Mental Health — a brief Critique by a Mental Hospital Worker (1973)

From the June 1973 issue of the Socialist Standard

If you are feeling the strains of life, if you are beginning to feel you cannot cope, or if you become aware that you see existence differently from other people, then watch out as you may find yourself in the clutches of a psychiatrist. Such characteristics may be considered symptoms of mental illness and, whereas you are free to accept or reject the advice of a doctor if you suffer from a physical illness, this right may be removed from you in the case of a disease of the “mind.” Although the 1959 Mental Health Act made treatment for mental illness on a voluntary basis possible, there are still over 10,000 individuals in Britain compulsorily detained in mental hospitals against their will. Beware unruly, aggressive behaviour as, if you are apprehended by the police, Section 29 gives leeway for you to be detained for 72 hours in mental hospital on the order of a mental health worker, temporarily overcoming the necessity of court action. Whether a short-term or long-term stay, the “care” of the individual in hospital involves the removal of control of life from that person; during that time existence will be regulated and regimented by hospital staff.

It is easy to fall into the trap of believing that what is being dealt with are “faulty brains” and that the “mental” person must immediately be guided totally by others before they cause damage to themselves or the public. However, we must look at the assumptions underlying this approach to insanity, the dangers to every individual in society arising from these assumptions, and also the power that medics have over the destiny of so many lives as a result.

Social Definition . . .

What is meant by “insanity?” The general model used is the medical one. The individual is said to be sick, with a disease of the brain. As a consequence the term "mental health” has been coined and this in turn results in a whole set of reactions towards the insane man or woman (such as sending them to a doctor who specializes in brains, putting them into hospital, and treating them with drugs or surgery) which are not necessarily correct.

This approach is often completely presumptuous, probably arising from the growth of psychiatry through the roots of medicine rather than psychology. Although “mental” behaviour may be an obvious result of brain malformation or brain damage (in which case the behaviour tends to be of a specific type), in a vast proportion of cases of disturbance, no physiological/structural abnormalities are to be found in the disturbed person. Classification of individuals as suffering from a particular mental syndrome is based almost completely on the individual’s behaviour, including responses to other people, the ideas expressed, the ability to hold down a job, and the patterning of results on “intelligence” tests. In other words, the definition of insanity is based on comparing individuals’ behaviour with the behaviour shown by the general population. So it is a social definition and cannot be the objective phenomenon that is claimed, but is subject to the prejudices and ideologies of the professionals involved in the field of mental health.

If the insane individual is the one who deviates from the normal what is meant by “normal” must be considered, as there is a great range of behaviour shown by members of society. Normality is behaviour that is generally tolerated throughout society, and the normal person is the one who has managed to survive in society with an acceptable balance between the development of his potentialities (including personality, intellectual and physical traits) and the conditioning by which his abilities are directed into socially acceptable functions (including such behaviour as being able to chat in the local).

. . . and Social Judgement

If, like Laing, you view the normal as sick (but see Socialist Standard, August 1972), what criteria have you for dealing with deviants from the “normally abnormal?” Bourgeois psychology indicates time and time again that present-day society is not one that permits individuals to fulfil their potentialities but one that inhibits people’s full development. Work by John Holt and Paul Goodman shows this process at work in the school setting where children’s creativity, inquisitiveness and desire to learn is progressively stilted as they become socialized to a regime that thwarts originality and praises tactics where “correct” answers arc provided without any understanding. This in turn reflects a wider conditioning where the “correct answer” is conformity to the requisites of capitalism; individuality means individuality within strict limits; to stretch beyond these is to become insane or criminal.

This is not attempting to exalt those in mental hospital, for their existence is often a miserable one. But questioning the very nature of normality and the conceptual — and practical — approach to abnormality exposes not only the inadequacies of the care for the “insane”, but also reveals a danger to every one of us. In Russia intellectuals are confined in mental hospitals and people are quick to condemn this. Yet this is only an extreme form of the attitude of those in the West: those who do not “fit in” must be locked away. Where are the boundary lines between the mad and the sane? Are you sure you belong to the population considered normal?

