Full conference programme – Psychologists and the Benefits System.

Abstract 

The consolidation of neoliberalism with Conservative moral authoritarianism has resulted in welfare policies that are designed with a reductive and punitive citizen behaviour change agenda. This ignores the structural context of citizens and personalises responsibility for circumstances of socioeconomic hardship caused by ideological prerogatives and political administration. 

The emergent psychopolitical form of governance, founded on expressions of an established hierarchy of power and influence, has profound implications for traditional notions of welfare, democracy, cognitive autonomy, citizen agency, equality and human rights. Not only does this behaviourist mode of administration fundamentally change the relationship between state and citizen, it extends inequality, prejudice, stigma and outgrouping, with damaging consequences for sociopolitical inclusion, self-perception and selfhood. 

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Introduction: context, subjectivity and neoliberalism 

R.D Laing once said that madness was a perfectly rational adjustment to an insane society. 

The parameters of psychological experience are defined by cultural, social, economic and political structures. This context has  a profound impact on individual subjectivities and the key institutions and organisations that have formed the basis of the Western social democratic consensus.  

The context I want to discuss is neoliberalism: an ongoing, totalising ideological and political-economic project of a resurgent political right that gained ascendancy in the US under Ronald Reagan and in the UK under Margaret Thatcher in the 1980s.  

Humans are social beings. We thrive best when we have a social rationale which tends towards the promotion of cooperative and collective creativity. This was perhaps expressed best in our civilised, progressive institutions and civilising practices, facilitated by the social gains and economic organisation that arose from the post-war democratic settlement.  

Those gains are now being systematically dismantled. Our culture has been saturated with conceptual schema that demand we remain committed to an economic Darwinism: a neoliberal competitive individualist obsession with our private, inner experiences, the pursuit of economic self-interest, and ultimately, this embellishes our separability from other human beings. It alienates us. 

Neoliberalism scripts social interactions that are adversarial and hierarchical in nature, rather than social and cooperative. It is the antithesis of collectivism, mutual support, universalism, cooperation and democracy. Neoliberalism has transformed our former liberal democracy into an authoritarian state that values production, competition and profit above all else; including citizens’ lives, experiences, wellbeing and social conditions.  

However, citizens are seen and are being politically defined in isolation from the broader political, economic, sociocultural and reciprocal contexts that invariably influence and shape individual experiences, meanings, motivations, behaviours and attitudes, causing a problematic duality between context and cognition. This also places responsibility on citizens for circumstances which lie outside of their control, such as the socioeconomic consequences of political decision-making, whilst at the same time, the state is steadily abdicating responsibility for the welfare and wellbeing of ordinary citizens. 

Geographer David Harvey describes neoliberalism as a process of accumulation by dispossession: predatory policies are used to centralise wealth and power in the hands of a few by dispossessing the public of their wealth and assets.  

Neoliberals see the state as a means to reshape social institutions and social relationships based on the model of a competitive market place. This requires a highly invasive power and mechanisms of persuasion, manifested in an authoritarian turn. Public interests are conflated with narrow economic outcomes. Public behaviours are politically micromanaged. Social groups that don’t conform to ideologically defined outcomes are stigmatised and outgrouped.   

The art of character divination:  justification narratives, stigma and neuroliberalism  

Stigma is a political and cultural attack on people’s identities. It’s used to discredit, and as justification for excluding some groups from economic and political consideration, refusing them full democratic citizenship. 
 
Stigma is being used politically to justify the systematic withdrawal of support and public services for the poorest – the casualties of a system founded on competition for allegedly scarce wealth and resources. Competition inevitably means there are winners and losers. Stigma is profoundly oppressive. It is used as a propaganda mechanism to draw the public into collaboration with the state, to justify punitive and discriminatory policies and to align citizen “interests” with rigid neoliberal outcomes. Inclusion, human rights, equality and democracy are not compatible with neoliberalism. 

