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Mental health and welfare: a stamping manifesto

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The tendency not to want to believe in mental illness festers across the Western world, and particularly in Britain, the nation that gave us Shakespeare, concentration camps and the stiff upper lip. From the friends and families of sufferers to the upper echelons of government, the suspicion that mental health difficulties are forms of weakness – simple personality flaws that could be eradicated if more of these mentalists would jolly well buck up – informs policy and influences behaviour. We need to look this institutional prejudice in the face and call it what it is: outdated, destructive and desperately unhelpful.

Over the past few months, I have interviewed a great many people suffering from mental health difficulties in the course of my work for the Independent and for One in Four magazine, and none of them are feeling optimistic about the New Year. All of them fear being forced back into work that they will not be able to cope with even if they find it; they fear government interference with benefits that they rely on for survival, and they are disappointed at the lack of positive changes the much-touted Welfare Reform Bill has brought.

In the face of what appear to be across-the-board rises in cases of serious depression, anxiety and other debilitating disorders, the response of our government in boom times has been to quietly shunt the sick onto a government poverty package and tell us to be grateful. However, as incapacity levels continue to rise, the DWP’s new Work to Welfare policy threatens to shunt us just as quickly back to the jobcentre, telling us that we’re scroungers who were actually making it up all along. This comes just as the little glut of crap menial jobs available before the stock market crash has disappeared. Nice timing, Purnell.

Many of the 40% of Britain’s 2 million IB claimants who are unable to work due to mental health difficulties already have a few problems with paranoia. But, as the noted social theorist Kurt Cobain observed, that doesn’t necessarily mean that they’re not after you. Because when any major political party talks about moving people off Incapacity Benefit, when they talk about instituting a system of interviews to ‘weed out’ benefit ‘scroungers’, we know that they’re talking about the mentally ill – those whose disabilities and challenges are most difficult to see and to quantify, often the poorest and most vulnerable members of society who have since Thatcher’s day been the first in the firing like when budget cuts needed to be made. I am, indeed, talking about Care in the Community, the policy decision also known as ‘chuck the nutter in the gutter’.

Yes, there are more people receiving IB now than there were a generation ago. No, this does not mean that all of the extra people are skivers who’d rather sit around watching Trisha and drinking milkshakes. The sweeping social change that has transformed society in the past fifty years has led to an increase in the numbers of those deemed unable to work due to mental illness for many reasons. Not only has society become more treacherous and unpredictable and the working world more stressful (especially in stonkingly pro-market, anti-worker countries which exempt themselves from working time directives) but more men and women are expected to hold down full-time jobs which are increasingly focused in the service, information and fourth-sector industries, meaning that it’s more important for these employees to be entirely mentally and emotionally on the ball. Simply put: as the labour market is changing and becoming more mentally and physically stressful, the mentally ill, whose care has been successively eroded by government after neoliberal government, are being left out in the cold.

Mental illness is perhaps the subtlest and most frightening of all forms of social difference, because of its invisibility, because of the difficulty in quantifying it, and because it is not a binary condition: you’re not either mad or sane, there’s a whole spectrum involved. But the hatred and fear that the mentally ill face on a daily basis, the lack of understanding shown to them by the welfare state and criminal justice system, and the fact that they are perpetually the first targets of punitive budget cuts, adds up to a sum of institutional bias which belongs in a previous century.

Just look at Mind’s recent report on mental illness within parliament itself. Twenty-seven percent of MPs, Peers and their staff have personal experience of mental health difficulty, and one in three said work-based stigma and the expectation of a hostile reaction from the media and public prevented them from being open about mental health issues. This is a problem that touches everyone, and it isn’t going to go away if we collectively stick our fingers in our ears and sing a little song.

Employment law is another area where the Disability Discrimination Act has so far failed to translate into action when it comes to the mentally ill. The argument goes something like this: it’s more risky and more costly for company x to hire person y if they suffer from a mental illness – after all, how is company x to know that that employee y won’t fall behind on their work, start slicing themselves up by the water-cooler or march into the office one day spraying slugs of hot lead death into co-workers and clients? Simple ignorance is the first obstacle to greater understanding here: in fact, the mentally ill are statistically less likely to perpetrate violent crime, and far more likely to become victims of it. But a subtler prejudice against minorities is inherent to the hypercapitalist machine – because yes, it is technically less costly for a firm to hire an individual who is entirely mentally well. By the same logic, it is also better business sense to hire someone who is neither physically disabled nor a female of childbearing age. Yes, these people represent a financial risk to the company; no, this doesn’t mean that discrimination is a logical and acceptable consequence of that risk.