Let us consider those unfortunate individuals who find themselves in mental hospital. Removed from a bewildering world of insurmountable problems they may feel happier in the protected environment of the hospital where life is organized for them, where they only have to obey the staff. Alternatively, they may be further confused by their removal from a world they know to this strange environment. Whichever the case, evidence indicates that the longer the time the individual remains in “care”, the less chance there is of them leaving. For institutionalization works itself upon the inmates who, devoid of opportunities to run their own lives, learn behaviour that is inappropriate for the outside world and so become greater misfits. Goffman gives a good analysis of this process in Asylums and indicates how the inmate can be reduced to an obedient moron who is quiet and always follows the rules. From my own personal experience, when working in a mental subnormality hospital (in many ways identical to a psychiatric hospital), it was blatantly obvious that the person who attempted to assert himself in any way suffered great social recriminations and punishments with withdrawal of privileges. This type of individual, probably with the characteristics to survive better than other patients, is unlikely to be allowed out of the hospital by those in authority as they consider such behaviour to be “bad” — and so the hospital becomes a prison.

What's it all About ?

People “outside” show little interest in the mental hospital and, possibly due to this, doctors are left free to give E.C.T., drugs and brain surgery despite very inadequate knowledge of the consequences of these actions. The patient has no means of self-protection, and this is an uncaring society — which is possibly why many people are in mental hospitals anyway.

The problems are many and knowledge very limited. Certainly those individuals suffering from “mental syndromes” require support, care and understanding from the community in order to learn how to cope with life rather than to be rejected and locked away. But one cannot help being sceptical about this being possible in a society where most people are in some way “mentally sick”, which places so many pressures upon everyone that time is too precious to concentrate on helping “social inadequates”, and where everyone has a multitude of their own problems.

Judy

London's Ring-Roads: How to Solve the Traffic Problem (1973)

From the April 1973 issue of the Socialist Standard

The ultimate argument for capitalism has always been that at least it works. The problems can be acknowledged, but while efforts to solve them are made the basic task of running society has to be accomplished; and in this capitalism passes the empirical test while Socialism remains untried. Unfortunately, it is quite untrue. Profit, the nest-feathering for which capitalism exists, is irreconcilable with social well-being or simple efficiency. The effect is that of a Fred Karno circus where the acrobats fall down, lions eat tamers, prancing horses have the botts and blazing hoops won’t light; but the ringmasters explain continually that with a change of management the greatest show on earth will get things right.

Thus, the politicians promise and plan for productive growth of which the system is incapable. Houses and flats are built by the million and the need for homes only grows. Schools everywhere like glittering palaces, and the attainment of literacy still elusive. The technical achievements fall flat, knackered by built-in obsolescence and cost-paring: each new wonder — motor-car, TV, household machine — leads at once to proliferation of repair shops in testimony to the models’ failure to work. The vision of space-travel is of men on their backs under non-starting rocketcraft all over the universe, with tow-in-and-mend stations on every star. Whatever capitalism does is done with atrocious inefficiency, its non-viability a comedy with tragic results.

Motors, Motors Everywhere

An outstanding example of this is the present-day struggle to accommodate road traffic. Generally, authorities find only one solution to attempt: the building of more and bigger roads. A new scheme for London was published at the end of February — a “box” of ring roads through the outer suburbs, girdling the city and linking the motorways which radiate from it. The existing ring-roads, North and South Circulars, have long become permanent traffic-jams in which the eight-miles-an-hour pace of Edwardian horse-traffic is seldom achievable. The box will take twenty years to build. It involves, of course, widespread destruction of homes and surroundings. At Blackheath on the south side it will go underground, not to spoil the select character of the area. To the north the intended route is through Epping Forest, which was rescued in 1870 from being nibbled-away by private enterprise to be eaten instead by governments and public corporations.

The question is: what is achieved? There are inevitably objections to the scheme, chiefly from the people whose lives will be affected by it. One argument says that the new roads are not necessary. Jeremy Bugler, writing in The Observer on 25th February, proposed that making more roads simply incites traffic congestion and that the occupants of sixty-nine cars could be put in one bus. Answers like these add to the confusion of capitalist practice. For one thing, the prime purpose of highways — and the most pressing today — is the commercial one of transporting goods. For another, the implication that people ride in cars unnecessarily for psychological ("status”) reasons is only a part-truth. The underlying fact is that the purchase of cars, their fuels and components is thrust relentlessly at everyone. Attributing the outcome to psychic weaknesses is to add insult to salesmanship.