Back in the nineteenth century, phrenology was the preferred “science” of personality and character. The growth in popularity of “scientific” lectures as entertainment also helped spread phrenology to the masses. It was very popular among the middle and working classes, not least because of its simplified principles and wide range of social applications that fit with the liberal laissez faire individualism at the core of the dominant Victorian world view. It justified the status quo. Even Queen Victoria and Prince Albert invited  George Combe to feel the bumps and read the heads of their children. 

During the early 20th century, there was a revival of interest in phrenology, partly because of studies of evolution, criminology and anthropology (pursued most notably by  Cesare Lombroso). 

Some people with political causes used phrenology as a justification narrative for European superiority over other allegedly “lesser” races. By comparing skulls of different ethnic groups it supposedly allowed for ranking of races from least to most evolved. During the 1930s Belgian colonial authorities in Rwanda used phrenology to explain the so-called superiority of Tutsis over Hutus. 

Phrenology is now largely regarded as an obsolete and curious amalgamation of primitive neuroanatomy, pseudoscience and Conservative moralising. 

Any system of belief that rests on the classification of physical or other distinctive “characteristics”, including speculation about personality “traits” being related to socioeconomic status, is almost always used to stigmatise, to justify prejudice, inequality, social stratification and the artificial ranking of human worth. And sometimes, this process results in genocide, as Gordon Allport recognised, when he identified the political and psychosocial processes unfolding stage by stage that resulted in the growth of prejudice and ultimately, the Holocaust. 

The process highlights “what” we are perceived to be at the expense of the more important “who” we are. It dehumanises us. It also stifles our potential, progress and development as a society. 

As Erving Goffman said: “The normal and the stigmatised are not persons, but perspectives.”  

The Conservatives have simplified the art of character divination. They established a new economic department of morality and personality in 2010 called the Nudge Unit, which houses the  Behavioural Insights Team. This fits with the Conservative motif of a “broken Britain”: an obsessive fear of social “decay” and “disorder.” Apparently, our society is always on the point of moral collapse. This of course preempts an authoritarian response.  

Of course it isn’t political decision-making or socioeconomic organisation that are problematic: poor people are entirely responsible for the poor state of our country. Those with the very least are entirely to blame. So targeted, class contingent austerity policies are needed to ensure they have even less. We can’t have the poor being rewarded with not being poor, that’s just bad for them and bad for big business. And big business shapes the neoliberal policy agenda.

After all, we really need the privatisation of public wealth and resources and a regressive public policy agenda. Why on earth should an economy meet the needs of a general population?

Under every neoliberal government, we suddenly see the proliferation of bad sorts; “scroungers”, “skivers,” cognitively biased and morally incompetent people making “the wrong choices” everywhere, and generally being inept, deficient and faulty characters. The way to diagnose these bad sorts is to establish whether or not someone is “hard working”. This is usually determined by the casting of chicken bones, and a quick look at someone’s bank balance. If it lies offshore, this generally indicates “a jolly good sort.” 

If you need to claim social security, be it in-work or out-of-work support, then you are most definitely a “wrong sort”; in need of corrective state “treatment.” Poor people are the new “criminal types.” The only cure, according to the government, is to make poor people even poorer, by a variety of methods, including a thorough, coercive, “incentivising” nudge: “remedial” income sanctioning and increased “conditionality” to eligibility for support; benefit cuts; increasing welfare caps and an incremental dismantling of the welfare state more generally.

Such state measures are called “reforms” and claimed to be “fair”, to “help” people into work, and to “make work pay.” Using those terms and phrases in such a draconian policy context is a technique of neutralisation: the rhetoric obscures the real intention behind policies and the social and economic consequences. It’s nothing less than political gaslighting. 

The Conservative shift in emphasis from structural to moral and pseudo-psychological explanations of inequality and poverty has far-reaching consequences. Such a partisan reconceptualision of poverty makes it very difficult to define and measure. This conceptual change disconnects poverty from more than a century of detailed empirical research. There’s been a shift towards an  experimental approach to policy-making aimed at controlling the behaviour of individuals rather than alleviating poverty and improving social conditions. 