What happens when companies are allowed to set their own hiring policies purely on the basis of business sense is that a large amount of the nation’s talent remains untapped, and swathes of people who need to be in work more than almost anybody become dependent on the state. Individuals suffer, and the entire economic community suffers. Anti-discrimination legislation and hiring standards are not only essential for the advancement of true equality; they advance free nations both spirituality and economically.

The market, by itself, cannot deliver health, happiness and universal suffrage by treating people as commodity inputs. This is why, especially in a period of social transition like this one when our ideals and our economic and technological mores so often clash, government intervention is one of the only logical temporary solutions.

It is not enough for the Ministry of Plenty Department for Work and Pensions to demand that mentally ill recipients of incapacity benefit find themselves a job in an employment market which was highly suspicious of them in the boom times and which is now rapidly contracting. What we need if we are to avert a genuine crisis both in employment and in public health is a radical restructuring of what it means to be a worker in the information age.

It is also not enough just to whinge about current policy without suggesting viable alternatives. We’re not just holding jobs and having dinner: the point of progressive debate is to work out how to create the better world that we want our descendants to inherit. So, what would a world with fewer stigmas against the mentally ill look like?

It would be a world in which employers and businesses recognise that mental disability, like physical disability, does make it more of a challenge for an employee to carry out a job of work – and that those challenges can be surmounted with understanding and reasonable adjustments Fifty years ago, the idea of having ramps on public transport, in offices and public buildings in order to help the physically disabled participate in normal life would have sounded preposterous and wildly costly – now it is more or less accepted that the physically disabled have just as much drive to work and live as the rest of us, and should be aided in that goal. The same attitude needs to be applied across the board.

It would be a world in which flexible and part-time working is not only available but a respected and well-taken up practice required of all employers, in order to help the mentally disabled, the physically incapacitated and those with caring duties, including parents, to stay in appropriate work. It would be a world in which part-time work is supported by government benefits, allowing the hundreds of thousands of people with mental health difficulties who cannot cope with full-time work to participate more fully in the economic and cultural life of the nation.

It would be a world in which the many laudable grants, higher education places, work schemes and training projects set aside specifically for the physically disabled and other minorities are matched by similar schemes for the mentally and emotionally disadvantaged.

Last but not least, it would be a world in which, for as long as necessary, large businesses were obliged to take on a set quota of people with mental health difficulties – say one in eight, helping to reflect the one in four citizens who will experience mental health difficulty at some point in their life.

This is about socialism, but it isn’t just about socialism. It’s about creating a world that is fairer and more efficient, carrying every citizen with it. If the government really wants to leave no one behind – if it wants to move more of the mentally ill into rewarding, taxpaying work, rather than simply pare more fat from the already scrawny welfare state – we need to dare to dream of a society in which everyone can participate.

******

And with that, I’m going to go and excercise another of my dysfunctional coping mechanisms and have a little cigarette. I’d offer, but you wouldn’t want one. It’s fucking menthol *cackles*.

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Gender fucked: what does ‘healthy womanhood’ look like?

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Starting posts with ‘when I was in a mental institution’ is really something I try to avoid. Penny Red is not my personal headspace blog, and it’s not all about Me and My Mental Illness. [If you like that sort of thing, like me, then you should do what I do and read Seaneen Molloy’s fantastic site, mentally interesting.] Penny Red is about politics, and gender, and activism, and poetry, and feminism and freak power. But the personal is political, and sometimes, mental illness is about those things, too.

When I was in a mental institution, a lot of otherwise well-meaning medical professionals conspired to screw up my gender identity pretty much permanently, for the best of reasons (they wanted to help me get better) and the worst (they believed that conforming to received ideas of ‘feminine’ behaviour was the best way for me to demonstrate a new, mentally healthy outlook). They were wrong. I am incredibly grateful for the inpatient treatment I received, which probably saved my life, but my political and personal feminism took a massive battering, and that’s less than entirely forgivable.

Give them their due, they tried. When I turned up, with my seventeen-year-old crew-cut, wild eyes and baggy hoodies, looking like the small scrawny one out of the Jonas Brothers and suffering from anxiety, depression BDD, self-harm and severe anorexia nervosa, their first assumption was that any young woman who wanted to look like a twelve-year-old boy must simply be a Secret Gay.

I am not a Secret Gay. I am an unsecret bisexual – about a 2 on the Kinsey Scale – I consider myself gender-weird and trans-curious, I enjoy wearing drag and I love, love, love the cock. I just love cock, I always have, I always will. I also find women attractive, but that’s not the whole story – in fact, that’s one of the few things in my life that I’ve felt uncomplicatedly comfortable with. My psychiatrist and some of the nurses tried to convince me otherwise, that if I could just come out of the closet I would magically start eating, stop having panic attacks, my family would accept me and all would be well.

