In Sedated, James Davies makes a powerful case that the marketisation of mental health ignores the social causes of distress, harming us while serving capitalism, finds Lucette Davies

James Davies, Sedated: How Modern Capitalism Created Our Mental Health Crisis (Atlantic Books 2022), 400pp.

Great importance has been placed on the need for the government to ‘balance the books’. It has been used many times to justify austerity and hide the fact that people are suffering needlessly. If only our population were told the full truth about the type of capitalism we have lived with since the days of Thatcher. Because this may be the key to unlocking a better future for us all, and this book, Sedated by James Davies, could be a pivotal factor in making this happen.

The book focusses on mental health, and as 25% of us are likely to be diagnosed with a mental-health condition each year then it is relevant to us all. It also uncovers the most malicious and underhand practices of government imaginable that easily trump the scandals of ‘partygate’.

Davies has used this book to describe the UK’s ‘marketised vision of mental health that has stripped our suffering of its deeper meaning and purpose’ (p.2). His arguments are evidenced by discussions of various research papers, by countless interviews he conducted and by his own attendance at events such as the Occupy movement in New York.

He argues that our: ‘entire approach to mental health is preoccupied with sedating us, depoliticising our discontent and keeping us productive and subservient to the economic status quo’ (p.3).

In the 1970s and 80s Margaret Thatcher embraced a new style of capitalism which promised the British people freedom. By imposing massive deregulation and pledging to us all that competition between the private sector would ensure us quality, she ‘freed up the market’. Taxes were reduced, public-sector services were privatised and the active role of government in society was reduced.

Many believed that we were being granted the freedom to grow personal wealth, giving us all the same opportunities. We adhered to the idea that this neoliberal freedom was vastly preferable to the very limited freedom of Soviet Russia. And every government since the 1980s has continued with this system, even if some did tweak it around the edges.

Now in 2022, we can clearly see the effects of this type of economic policy. Wages have stagnated, GDP has stagnated, and inequality has grown. Many people feel they can no longer buy good quality healthy foods, our large corporations are routinely shown to be unethical, consumer choice is limited and increasing numbers of households live in poverty. For so often, corporations and the wealthy grow their profits on the back of suffering by others.

Corporate psychiatric swindle

But Davies has outlined a level of underlying maliciousness that has shaken me in a way I have no words for. He has shown how normal human distress that results from the failures in our society has been re-designated as mental illness. Our suffering is then commodified in order to support the economy by treating us with psychiatric drugs. Last year in England 7.4m people were prescribed antidepressants. But as the numbers who are diagnosed with mental illness have risen since the 1970s the number of people who recover has decreased. These drugs are the reason many do not fully recover.

The evidence behind this claim comes from research undertaken by Professor Martin Harrow and published in the Journal of Nervous and Mental Disease. Harrow’s research showed that many psychiatric drugs when taken long term harm the people they purported to help (p.44). Davies interviewed another researcher, Robert Whittaker, who having seen Harrow’s work engaged in a study to look at the effects of psychiatric drug use on many major mental illnesses. Whittaker showed that in aggregate people who continue to take psychiatric drugs do much worse in the long term than those who stop them (pp.49-50).

In countries like Nigeria, Colombia and India where schizophrenia is less likely to be treated with drugs, recovery rates are greater than in the UK, America, Europe and Canada. (Ironically the Covid-19 death rate per capita, for the UK is five times that of India.) Could our supposed wealth in the ‘developed’ world be dangerous to our health?

In the UK and America our distress often reflects badly on the society we live in. So we get labelled as sick, shifting the blame away from something for which the government could be held responsible. It is not by accident that mental illness is greater in areas of deprivation or amongst the unemployed.

We are then prescribed psychiatric drugs which the corporations who manufactured them claim to have proved will be effective. If we ask our GPs to help us withdraw from these drugs they will look to evidence provided by those same organisations that show that this can be done easily. When many patients experience extreme withdrawal effects, the doctor will suggest that is proof the drugs are still needed. They may even up the dose.

Our suffering is now being blamed on us, not the circumstances of our lives. We are in this way objectified as simply a tool to help the accumulation of profits for the pharmaceutical companies. It is no accident that the profits of pharmaceutical corporations have mushroomed since the 1980s.