Material poverty steals aspiration and motivation from any and every person that is reduced to struggling for basic survival. Abraham Maslow explained that when people struggle to meet their basic physical needs, they cannot be “incentivised” to fulfil higher level psychosocial needs – that includes job seeking. The Minnesota semi-starvation experiment supported Maslow’s theory of cognitive priority with empirical evidence. A behaviourist approach, using punishments such as benefit sanctions, cannot possibly motivate people to find work.  

The increasing focus on social control and conformity in public policy design and governing has been dubbed “neuroliberalism”, reflecting something of a behaviourist turn. It draws on social marketing as a policy tool, in which principles from private marketing and advertising are applied to the definition and promotion of “good” behaviours. Deviance (“bad” behaviour) is defined politically through the intentional and systematic stigmatisation of already marginalised social groups, leading to the creation of folk devils and moral panic which is amplified and perpetuated by the media. 

Othering and outgrouping have become common political practices. 

This serves to desensitise the public to the circumstances of marginalised social groups and legitimises neoliberal “small state” policies, such as the systematic withdrawal of state support for those adversely affected by neoliberalism, and it also justifies inequality. By stigmatising the poorest citizens, a “default setting” is established regarding how the public ought to perceive and behave towards defined outgroups.  

Neoliberals believe that wealthy people are “incentivised” differently from the rest of us: apparently they need rewards of even more money, tax breaks and large bonuses to ensure they are “responsible citizens.”  

Behavioural economics theory is the new phrenology. “Cognitive bias”, making “the wrong decisions” and “faulty behaviour” are what differentiates poor “bad” sorts from those who are righteous and wealthy.  

I’m half expecting an announcement that the Department for Work and Pensions is to be renamed the  Malleus Maleficarum.  

Sometimes the best way to highlight the absolutely outrageous is to ridicule it. 

Who is nudging the neoliberal nudgers?  

Institutions structure political struggles, providing models, schemas and scripts for citizen behaviours. Bureaucratic norms within the welfare state have become increasingly about moral and behavioural rectification. The debate about the causes of poverty has been personalised and reduced to political rhetoric about “incentives.” Welfare dependency and worklessness are now Conservative synonyms for disability, unemployment, vulnerability, poverty and inequality, with perceived dimensions of moral and psychological dependency accepted as “character traits”, such as the controversial Welfare Trait recently proposed by neurobiologist Adam Perkins.

Yet research tells is that most people claiming social security move in and out of insecure jobs, and those in low-paid and precarious employment due to structural constraints are queuing at food banks too.  

Things ain’t what they ought to be 

Perkins claims that the welfare state will erode the nation’s “work ethic” by increasing the proportion of individuals in the population who possess an “employment-resistant personality profile.” Welfare, in this eugenic view, encourages the “reproduction” of people with “undesired traits”.

However, Conservatives often present structural patterns and social circumstances as “natural” and moral laws. Yet the naturalistic fallacy (is-ought distinction) informs us we cannot use descriptive statements – of what “is” – to make or justify prescriptive ones – what “ought” to be).  

It’s become “common sense” that the neoliberal world view of competition, mysterious “market forces” and the “invisible hand”, economic Darwinism and Randian self-interest is simply how things are: that these qualities are somehow fundamental to our social and “human nature” – presented as a fait accompli. Yet philosophers, specialist social and cognitive scientists are still debating the nature of “human nature” after a few centuries of controversial discussion.  

The government’s armchair pseudo-psychology is used to justify increasingly irrational requirements being embedded in policy. For example, the government plan to merge health and employment services, redefining work as a clinical health outcome. According to the government, the “cure” for unemployment due to illness and disability and sickness absence from work, is… work. The new work and health programme, “support” for disabled people, is actually just another workfare programme.  

Labour is the only prescribed “route out of poverty” for disabled people, including those with mental distress and illness, regardless of whether or not they are actually well enough to work. In fact the government implicitly equates mental health with economic productivity. Work will set us free. Yet paradoxically, disabled people haven’t been and won’t be included in the same economic system which is responsible for their exclusion in the first place. 