Believe it or not, this represents a positive step for the psychiatric profession. They were prepared, within certain rigid limits, to accept non-heteronormativity as an alternative model for good mental health. At no point did anybody (apart from some of the other inmates) suggest to me that if I were a secret gay that would mean that I was somehow a pervert. And that would not have been the case a decade or so ago. It just so happened that they got it horribly wrong.

After months of my stolid defiance, they gave up and tried a different tactic. If I wasn’t Gay, it followed that I must therefore be Straight. If I was Straight, the only healthy option was for me to Accept My Womanhood. A lot of the received wisdom about anorexia is that it’s a method that young women turn to to escape the stresses of modern femininity. Anorexia, the logic goes, removes you from this struggle altogether because when you stop eating, when you cut down from 600 to 400 to 200 calories per day, your periods stop, your curves disappear and you return to an artificial pre-pubescent state. And young women behave like this because they’re scared and angry about the roles that they are being forced into.

Really? Do you think so? Well, gosh, I don’t see any way in which growing up female and Western in the 21st century could possibly be something to want to avoid. They must be mad, those girls.

Well, yes, we were mad. We were completely and utterly bonkers, mental, loopy, batshit insane – but there was a reason. Instead of analysing why we might be unwilling to go through the process of self-subsumation that represents the western journey into ‘womanhood’, the doctors prescribed a strict programme of feminisation for me. I was told in no uncertain terms to grow out my hair, throw away my old baggy black clothes, start wearing skirts, pretty shoes and make-up, sit with my knees together and be less ballsy and confrontational. The other women on my ward, with nothing to do all day, were only too happy to dress me up like a tiny mannequin, teaching me to paint my face and nails and lending me foofy dresses until I was allowed off the ward to buy my own.

Pretty soon, as a day patient, I was getting regular compliments from leery men on the tube about my nice pink low-cut tops and nice tights and nice impression of absolute submission. This represented progress, my doctors told me. Wolf-whistles were something I should be proud of. I was nearly at my target weight: the attention of men in public places, wanted or unwanted, was proof that I was nearly ready to return to normal society as a ‘proper grown-up lady’.

And the worst thing is that I believed it. Desperate and distressed, I was ready to accept that what the doctors told me was true – note that accepting and submitting to the doctor’s rules, however seemingly illogical, is officially an important part of the ‘journey to recovery’ for many psychiatric inpatients, at least in the all-female wards I’ve had the good fortune to visit. I got down on my knees, and I swallowed it all. I lost my feminism. I believed that in order to be truly well, I would have to behave like a ‘proper’ woman: no more demos, no more trousers, no more going out with short hair and no make-up, a boyfriend as soon as possible and certainly no bisexuality. Being a ‘proper’ woman meant fitting yourself out for sexual and physical attention, and that was all there was to it.

It took me years. Years and years of relapse after relapse to even countenance the notion that the part I was acting wasn’t truly myself. Years to get up the courage to cut my hair short again and stop wearing mini-skirts. I listened to ‘normal’ music (whatever was on Radio 1) instead of the shouty punk-rock, riot grrl and folk that I truly love. I stopped reading almost entirely, which was a pain seeing as I was studying literature at the time. I’m still not there yet. I still find it difficult to leave the house without make-up on, and not just because I have low self-esteem, but because a part of me still believes that ‘healthy’ women should look ‘pretty’ at all times. I still try to dress in ways that flatter my body; five years on, I still spend far too much time, money and mental energy ‘fussing’ over my appearance. I’m still nervous to truly express my politics in person, when I’m not with my friends or writing online. I still think I’m too fat, and have to stop myself reading the diet supplements in trashy magazines.

Conforming to feminine norms doesn’t make you a good person. It doesn’t make you a healthy person. Facebook has allowed me to make contact again with some of the hollowed-out husks of desperate, beautiful women I met in hospital, and most of them have now relapsed. Most are too thin, smiling desperately out of fragile, oddly-angled bodies wrapped in clothes they can’t afford and polished for hours with make-up they don’t need. In pictures, their boyfriends and parents hold them like precious ornaments that might snap if they cling on too tight. If that’s real womanhood, I don’t want any of it.

But conformity is safe. No matter how much time and effort you put in to making yourself acceptable and well-behaved, never doubt that it’s the easy option. I never feel more alive, or more free, than days like today when I stamp into work in big boots, a baggy black hoodie covered with slogans, a bobble hat and no make-up. But it takes courage. Courage to step outside the cosy cage of automatic approval and be your own, real person, without rules.

