Whilst mental illness and suffering has been documented throughout civilisation, the explanation and treatment of it changes depending on the dominating system or school of thought in medicine, psychology or philosophy as well as the level of scientific understanding. We can see this with capitalism’s influence on the treatment and explanation of mental illness. Particularly in capitalism’s more recent history, the struggles of working-class, young and disabled people, have led to a dramatic shift in attitudes – with the fight for a society which prioritises people’s mental well-being now central.
Mental suffering in history
In the 1700s came the emergence of capitalist social relations which created a separation between workers and those who couldn’t work, with those who were mentally unwell in the category of those who couldn’t work. During this period came the first institution for the mentally unwell in Britain and the creation of subsequent private institutions – or ‘asylums’ as they came to be known.
The mid-1800s saw a shift from private institutions to public institutions as capitalism was forced to respond to what it saw as an “unproductive and unprofitable” class of people. These institutions were often underfunded and overcrowded – though some did provide a more holistic, communal, gentle form of treatment such as The York Retreat built by William Tuke, providing a model different to the majority of cramped, brutal institutions at the time. From the 1800s to the 1900s asylum populations increased, and whilst some provided a compassionate form of mental health care, it was clear that the general treatment was obviously not sufficient and often hellishly abusive.
The early 1900s saw the rise of psychotherapy, with the focus being on talking therapies based on cognitive explanations of mental health conditions, placing emphasis on the mind and thinking patterns in the development and maintenance of them. In the 50s and 60s there was the identification of the role of chemical imbalances in the brain of those with mental illnesses and the development of more pharmacological treatments. This prompted a shift to attributing the cause of mental illness to a simplistic, biological reductionist one which also happened to serve a capitalist agenda.
For many people suffering mental ill-health, medication is absolutely essential to help stabilise themselves and live with conditions. However, instead of using pharmaceutical breakthroughs to assist in a more comprehensive solution of the causes of mental illness, capitalism has used clinical drugs to create new markets and new profits from managing the continuation of mental illness rather than seeking the resolution of it.
With this, fewer public funds needed to be given to institutions, pharmaceutical companies profited off the resulting medical treatment, and responsibility was now put on the individual suffering from a mental illness and away from capitalist society and its influence on poor mental health. In the early 2000s there was an increase in the rates of depression, anxiety, and suicide globally, and the antidepressant market was now worth more although they were not able to halt the rise in depression as the causes of this surge in mental illness were not adequately addressed. This created the paradox of an increase of medication prescriptions at the same time as a worsening of the mental health crisis.
Since the 2000s there has been a pattern of the mental health crisis worsening for years. From 2005 to 2015 there was an 18% increase in those living with depression, and a 15% increase in those living with anxiety. In 2015, suicide was the biggest cause of death amongst the youth with overall male suicide rates also increasing along with patriarchal influence and pressure under capitalism. These rates have been further worsened during Covid both in the Global North (including countries like Japan, Canada and the UK) and the Global South.
Alienation
It’s important that we recognise the social, political, and economic organisation of society and its impact on our mental health and mental well-being – in other words, how capitalism is bad for both. This system is rooted in an incompatibility between the pursuit of profit and the essential needs of people.
While many academic and clinical experts chose to simply ignore this, the 1950s and 60s saw an explosion in new, radical approaches to understanding the roots of mental suffering. For instance, the German social psychologist and democratic socialist, Erich Fromm, explored this, by trying to bring together the work/theory of Karl Marx on alienation and the structures of class society, with psychoanalysis. Fromm effectively created a theory of the individual whose consciousness is shaped by the organisation of capitalism and rooted in alienation.
Because of how it functions, capitalism separates us from our human nature and not only do we need to have our basic needs met (such as the need for food, sleep, shelter, which aren’t met by capitalism as we can see with global poverty, wage labour, homelessness etc, all massive sources of anxiety, stress and mental illness in and of themselves), we need to satisfy the drives Fromm described as being rooted in the “human condition”.