Competitive market economies exclude marginalised groups, that’s something we ought to have learned from the industrial capitalism of the last couple of centuries.  

GPs inform us that employers are not prepared to make the necessary inclusive workplace adjustments sick and disabled people often need to work.  

But in a dystopic Orwellian world where medical sick notes have been  politically redefined as ”fit notes”, sick and disabled people are no longer exempt from work, which is now held to be a magic “cure”. People are being punished into taking any available job, regardless of its appropriateness, in an increasingly competitive and exclusive labour market.  

The politics of punishment: sanctions 

Policies directed at the poorest and some of the most vulnerable citizens are being used to extend behaviour modification techniques, based on methodological behaviourism. This is a psychocratic approach to administration: the government are delivering public policies that have an expressed design and aim to act upon individuals, with an implicit set of instructions that inform citizens how they should be.  

Aversives and punishment protocols are being used on the public. Coercive and harshly conditional welfare policies are one example of this. Recently a eugenics by stealth policy entailed the restricting of welfare support to two children only. This was introduced with the explicitly stated political intention of “changing behaviours” of poorer citizens. Those that cannot or will not conform are “disciplined” by state-imposed economic sanctions. 

Researchers from a variety of universities across the UK, using qualitative longitudinal interviews with nine groups of welfare service users from across England and Scotland, aim at determining longer-term effects of sanctions. The first wave findings from this collaborative ongoing study regarding the effects and ethics of welfare conditionality were released last year. 

It was found that linking continued receipt of benefit and services to mandatory behavioural requirements has created widespread anxiety and feelings of disempowerment. The impacts of benefit sanctions are universally reported by service users as profoundly negative, having severely detrimental financial, material, emotional, psychological and health impacts. Some individuals disengaged from services, some were even pushed toward “survival crime”.  

A recurring theme is that sanctions are grossly out of proportion to “offences”, such as being a few minutes late for an appointment. Many reported being sanctioned following administrative mistakes. The Claimant Commitment was criticised for not taking sufficient account of individuals’ capabilities, wider responsibilities and vulnerabilities. Many saw job centres as being primarily concerned with monitoring compliance, imposing discipline and enforcement, rather than providing any meaningful support. 

Power relations, class and economic organisation have now disappeared from public conversations about poverty. Neoliberal anti-welfarism, amplified by a corporate media, has aimed at reconstruction of society’s “common sense” assumptions, values and beliefs. Class, disability and race narratives in particular, associated with traditional prejudices and categories from the right wing, have been used to nudge the UK to re-imagine citizenship, human rights and democratic inclusion as highly conditional.  

This is not just about shifting public rational and moral boundaries to de-empathise the electorate to the circumstances of politically defined others. It also obscures the consequences more generally of increasingly non-inclusive, antidemocratic, prejudiced and extremely punitive policies.  

The state has depoliticised disadvantage, making it the private responsibility of citizens, whilst at the same time, justifying a psychopolitical approach that encodes a punitive Conservative moral framework.  

The government is currently at the centre of a United Nations inquiry  into abuses of the human rights of disabled people. The UK is also in breach of the rights of women and children, because of profoundly anti-humanist welfare cuts. Human rights are the bedrock of democracy. Observation of them distinguishes democrats from despots. Targeted social groups are experiencing political discrimination and the failure of a government in a wealthy first-world liberal democracy to observe what are meant to be universal human rights. That ought to be cause for our concern. 

Neoliberals argue that public services present moral hazards and perverse incentives. Providing lifeline support to meet basic survival requirements is seen as a barrier to the effort people put into searching for jobs. From this perspective, the social security system, which supports the inevitable casualties of neoliberal free markets, has somehow created those casualties. But we know that external, market competition-driven policies create a few “haves” and many “have-nots.” This is why the  welfare state came into being, after all – because when we allow such competitive economic dogmas to manifest without restraint, we must also concede that there are always  “winners and losers.”

Neoliberalism organises societies into hierarchies.  

The UK currently ranks highly among the most unequal countries in the world.  