Therapy for capital’s benefit

Davies also aims criticism at the concept of therapy, specifically the IAPT Programme introduced by the Labour government in 2006. The programme was embraced by the Labour Party as a method of reducing disability payments to people suffering from mental disorder. Davies refers to it as ‘back to work psychological therapy’ as opposed to a ‘back to health therapy’. Only those whose distress had first been medicalised through diagnosis could be admitted to the programme. Remarkably though, the initial reports of IAPT’s success were soon uncovered to be a case of the authorities marking their own homework. Through an interview with Dr Michael Scott, Davies shows how these results are manipulated to be favourable to IAPT (p.112). In fact, when analysed correctly, recovery rates after IAPT are no different to the recovery rates we would see if people had no treatment at all.

Since the 1980s, our country has changed dramatically and now 80% of us work in the service sector. We work longer hours, change jobs more frequently and are more likely to live in large cities. In 2018 55% of Brits felt under excessive pressure, exhausted or miserable at work. We are forced to strive to meet targets at work which are placing workers under even more pressure. Even our school children are placed under pressure to pass exams, bolstering their school’s position in the league tables. Is it any wonder that one in six school children now have a diagnosable psychiatric condition?

We are effectively encouraged to use material comforts to treat our distress. Buying something new, something better, will make you feel good. Eating, drinking, smoking, holidays or new clothes become crutches, but profitable for capitalism. At the same time, governments and authorities lecture people about taking personal responsibility for our health and consumer choices. This is a social catch-22, since we have not had governments with any interest in alleviating our distress. We are simply being seen as a source of profits when in distress.

A social cure is needed

But the shocking fact is that psychiatric drugs cause damage to the brain. Withdrawal from these drugs is frequently traumatic and many people find it extremely difficult to get professional support. It is also utterly dehumanising for a person who suffers deep emotional distress to be told this is just a ‘chemical imbalance in our brains’. Our society teaches us to accept the ‘physical cure’, the tablet or medicine as opposed to addressing the social causes of rising mental-health problems.

But this may be where recent years have set the scene for a turn around. Because as Covid-19 hit our shores and lockdowns started, people began to realise the importance of human connections. Many people enjoyed having time to develop creative skills, to get outdoors, and appreciate nature. We saw how it was the bin men, the delivery drivers, the nurses, the bus drivers and street cleaners whose labour kept us all alive.

We saw how those on lower incomes and the BAME communities were far more likely to suffer with Covid-19. We saw how children studying from affluent homes were able to learn so much more than those who didn’t have access to the same resources. And we watched the government behave as if their rules didn’t apply to them. Matt Hancock was found to have acted unlawfully when handing out large contracts, such as the test-and-trace contract to mates like Dido Harding. Dominic Cummings was seen to break Covid regulations when he drove to Barnard Castle and claimed it was to test his eyesight. More recently we have had the partygate scandal resulting in twenty fines being issued to senior Conservatives for breaking Covid rules. But we also saw how small kindnesses from others can make such a difference. How communities can pull together and improve lives. And we experienced life without shopping and realised it didn’t matter that much after all.

We are not yet through with Covid-19 but our government has shown it is only prepared to address the pandemic with vaccines. Perhaps for the same reason our distress is only going to be managed with psychiatric medicines. But now we all know what really matters in life. We also know who matters and that is the workers. We can choose to take Davies’s book as a prompt to act against the way in which our suffering is seen as a commodity and a source of profit. We can fight against the warped values promoted by the establishment and replace them with our own. But most of all we need to turn on its head the argument that government must ‘balance the books’ as an excuse for rampant capitalism.

James Davies finishes his book by saying that no economic paradigm has ever existed in perpetuity and this one is no different. He challenges us to keep working to defy the neoliberal pressures in order to create a shift in mental-health care. But to end the lies and deceit of a government prepared to damage our brains in order to maintain neo-liberalism, would serve to benefit people and planet alike in countless other ways. It starts with the workers recognising the power they have. Neoliberalism will collapse without their support.

Before you go

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Lucette Davies

Lucette is a People's Assembly activist, member of Counterfire and founder of East Sussex Save the NHS

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