Therapy is about reducing suffering, right? Living a fuller life? Not according to current moves to place employment as a central aim of therapy. How come this move is so damaging? Why will so many of us activists and therapists be protesting outside the New Savoy conference on Tuesday, the conference that hopes to set the agenda for the next wave of mental health reform?
In recent years, the government has started to use psychology to get people off benefits, and back to work. In 2006 an economist, Lord Layard, published The Depression Report, an attempt to justify a new wave of therapy for the masses through cost-benefit analysis, the argument the government would actually save money in the long term. Though in many ways a brilliant strategic move, the coupling of saving money with mental health outcomes has become acceptable in a way we would not see with, for example, cancer treatment. We do not, would not, hear that chemotherapy is worth funding because it helps the public purse through getting people back to work. The emphasis is rather on quality of life and the reduction of suffering, precisely the kind of outcomes mental health service users are most interested in. Yet these ideas are not challenged in mental health because of the ongoing link between mental distress and moral failure, or failure to have sufficient willpower.
In 2010, the government began to introduce a new wave of policies for benefits claimants, including those with disabilities. These are based on a psychological principle called behaviourism – punish people who don’t do what you want, and give rewards to people who do. This carrot and stick policy took the form of taking benefits away from people who didn’t or couldn’t meet the government’s requirements that the disabled should be work-ready, with a positive, psychological mindset.
The disabled began to report threats, explicit and implicit, that they would be sanctioned if they didn’t go along to therapy to change their mindsets, or take courses based on cognitive-behavioural principles to gain the appropriate attitude. There is little choice here for benefits recipients, who would lose their means to eat, to have a roof over their head, if they didn’t comply. It is difficult to emphasise enough how maddening this is. It is like being forced to act as if “everything is awesome“ when the actual situation is one where there are few jobs, and where the jobs that are available are often deeply damaging based on inhumane practices such as zero-hours contracts and dire working conditions