Inequality and poverty are central features of neoliberalism and the causes therefore cannot be located within individuals.  

Addressing stigma, exclusion and disempowerment: a prefigurative framework 

Government policies are expressed political intentions regarding how our society is organised and governed. They have calculated social and economic aims and consequences. In democratic societies, citizens’ accounts of the impacts of policies ought to matter. 
 
However, in the UK, the way that policies are justified is being increasingly detached from their aims and consequences, partly because democratic processes and basic human rights are being disassembled or side-stepped, and partly because the government employs the widespread use of linguistic strategies: euphemisms, superficial glittering generalities and techniques of persuasion to intentionally divert us from aims and consequences of ideologically (rather than rationally) driven policies. Furthermore, policies have become increasingly detached from public interests and needs. 

The government has denied there is a causal link between their welfare “reforms”, austerity measures and an increase in mental distress, premature death and suicide. However, there is a well-established correlation which warrants further investigation.

But the government are refusing to be accountable, denying any association at all between policy and negative impacts. 

It’s not unreasonable to be concerned about policies that have profoundly unethical dimensions presented by state action that involves removing lifeline support that was originally calculated to meet only the costs of basic survival needs, such as for food, fuel and shelter. It doesn’t take much of an inferential leap to recognise that such policies will inevitably have some “adverse consequences”, materially and psychologically.  

There has been no cumulative impact assessment or monitoring of welfare cuts.  No government research regarding the  established correlation with extremely negative consequences and “impacts”, and a longstanding refusal from the government to undertake any of these. There is no evidence for government claims that their policies are justified. 

There have been calls for an independent review to examine controversial benefit sanctions policy and to ensure vulnerable people are protected. Ministers have refused to examine the effect of sanctions on mental health, claiming there is no evidence that sanctions particularly affect people with mental health problems – a claim contrary to the evidence of independent research. 

The government have persistently refused to engage with criticism of the effect of sanctions on mental health outcomes. The highly critical study by Mind last year found 83 per cent of Work Programme participants with mental health issues surveyed said the scheme’s “support” made their mental health problems worse. 

Professor Jamie Hacker Hughes, then President of the British Psychological Society, has also raised concerns about benefit sanctions and a number of other issues concerning the psychological welfare of those on benefits.  

He said: “We have repeatedly sought a meeting with the Secretary of State and his team and now repeat that request so that his Department may become aware of the most up-to-date psychological research and opinion on these issues”. 

He also pointed out that many people suffering mental health problems are sanctioned for failing to meet rigid behavioural requirements, many of which are inappropriate because people find it difficult to participate consistently in work-related activities due to the nature of their health problem. 

Jamie also raised concerns about the WCA , along with many others, pointing to the now significant body of evidence that it is failing to assess people’s fitness for work accurately and appropriately, with people who are seriously physically and mentally ill being found fit for work. 

Political denial of causality does not reduce the possibility of it. If policy impacts cannot be measured, then it is not good policy.

What can we do? 

It isn’t appropriate to expect people to simply re-rationalise their unlivable experiences. What are we if we fail to promote human welfare and wellbeing? What are we if we cannot ensure and extend kindness to our fellow humans? 

Paul Atkinson, writing for The Alliance for Counselling & Psychotherapy, in his article called  NOTHING ABOUT US WITHOUT US? ARE YOU BONKERS? said: 

“Poverty and mental illness [are the] handmaidens of hell. What they have in common is their contagion. We psychotherapists are scared of this. We fend it off with the technologies of our trade, our magic words like “countertransference” and “projection” – spells we cast to keep the horrors at bay. They make it clear that it’s your problem not ours.” 

Perhaps another such spell is “value neutrality.” Paul also said: “When people move us, it’s not necessarily into worlds we want to visit.”   

Value neutrality permits us to safely remain outside, as onlookers. 

In social research, quantitative methods emphasise maintaining objectivity and “value freedom.” However, the area of study is intentionally selected by researchers, funded by interested parties and there are problems related to the connections between observation, those being observed and interpretation.  
 