These drives are: relatedness, creativity, rootedness and belonging, a sense of identity, and a framework to make sense of the world. It is easy to see how capitalism through its exploitation, oppression and alienation goes against every single one of these and we can therefore see that the origins to poor mental health to at least some extent is located in the mode of production, i.e. capitalism.
For example, the ideology of individualism and the sham of so-called meritocracy that’s pushed by the capitalist class can harm people’s sense of ‘relatedness’. Capitalism’s need for a mobile workforce that can be moved across continents to help make profit for the bosses can undermine rootedness, and so on.
It follows then, that one of the reasons why capitalism is bad for our mental health is due to the relationship between work and the repression of creativity. As individuals we use creativity not just to express ourselves but to alleviate our suffering. Under capitalism, labour alienates us from both our work and each other. Through the monotony and obligation of this wage labour it suppresses creativity. Meanwhile the demand on workers to put in more and more hours minimises the opportunities people have to express themselves outside of work. In the UK severe mental health conditions are continuously emerging due to discontentment at work along with increasing rates of burnout, with many forced to work long hours with little social interaction and pitted in competition with each other.
The education system, especially as it begins to present itself more and more like a business needing to generate profit often at the price of students wellbeing, in the same way that wage labour sucks out all the passion people may have for their field of work, and prioritises extrinsic rewards over intrinsic satisfaction, so too does education (particularly higher education institutions in the US and UK, focussed relentlessly on exam results, league tables, and graduate earnings, for example).
Capitalism also fails to meet our need for meaningful association, as is shown by the trend towards increasing loneliness. We need meaningful personal relationships and solidarity for a positive mental well-being as it satisfies our needs for relatedness and belonging. We need social connection but the promotion of individualism under capitalism has led to increased loneliness.
Loneliness is now considered a public health concern with the recent appointment of a Minister for Loneliness in the UK, and it could lead to the development of mental health conditions or exacerbate already developed ones. It is the outcome of capitalism’s opposition to collectivism and its promotion of competition (both ideological and economic). Under capitalism we have seen the breakdown of social relations through: divide and rule tactics, individualism, and imperialism in which previously established community relations of many communities were effectively severed in an effort to promote colonial rule and divide communities and people apart.
In Britain this includes the loss of stable employment in unionised workplaces suffered by millions during decades of deindustrialisation and attacks on workers’ rights, and the housing crisis, which has forced huge numbers of people to move to live far away from their families and support networks. Internationally, capitalism has created many long-running conflicts, and generated decades of suspicion and division between peoples and communities. Racism and xenophobia are pushed by the capitalist classes at home and abroad in an effort to divert attention from the real causes of hardship.
This breakdown and severing of social relations continues to have a resounding impact on our mental health along with secondary effects on trauma (especially but not limited to South Asian communities where there’s very little social support due to broken community relations, social stigma, and other lingering effects of colonial rule along with its brutal racist, sexual, and anti-LGBTQ+ violence). In this way, not only are people facing trauma through oppression and exploitation, but there is also very little access to community support as the burden of support gets placed on the individual themselves, ultimately impacting our mental health.
There’s also the impact of the neoliberal period and postmodernist ideas. From this period came the use of psychology to again ignore societal causes of mental health conditions and instead see it as an individual problem that it could potentially profit off of through its push for ‘self-care’ and ‘mindfulness’ tools to help people on the surface without addressing the systemic causes and the need for community care as well as self-care.
That isn’t to say that these tools aren’t helpful or that people should absolutely not rely on them, for those with mental health conditions under this system it is often that they have to rely on whatever is most available, whether that’s medication or self-care techniques. In the same way that capitalism will try and sell us a revolution, it will try to sell us ineffective tools to cope with mental health conditions – ineffective as they don’t address the root cause of trauma/mental illness outside of an individual lens, and when these services are charged for, this becomes essentially capitalism repackaging our mental health crisis and selling it back to us.
Another reason why capitalism is bad for our mental health is because of the relationship between consumerism and the search for an identity. Promoting the desire to consume is integral under capitalism. It is, in fact one of the main things it relies upon. Instead of this consumption being a meaningful and satisfying activity, it becomes an artificial and hollow one, ultimately adding to poor mental well-being instead of helping to fulfil children and adults, because of the never-ending cycle of consumption and the alienation people have from their consumed goods.
