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The 1960s saw a challenge to the dominant ideas not only in areas such as women’s oppression and the position of black people, but also in relation to mental health. A central figure, perhaps the central figure, in these debates around mental health and ‘mental illness’ was the Scottish psychiatrist and psychoanalyst R.D. Laing. This article aims to provide an outline of Laing’s key ideas and activities, and to assess the extent to which these ideas are still of value for those seeking to develop less medicalised responses to mental distress in the context of the current crisis in mental health.
More than 60 years have now passed since the publication in the USA of The Sane Society by Marxist psychoanalyst Erich Fromm (1955/2001). Fromm’s main argument in that book was that in promoting the idea that the road to happiness and fulfilment lay in consumerism, in persuading people to conform to a very narrow conception of ‘the good life’, and in encouraging people to deny their real needs and feelings, American society in the 1950s was actually creating mental ill-health. Far from being a ‘sane society’, it was in fact an ‘insane society’. Consumer capitalism, Fromm argued, was making people ill.
The book struck a massive chord and within weeks of its publication was fifth in the New York Times bestseller list. Since that time, it has sold more than 3 million copies.
Following Fromm, the central argument of this chapter will be that the world in which we live today – the world of neoliberal global capitalism – is also creating mental ill-health on an industrial scale. Three examples will illustrate the point. Firstly, according to the World Health Organisation, depression now affects over 300 million people worldwide and is the leading cause of disability in the world (WHO 2017). As George Brown and Tirril Harris argued some 40 years ago in their classic study of depression in women, while sadness, unhappiness and grief are inevitable in all societies, the same is not true of clinical depression (Brown and Harris 1978/2011). Rather, depression on this scale tells us something about the nature of the society we live in.
28 April 2020 was International Workers Memorial Day (IWM). It’s an annual event organised by trade unions to commemorate the many thousands of workers who have died unnecessarily and too young as a result of government or employer negligence, through industrial accidents or through avoidable industrial diseases like asbestosis.
In 2020, IWM Day was a bit different. For this year we observed a minute’s silence for all the frontline workers – health workers, care workers, bus drivers, shop workers and social workers – who have lost their lives due to COVID-19. It was not, however, as British Prime Minister Boris Johnson tried to suggest, a “day of national unity”. For many of these frontline workers will have died as a direct or indirect result of his government’s failure to prepare adequately for the crisis or to provide adequate personal protective equipment.
The slogan of International Workers Memorial Day is ‘Remember the dead, fight for the living’. We should remember the dead and one role of social work is to help people deal with the pain of loss. But in this short contribution I want to look at what kind of role social work might play in ‘fighting for the living’ in the face of this crisis.
In Part II of this book, contributors from Greece, Chile, South Africa and elsewhere report on the new and imaginative ways that social workers are developing practice to keep in touch with service users during the crisis, to reduce social isolation and protect mental health.
This chapter explores the extent to which class continues to matter for social work in Britain. It looks at three distinct but related aspects of class: class as social division and determinant of life chances; class as an explanatory framework, a way of making sense both of the experience of people who use social-work services and those who work in them; and class as agent of social change – the politics of class. The chapter also discusses John Hills et al.’s government-commissioned report entitled An anatomy of economic inequality in the UK, focusing on two key findings that relate to the themes of this chapter: inequalities in income and the levels of inequality between different social groups (such as women and minority ethnic communities), as well as the degree of inequality within them. In addition, it examines three main contemporary contenders for the role of an explanatory framework for poverty and inequality, as proposed by the American Marxist sociologist Erik Olin Wright.
On 12 November 2014, a demonstration of around 200 people – mental health workers, trade union activists, service users and carers – gathered outside the Victorian City Chambers in George Square in Glasgow. Inside the building a full meeting of the Labour-controlled Glasgow City Council was voting on whether to make cuts to social care services of almost £30 million. The cuts included a proposed reduction of 40% to the budget of the Glasgow Association for Mental Health (GAMH), one of the biggest voluntary sector providers of mental health services in the city. The message of the protestors outside to the Labour-controlled council inside the building was a simple but powerful one: ‘Cuts cost lives!’ This was no empty rhetoric. While not easy to quantify, in Scotland as elsewhere in the UK the politics of austerity have led to an increase both in levels of mental distress and also in the number of suicides (Psychologists against Austerity (Scotland), 2015).