Objection and Reconstruction

No doubt the new roads are necessary, in the same way that London’s Third Airport is necessary: given what goes on in capitalism. Indeed, the objections to the ring-road plan closely resemble those to the sites named in the airport controversy. The ruination of historic and attractive places; hardships and losses created; the noise and nuisance a major highway brings; and agreement that the thing is needed if only it is put somewhere else. The great weight of objections, too, comes from the better-to-do — conscious, apart from anything else, that they have bought better surroundings than most people get. The inference is that areas where poorer-paid workers live could be demolished without regret. In itself, that is true enough (the only thing to do in a sane society with great chunks of working-class housing, not necessarily old, would be to blow them up). But the well-off can, if they lose their fight, choose other agreeable surroundings. For the poor, the position is still as Engels described it in The Housing Question in 1872:

  I mean the practice which has now become general of making breaches in the working-class quarters of our big towns . . . from considerations of public health and for beautifying the town, or owing to the demand for big centrally-situated business premises or owing to traffic requirements, such as the laying down of railways, streets, etc. No matter how different the reasons may be, the result is always the same: the scandalous alleys and lanes disappear to the accompaniment of lavish self-praise from the bourgeoisie on account of this tremendous success, but they appear again immediately somewhere else and often in the immediate neighbourhood.

Augean Stable on Wheels

From such an upheaval, something effective should result. The strong probability, however, is that before ten of the twenty years are up the inadequacy of the half-build road system will become a major public argument; that new schemes will be announced for relief highways and other radial roads; and that palliatives for the traffic problem will redound in the Sunday papers. A new dilemma is emerging now from motorways and ring-roads in that the approaches to them become protracted snarl-ups, the gain in movement creating a compensatory loss. There are several instances where a town’s by-pass road has grown so congested that traffic takes the town instead; the authorities’ response has been to drive it back by shutting-off the town route, making congestion worse.

One needs only to look at any urban area to see the problems and contradictions. The destinations and amenities the car is believed to bring to hand are inaccessible from it: workplaces, shops, stations, public lavatories surrounded by traffic prohibitions make the approach more tortuous than by pedestrianism. The most characteristic example is a public telephone in its commonest place, a busy spot. The motorist cannot get near to use it, but when he does so on foot conversation is made near-impossible by the noise of the traffic.

Impotence

Needing the free flow of traffic, capitalism lacks the competence to obtain it. The brothers Goodman in their book Communitas give a plan of what a traffic-orientated commercial city should be like. The metropolis is seen as a gigantic department store, with the highways as its corridors (elevated or tunneled as well as at ground-floor). Intermediary streets are abolished; the highways lead direct to the central container where homes, workplaces and institutions can all be driven into. Round this automobile city is the recreation land, stadiums and holiday camps and imitation wild parks. The authors’ point is this the way to do it if you want that sort of thing. Yet capitalism urgently wants that sort of thing, but cannot manage it.

The reason is simply the conflicting pressures which refuse any coherent development. Whatever the public and the journalists may think, every local councillor knows that “planning” is simply scrabbling for the least unsatisfactory compromise available at the time. The limiting factors include the contrary demands of commerce and industry; the strength of the property market; government policies over housing and population distribution; and, of course, cost. One of the aims of nationalization was to reduce these self-conflicts in capitalism (incidentally, one of the earliest nationalizations, in effect, was bringing highways under corporate control to facilitate traffic movement), but it has done little or nothing. So far from executing an ideal communal will, the nationalized industries and undertakings have to compete in the melée with everyone else.

Another Kind of World

Can Socialism do better? The cause of all the chronic dilemmas and idiocies of capitalism is organic: its structure on the class ownership of the means of production. There can be no hope of solutions or efficiency until this fetter is broken. Given its replacement by common ownership, social cohesion and planning of the environment we want become possible for the first time.