A crisis-ridden system
Oppression under capitalism also negatively affects the mental health of huge numbers of people. The oppression of women and gender-nonconforming groups, religious and ethnic minorities, LGBTQ+ people, and others, traumatises millions. We can see this oppression first hand in many examples: in Gaza where children are suffering from PTSD and the effects of ongoing trauma due to the occupation by the capitalist Israeli state forces, in the increase of gender-based violence, and in the alarming rates of suicide amongst the transgender community. This again relates to isolation. The potential protective factor of community care/support against ill-health is actively ruptured and made nearly impossible by capitalism.
The climate crisis impacts our mental health. It’s clear to see how this existential threat – one that parts of the world are already experiencing – can fuel hopelessness and an apocalyptic attitude, and hopelessness can in turn lead to poor mental wellbeing as well as worsening it for some people. This is just one of the reasons why participating in struggle both against the climate crisis and in general is so important, because not only does it tackle capitalism, it gives us a sense of purpose, identity, relatedness and hope. Not only is revolutionary struggle ‘revolutionary’ because it fights against capitalism for a system that doesn’t thrive on the exploitation/oppression of its people. But it is also revolutionary in that it brings people together in a meaningful way that promotes the aspects of the human condition that capitalism neglects.
Whilst the ‘medical model’ is the dominating model to explain and treat mental illness, we have to recognise capitalism’s influence on our mental health and also its influence on those who are neurodivergent or have mental disabilities. In the same way that capitalism will never provide full equality and justice to people with physical disabilities as it isn’t profitable or “productive”, it will never do so for people with mental illnesses, disabilities or anyone who isn’t neurotypical. Capitalism will even actively discriminate against disabled people including mentally disabled patients, as was seen in the UK during the pandemic where Do Not Resuscitate orders were inappropriately issued against the mentally ill and those with disabilities who had severe cases of coronavirus.
What we need instead is a community model of mental health and mental illness and a socialist programme that addresses exploitation, oppression, material disadvantage and exclusion as causes of mental illness. This would have to be matched with a struggle for access to compassionate and holistic mental health care for all those who suffer mental ill health. We need to build a struggle that involves mental health workers, students, trade unions and all oppressed groups for system change and structural solutions to the mental health crisis. Demands under this struggle would call for:
- Free public mental health care for all with sufficient funding of mental health workers, research and treatment,
- Affordable housing for all
- A decent job for all, with guaranteed paid sick leave
- A fair and justified alternative to exams for a move to a democratised, free and fair education for all
- For Big Pharma into democratic ownership leading to a more holistic treatment of mental illness
- For an end to all forms of oppression.
Mental health care and suicide prevention IS an end to homelessness, it is paying workers a living wage, it is an education system that puts students before profit and crude measures of achievement. It’s an end to a system that thrives off the oppression and exploitation of the working class and the discrimination against all those who don’t fit the label of an “ideal worker”.
It’s important that we move beyond just mental health awareness to mental health resources which of course won’t happen sufficiently under capitalism. Regurgitating the need for “awareness” without any properly funded resources or interventions is capitalism’s way of deflecting and responding to the mental health crisis (as it does with other crises) without having to admit its own key role. Its inability to support those with mental health conditions can be seen in the discourse around mental health and mental illness where it even fails to differentiate between the two, with shallow calls such as ‘mental health is real’, ‘for those suffering with mental health…’ and nothing beyond that. In the UK this means stepping up the struggle to stop cuts and privatisation in our NHS, demanding well-funded mental health services that are easily accessible by all who need them, properly funding social care and making it free at the point of use for all who need it, and supporting the struggles of health workers for decent pay and conditions.
Capitalism will never provide sufficient support for those with mental health conditions and will always be bad for our mental health. A system that makes us work long hours with little security, built on the oppression of anyone who isn’t a white ruling class man is not going to solve the mental health crisis. So the struggle to build a socialist society, one founded on the solidarity of all working-class and oppressed people, is also the fight against the mental health crisis and a fight for the mental (and physical) wellbeing of all people.