Glasgow, of course, is far from unique. Massive cuts to services, alongside reductions in disability benefits, the application of brutal sanctions and the imposition of a punitive and degrading Work Capability Test have greatly increased the levels of stress experienced by many disabled people across the UK (Gunnell et al, 2015). The picture is a grim one. In this context discussing service user participation can seem either hopelessly naïve or akin to re-arranging the deck chairs on the Titanic: exactly what is it that service users are being invited to ‘participate’ in? Yet amid the nightmare of ‘welfare reform’, there is one bright light.
This chapter is written against a background of far-reaching and significant changes in social work in Scotland. New policies have been developed, new regulatory structures implemented and social work training and education has been restructured. In addition, however, social work is increasingly faced with problems of staff recruitment and retention in part a consequence, it is argued here, of the increasing dominance of market-based and neoliberal social policies that have impacted on social work in different ways. Such problems contribute to the sense of social work as a profession in ‘crisis’.
This chapter considers developments in three key areas of social work policy and practice in contemporary Scotland:
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community care
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children and families, and
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criminal justice social work.
Social work and social care services in Scotland in the first decade of the 21st century present a complex, sometimes contradictory picture. Since devolution in 1999, there has been a continuous stream of policy initiatives in almost every area, often leading to new legislation and major organisational change. These have included the introduction of free personal care for older people, major policy and/or legislative developments in areas such as homelessness, drugs, and mental health, as well as the extension to Scotland of UK-wide schemes such as Sure Start (offering support to families with young children in deprived areas) and Supporting People (supported accommodation for vulnerable adults).Within social work, new regulatory bodies (the Scottish Social Service Council and the Scottish Commission for Social Care) have been established, a new educational body (the Scottish Institute for Social Work Excellence) has been created to coordinate and develop social work education, and a new four-year honours degree has replaced the Diploma in Social Work as the main professional qualification.
Adult social care in Britain has been at the centre of much media and public attention in recent years. Revelations of horrific abuse in learning disability settings, the collapse of major private care home providers, abject failures of inspection and regulation, and uncertainty over how long-term care of older people should be funded have all given rise to serious public concern. In this short form book, part of the Critical and Radical Debates in Social Work series, Iain Ferguson and Michael Lavalette give an historical overview of adult social care. The roots of the current crisis are located in the under-valuing of older people and adults with disabilities and in the marketisation of social care over the past two decades. The authors critically examine recent developments in social work with adults, including the personalisation agenda, and the prospects for adult social care and social work in a context of seemingly never-ending austerity.
How is social work shaped by global issues and international problems and how should it address them? This book employs a radical perspective to examine international social work.
Globalisation had opened up many issues for social work, including how to address global inequalities, the impact of global economic problems and trends towards neoliberalism. By examining the origins of modern social work, problematising its definition and addressing the care/control dichotomy the book reveals what we can learn from different approaches and projects across the globe.
Case studies from the UK, the US, Canada, Spain, Latin America, Australia, Hungary and Greece bring the text to life and allow both students and practitioners to apply theory to practice.
As the world grapples with the complex impacts of COVID-19, this book provides an urgent critical exploration of how Social Work can and should respond to this global crisis.
The book considers the ecological, epidemiological, ideological and political conditions which gave rise to the pandemic, before examining the ways that social work has responded in different nations across the Global North and Global South. This series of nation studies examine good practices and suggest new ways to renew and regenerate social work moving on from COVID-19.
Contributors also reflect on the key themes that have emerged, including a rise in domestic violence and the ways that the pandemic has disproportionately affected those in working class and minority communities, exacerbating existing inequalities.
