Talk is the trickle-down economics of mental health


Since 22 July 2018, some forty-nine thousand people have reacted positively to a Facebook post by Australian TV personality Osher Günsberg, a heartfelt rumination on his experience with what he refers to as ‘complex mental illness’. Günsberg wrote about anxiety, alcohol abuse, obsessive compulsive disorder and psychosis – diagnostic dots forming the outline of a person who needed and eventually sought help.

Günsberg’s purpose in writing the post was to show that mental illness can be endured and recovered from. He wanted to show other sufferers that they can ‘still fall in love, get married, hold down a job and enjoy a rich and fulfilling life.’ Ultimately, he wrote, ‘the only thing that reduces stigma is to make the topic of complex mental illness more normal to talk about. So, here I am.’

This idea, that talk is the best and perhaps only means of erasing stigma – around any topic but especially mental health – is pervasive. I serve as the editor of an online magazine that discusses masculinities and we regularly receive pitches and submissions about men’s mental health and illness written with the aim of reducing stigma. There are whole organisations founded with this goal in mind, and major public health organisations are rarely without a specific branch or initiative targeting men’s mental health, and very often specifically ‘reducing stigma’ around men opening up about it.

Osher Günsberg may be one of the highest-profile Australian men to be talking regularly about this issue, but he’s part of a trend. There’s enormous, ongoing investment in discussing men’s mental health and in presenting this discussion as a solution to the ‘problem’ of men’s mental health.

The way we talk about mental health is complicated, but it’s chiefly informed by what sociologist Nikolas Rose dubbed the ‘psy-professions’: psychologists, psychiatrists, psychotherapists and so on – people who position themselves as experts based on their knowledge of what Rose calls the supposedly ‘real nature of humans as psychological subjects.’ Psychology and its correlates have in the last century claimed a status as a ‘science’ – a hard one, founded on empirical research, the science of the mind. Rose was a pioneer of scepticism about these empirical foundations, arguing that the psy-professions are in fact highly susceptible to political agendas.

Bruce Cohen, a sociologist at the University of Auckland, has since taken Rose’s ideas further, arguing from a Marxist perspective that the psy-professions partake in systematic labelling of deviance in capitalist societies in order to respond to what is politically troublesome. They’re able to do this with some authority, argues Cohen, because they are symbolically associated with the (actually, at least mostly, scientific) study of biomedicine, which accords their diagnoses of health and normality a veneer of legitimacy. In his book Psychiatric Hegemony, Cohen shows how the psy-professions have used this perception of legitimacy to provide quasi-scientific justification for the maltreatment, abuse and warehousing of societal ‘threats’: most regularly women, the homeless, the poor, and religious, racial and ethnic minorities.

One of the most insidious aspects of this process of labelling deviance is that it places the fault in the individual. It locates ‘aberration’ as something that exists in your own mind and body. Rose’s and Cohen’s analyses are important for returning the critical gaze to the society – its structures, biases and vested interests. Rather, then, than seeking solutions to mental ill-health through medication, therapy or ‘talk’, we start to seek them in societal reform: better working conditions, housing, education, healthcare, representation and so on.

It’s this framing of mental health that should give us pause at salvation through ‘talk’. What a turn to conversation and confession as solutions to men’s mental health overlooks is that men’s unhappiness is depoliticised when it is individualised. That men might then turn to each other with this framing in mind robs this situation of its potential to suggest the political reform of the society that almost certainly played a part in the creation of that unhappiness.

It strikes me as no coincidence that the men most commonly advocating ‘talk’ in order to ‘reduce stigma’ are the ones likeliest to be listened to. With rare exceptions, they are white, well-educated and conversant in the languages of personal wellbeing, mental health and self-development. They have people to talk to, people who also speak these languages. These are not universal vocabularies, but rather ones bound up with race, privilege and class.