Social phenomena cannot always be studied in the same way as natural phenomena, because human beings are subjective and intentional. One problem with quantitative research is that it tends to impose theoretical frameworks on those being studied. It limits responses from those participating. It’s not very inclusive. Nor does it encourage ethical authenticity. 

Politically, there’s been a marked shift away from understanding the intersubjective, lived experiences of citizens in context. 

There are distinctions between facts, values and meanings. Qualitative researchers are concerned with generating explanations and extending understanding rather than simply describing and measuring social phenomena, to establish basic cause and effect relationships. Qualitative research tends to be exploratory, potentially illuminating underlying intentions, responses, beliefs, reasons, opinions, and motivations to human behaviours. This type of analysis often provides insights into social problems, helps to develop ideas and establish explanations, and may also be used to formulate hypotheses for further quantitative research. 

The dichotomy between quantitative and qualitative methodological approaches is not nearly so clear as it once was, however, with many social researchers recognising the value of  both means of data and evidence collection, reflecting a commitment to methodological and epistemological pluralism. (Epistemology being an underpinning branch of philosophy that extends various theories of the nature and grounds of knowledge in the social sciences, particularly with reference to its limits, reliability and validity.) 

Qualitative methods tend to be more inclusive and authentic than quantitative analysis, lending participants a dialogic, democratic and first hand voice regarding their own experiences. 

Yet the government have tended to dismiss qualitative evidence from first hand witnesses of the negative impacts of their policies – presented cases studies and accounts – as “anecdotal.”  

Old school positivism always struck me as kind of epistemological totalitarianism when I was a student. It’s very conservative. I have issues with how it is sometimes used to exclude criticism and debate. 

Qualitative research may provide insight, depth and richly detailed accounts. It’s coherent and comprehensive, because it explores beneath surface appearances, and above causal relationships, delving much deeper than the simplistic analysis of ranks, categories and counts. It provides a reliable and authentic record of experiences. It prompts an openness. It is expansive, whereas quantitative methods are somewhat reductive, tending to impose limits.  

Importantly, qualitative methods may be used prefiguratively, to bypass problems regarding potential power imbalances between researchers and subjects, by permitting participation and creating space for genuine dialogue and reasoned discussion to take place.  

Research regarding political issues and policy impacts must surely engage citizens on a democratic, equal basis, permit participation in decision-making, to ensure an appropriate balance of power between citizens and government.  

However, that assumes that governments want citizens to engage and participate. There are no safeguards from a government deliberately exploiting a research framework as a way to test out highly unethical and ideologically driven policies, and to avoid democratic accountability and transparency. How appropriate is it to apply a medical model of prescribed policy “treatments” to people experiencing politically and structurally generated social problems, such as unemployment, inequality and poverty, for example? 

Praxis makes perfect:  Pedagogy of the Oppressed 

Perhaps we  ought to move away from purely individualist models in psychology and draw inspiration from the ideas and critical praxis most famously articulated by Spanish-born Salvadorean Jesuit priest, activist and psychologist Ignacio Martín Baró, who developed liberation psychology in response to suffering and oppression in Latin America. Briefly, praxis is action which embodies a commitment to human wellbeing, the search for truth and empowerment. It’s a synthesis of critical reflection and action.  

Martín-Baró emphasised the psychological dimensions of political repression, the role of ideology in obscuring the political and socioeconomic forces, and the power relations that create and maintain oppression. He proposed that one key task for psychologists is to de-ideologise reality, making dominant ideology, designed to obscure, transparent.

He worked with marginalised populations to support the promotion of their own interests rather than those which are hegemonic, enabling citizens to act for themselves. From this perspective, the behaviour of oppressed people is conceptualised not through intrapsychic processes, but as a result of an alienating environment. Distress is understood in the context of an oppressive environment that psychologises and individualises distress.  

Paulo Freire strongly influenced this perspective, with an emancipatory education approach, providing a lens through which to understand systems of oppression in order to transform them. He flipped mainstream pedagogy on its head by insisting that true knowledge and expertise already exist within people.  