I respect those few, fabulous women for whom living without conforming to stereotypes seems to come effortlessly. Those angels who stride down the streets of London and Birmingham and Brighton apologising to no-one, fizzing with life and snug in their own skins. One day, I’d like to be one of them, and until that day I’m reading all the feminism I can get my hands on and meeting all the inspiring women I can get my hands on I possibly can. I’m writing about feminism and gender identity to raise awareness of just how much these issues affect the lives of everyone in this country and beyond. You won’t be hearing reams and reams about my own issues on this blog – that’s not what it’s for, and besides, a surprising amount of my time is spent trying not to become Elizabeth Fucking Wurtzel. But I thought it might be useful to explain precisely where some of the nebulous feminist rage comes from. I’m alright now. I’m not mad anymore. But I’m pretty damn angry.

Catastrophe Princesses and other mythical beasts..

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Today, Tanya Gold in the Guardian has an interesting take on why so many young women are boozing, shagging around and otherwise checking into rehab wired on cocaine and existential terror: apparently it’s celebrity magazines driving us, like so many jimmy-choo’ed lemmings, over the edge of sanity.

In this article, as has been smeared over the covers of every Metro and Reveal for the past twelve months, Britney Spears, Amy ‘Wino’ Winehouse and other Catastrophe Princesses are wheeled or stretchered out for our scrutiny, evidence of a ‘burgeoning trend..of mental illness’ amongst young women in the West.

Ms Gold is a high-acheiving woman from a ‘nice’ family, neither of which preclude her from being shockingly unhappy – I should know, I’m one too. Yes, Gold is in the process of kicking the booze: well done her. So all this sanctimonous twaddle about celebrity culture and size (ugh) zero can’t just be an attempt to cash in on a personal sob-story by jumping on the celebrity bandwagon – can it?
Of course not. It’s simple, really. The pressure of being a woman in a culture that demands more of you than you can possibly give, the impulse to lash out against the imperfect self, all of this could be solved if we simply switched off the telly and stopped buying Cosmo. After all, girls are so fragile and impressionable that their brittle little brains will break under more than a small amount of pressure to look like Victoria Beckham. Tanya Gold’s article plays into the dominant celebrity fantasy of the zeitgeist: that women – especially successful women, and especially beautiful, successful young women – are not strong enough to cope with the pressures of modern living without having their heads confiscated and their children shaved and being stretchered off to Rehab like poor Britney Spears.

In some respects, of course, Gold may have a point. There have been many afternoons, in that black and bile-encrusted teatime of the soul, when I’ve come to on the carpet, my DMs full of vomit, with an HIV-positive transsexual schoolgirl from southend mopping up the bloodstains on my arms and legs with a copy of The Complete Nietzsche, when I’ve thought to myself, ‘why can’t I be more like Cheryl Cole?’

And yes, there have been times, practising Kuburi rope bondage on a rooftop in Haringay with otherwise well-behaved undergraduates from respectable homes, snorting Ketamine off the shrivelled genitals of today’s misspent youth and screaming my latest psychotic break to the sky whilst listening to the music of My Chemical Romance, that I’ve wept for the latest puffball dress or bikini waxing treatment….

There have been nights, getting my nipples pierced by illegal immigrants in Soho, five fags clamped between my teeth, tripping my tits off on a ground-up-and-snorted copy of Heat magazine, that I’ve wished that I had the figure of Geri Halliwell or the address book of Jade Goody….

And often I’ve staggered home from binge-drinking in terrible pubs with my pinko commie bisexual friends, mainlining raspberry flirtinis and gang-raping local members of the landed middle-classes with copies of The Socialist Worker, only to bleed my expensively educated brains away in front of Big Brother 18: Stripper Slaughter Nightmare, and on waking to find the words ‘what went wrong?’ tattoed into my forearms with a blunt stanley knife, I’ve wondered…what went wrong?

Tell me something I don’t know, Tanya, and tell it to me without anodine celebrity name-dropping. Tell me what it’s like to be a young (or not so young) woman growing up in a world that wants too much of you.

We are infinitely more fucked up than you realise, and infinitely more in control than the trim-taglined world of ‘grown-up’ journalism can understand or countenance. We are not catastrophe princesses, fragile and beautiful, living in towers of stacked magazines and slimming guides, waiting to be rescued. You do us a disservice by reducing us to our drinking habits, our eating disorders, and any crushes on Russell Brand we may or may not entertain.

Young women in the West are not as delicate and broken as, perhaps, you would have us be. We may be in the gutter, but we’re not just looking at the stars and longing for escape: we’re wiping our lips and coming up punching.