton Friedman and The Chicago Boys.

I cannot speak for everyone, but what this has meant locally is that state provision has certainly declined. The dream that one day mental health services would be there to aid your search for employment or indeed any meaningful activity now seems like some distant idyll. Although there is a local service in Stoke-on-Trent for those seeking employment after illness, one still has to be under secondary care to gain access to it, and many I know in my position have simply been discharged from such care.

So, where to go? If the big society is working than surely one can find some kind of support from the third sector. However, once again it seems that such support is on the wane. Both the local mental health charities I have worked for have now closed due to a lack of  funding. The Media Action Group for Mental Health closed its doors in around 2012, and at the very end of last year, North Staffs Voice for Mental Health finally gave up the fight for adequate funding.

There is then, I feel, in practice, a sort of gap in the recovery model, where the social rehabilitation and reintegration of those with long-term problems is being virtually ignored. Indeed, one psychologist I spoke with about this said that it was of great concern to her, and she described the predicament as a sort of quiet suffering. The problem of stigma also, I feel, is still a significant barrier to opportunity for those with more severe diagnoses.

So, as the state shrinks, is society really getting bigger? Somehow, I don't think so.