Freire’s Pedagogy of the Oppressed frames education as a practice of freedom, which contrasts with education as a practice of domination. Education is a political act. Freire says that the system of power relations creates a  culture of silence that instills a negative and suppressed self-image  which is internalised by the oppressed, resulting in fatalism - people become resigned to their social circumstances. Freire proposed a genuinely dialogical, participatory and democratic approach to learning that was distinctly prefigurative.*  

From this perspective, we are all activists, working towards raising awareness and inspiring critical, collective and cooperative action to transform oppressive sociopolitical realities. 

This approach has inspired community-based professionals to develop a vision for including the values of self-determination, distributive justice, collaboration, and democratic participation in psychology, but nonetheless we often shy away from raising political awareness in our work, and in doing so, we overlook the sociopolitical and historical dimensions of pathology and oppression. 

I started my professional life in a youth and community role. Pedagogy of the Oppressed was required reading back then. Recognition of the sociopolitical conditions which lead to distress and poor mental health is crucial in developing a consciousness and language of critique, and in dismantling prevailing mythologies to reach an awareness of oppression. The oppressed being objects of political intent rather than self-determining, autonomous “subjects.”

Prefigurative framing offers us an opportunity for invaluable mutual learning experiences in therapeutic settings. Practices designed to meet an expectation that changes should happen within complicit individuals avoid addressing the need for change at context level, and alienates people.

We know that poor mental health is linked with poverty (Melzer et al. 2004) poor community integration, and competitiveness amongst social groups (Arrindell et al., 2003).  Research suggests community based work may be much more effective than working with individuals only. (Orford, 2008). 

For example, the Beacon Project (Stuteley, 2002), pioneered by health workers who supported people with depression and a range other health problems by working with their whole community – addressing their basic social needs and developing mutual social support systems, extended significant changes in physical and mental health for the whole community, showing the benefits of fostering a psychology of mutual support, altruism, cooperation, solidarity and building social capital. At the very least, this approach encourages positive role modelling, participation and empowerment. 

Human needs, public services and provisions, developmental processes, and social relationships are crucial to any comprehensive model of mental health.  

Community based work offers something that perhaps individualist “firefighting” approaches can’t: an unlimited scope and reach, sustainable, self-perpetuating, long-lasting mental health provision with an inbuilt preventative agenda, which addresses alienation, disempowerment, and rebuilds democracy and social solidarity. 

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*Prefigurative – by this, I mean engaging in ways of working, modes of organisation and social relationships that strive to reflect the positive changes and the kind of future society we want to see. A prefigurative approach embodies those forms of social relations, decision-making, culture, and human experience that are our ultimate goal. It’s a co-creative approach and one of breaking with hierarchy. Historical experience shows that movements arising and conducted in an authoritarian fashion do not lead to open and democratic political systems and societies.

It means we have to practice what we preach.

It also means we each share the responsibility of activism, and of making a positive difference. 

As James Guillaume wrote: “How could one want or expect an egalitarian and free society to issue from authoritarian organisation? It is impossible”

 

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Additional

   Arnstein’s Ladder of Citizen Participation and Power 

 
Citizen participation is a vital aspect of democracy. Sherry Arnstein was especially concerned with the problem that while many people applaud participation, it can be used as a euphemism or an empty ritual instead of a marker of real citizen power. She said that citizen power is “the redistribution of power that enables the have-not citizens, presently excluded from the political and economic processes, to be deliberately included in the future… the means by which they can bring about significant social reform.” In the ritual of participation, power-holders can claim that all sides were considered, but still retain power. 

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Some relevant links:

The importance of citizen’s qualitative accounts in democratic inclusion and political participation

What you need to know about Atos assessments

G4S are employing Cognitive Behavioural Therapists to deliver “get to work therapy”

The power of positive thinking is really political gaslighting

Nudging conformity and benefit sanctions: a state experiment in behaviour modification

The new Work and Health Programme: government plan social experiments to “nudge” sick and disabled people into work

Research finds strong correlation between Work Capability Assessment and suicide

 

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