Assuming a man suffering poor mental health can talk, that he has people to talk to who understand that talk, and that that talk will in fact fix or even significantly improve the conditions that led to his poor mental health in the first place, is a lot of assumptions. A person in a position to understand, personalise and prioritise mental health talk should talk, but talk is not a model that scales – unless you are talking about how to radically redistribute society’s resources so that everyone has access to them, understands how to use them and is in contact with people with whom they can use them.

The sociologist Mary Douglas was among the first to point out that communities and societies stigmatise what is dangerous in order to protect and solidify their own identities. Stigma doesn’t arise because people aren’t talking, it arises because something is perceived to be threatening to a society. In this case, men’s mental ill-health is stigmatised into a non-political vacuum – we need to ask why.

The implications of widespread mental ill-health might include shortages of work, unaffordability of housing and healthcare, the impending heat-death of the planet, a lack of meaningful political representation, failing trust in social institutions and the increasing alienation of people from each other and themselves. But once you place the cause of an individual’s woes inside their body, inside their mind, you remove the focus from the society in which that person exists, as well as removing any pressure for that society to change.

So men, the most privileged and powerful men at that, end up talking to each other to resolve their own feelings of anxiety, depression or alienation, without ever asking what it is about society that makes even them feel this way in the first place.

I’m not suggesting men stop talking – on the contrary – but men in a position to talk can’t assume talk will be working for anyone else any time soon. In the meantime, men would be far better off asking what their unhappiness, generally, is a result of, and talking about that.

 

Image by Ilyass Seddoug.

Ashley Thomson

Ashley Thomson is the founding editor of Homer, an online magazine dedicated to discussing masculinities and challenging ideas of what it means to be a man. He lives in Canberra, Australia.

More by Ashley Thomson ›

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  1. Individual solutions to structural problems. You’re absolutely right, and you’re saying something I hadn’t thought much about before. Thank you.

    TRiG.

  2. I became a social worker to address exactly these structural, systemic problems… unfortunately, capitalist encroachment into education means universities are guiding social workers into clinical practice. So I’m learning how to identify pathologies and counsel individuals, a Sisyphean task. Thanks for this article. It reminded me how important it to forge a career path into macro social work.

  3. Ashley I couldn’t agree more! As a social worker and educator it is disheartening to see the power of the medical model of mental ill health continues to be maintained, yet serious critiques of this are rarely in the public discourse. So thank you for your article.

    BTW, many of the same arguments can be made for the way we are addressing family violence, too.

  4. Osher has just scratched the surface when it comes to the stigma, care and treatment of the who live with mental illness. I went through a battery of test including a psych profile questionnaire that covers many mental illnesses. Yet some 20 plus yeats later diagnosed with multiple mental illnesses I only openly talk about 2 of them. I was first diagnosed with PTSD ( post-traumatic stress disorder), type 2 Bipolar and the one I rarely talk about
    Borderline Personality Disorder.Although most people in society are more accepting even if they really don’t understand it of PTSD, Bipolar 2. When it comes to BPD even most clinicians have no idea what they’re doing and do far more damage to the patient thinking they are helping them all because of what they read in some bloody which was part of their curriculum while studying for their degree in psychology or psychiatry. Sadly Australia ‘s mental health system and the majority of people working within the scope of this field are so far behind the rest of the world it’s scary. But for the patient, it has devastating consequences and in the end, they don’t trust the system or the clinicians to help them and 10% of these patients with BPD will end up committing suicide. Then to top it off and the fact that a smaller percentage are males. These poor men are overwhelmed with chaotic emotions not feeling good enough and that there is something fundamentally wrong with them. Not to mention the guilt and shame that constantly resonates inside your head because you can’t seem to fix it or work out a solution to manage all that is going on inside of you. The end results to hide all of this and what they are feeling and to not appear weak to the outside world is mask it with drugs or alcohol and with most not all agression.

  5. Just wondering, is continually spouting absolute bollocks like “more than 28 years of consecutive economic growth” a sign of mental illness …

    Hell, you’ve got to think there is something seriously loopy about people who consider tangible environmental concerns as fanciful, but the abstract construct of economics completely real.

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