Some immediate changes in town life on the establishment of Socialism are apparent. With the end of the use of money, numbers of buildings or their uses become obsolete. Banks (and the accountants’ and brokers’ offices which invariably live over them); labour exchanges and social security buildings; rates and rent offices, insurance offices, betting shops, estate agents’, solicitors’. There is the immense multiplicity of shops, for competition not convenience: supermarkets, electric wares and furniture stores juxtaposed down the Hight Street, each selling exactly the same as the others and vying for trade with special offers. The nationalized boards’ own showrooms, where electricity and gas are flogged as if in mortal combat with the popularity of rush-lights and turf-burning. Add, too, the socially wasteful services — repairs and replacements for rubbishy products and those made to “agreed standards”. To visualize the town with all these gone is to see a surprising difference in its shape, but the greater difference is in its function. Other, still more radical, changes can be envisaged: a new conception of housing, for instance.

The Real Alternative

The frequency and use of the motor-car arise from this general pattern of social life. A comparison can be made between Jeremy Bugler’s desire to get commuting drivers out of their cars and into buses, and the quite different conditions which would exist under Socialism. In the first, the suggestion is for legislation: to ban cars from town areas, or to promote bus services by subsidy, or both. In Socialism, the kinds and conditions of work would be very much different from those of today. Commuting, the life of hurrying from work to watch TV and sleep in the same way that a boxer returns briefly to his corner between the rounds, might be chosen by the specially dedicated but would no longer be enforced on millions. Housing comes into it as well. When giant office blocks are built on the most expensive land in the centre of cities and housing developments on the cheapest at the outskirts, movement becomes the least economic and the most troublesome.

Likewise, road transport. One can subtract a great deal which for obvious reasons will cease to exist under Socialism, and the craziness out of which money is made — “carrying coals to Newcastle” is a cliché for the height of uselessness, but they actually do it for capitalism (no doubt in forty-ton lorries). Whenever an alternative to lorry transport — the rehabilitation of canals or railways for example — is perceivable, it has to be discounted on the grounds of cost.

The question of the roads in general is one of social organization and motivation. With those changed fundamentally, new functions and attitudes appear; the motor-car will have a different evaluation. But where problems do arise, the resources and intelligence of society can be applied to solving them. Mankind can choose, and that is the essence of a responsible, free society. Marx and Engels saw Socialism as ending the division between town and country. That does not mean the town consuming the green fields; but it may mean pastures where a ring-road box has been.

Robert Barltrop

Raising of the school leaving age (1972)

From the April 1972 issue of the Socialist Standard

A Teacher writes . . . 

Over the past twenty years or so education has become one of the most popular discussion topics among pundits, practitioners and participants alike. Following the 1944 Butler Education Act, and the resulting tripartite secondary system of grammar, technical and modern schools, there has been much heated argument about early selection and the relatively privileged position of the grammar schools. This in turn has been followed by a movement towards comprehensive schools and their gradual and partial replacement of grammar schools. But the concept of “equality of educational opportunity" has meant many things to many people in the past, not least among supporters of the comprehensive movement who saw in such schools the opportunity to put into practice such ideas of equality. The publication of three "Black Papers" on education by anti-comprehensive writers, and indeed other writings by some who support the idea in principle, has shown that much of the expected outcome has not been fulfilled, and the ethos within these schools today seems to hold little promise of a more egalitarian structure in education. As Dennis Marsden point out, in Education For Democracy, the early supporters of comprehensives looked to these new schools to provide a solvent for class barriers and inequality. They urged the abolition of grammar schools on the grounds of social exclusiveness, narrowness and rigidity of academic curriculum. By contrast, many of the later supporters of the comprehensive schools have wanted merely an extension of the grammar school traditions with a higher proportion of the population benefiting. Also, instead of the proposed unstreaming and the common curriculum, with flexible teaching methods intended to promote a new co-operative atmosphere especially geared towards the average or less-able child, the existing competitive streamed and specialised structure has for the most part been retained. The measure of success is still the number of GCE passes, university places and the more efficient use of scarce science and maths teachers.

Accompanying these arguments have been other equally passionate themes such as forms of examinations, school organisation and size of classes, changing pattern of sixth forms, abolition of free milk, and as a reminder that teachers are very much part of the class struggle there has been regular recurrences of teachers’ pay negotiations. Now comes the latest controversy in this long line of reform, namely the raising of the school leaving age, or ROSLA as it has become popularly known. From next year pupils whose fifteenth birthday falls on or after 1 September, 1972, will have to remain at school for one year more than they would otherwise have done, although it must at once be made clear that many children already stay on at school quite voluntarily. In fact there is an average of some 60 per cent of the age group throughout the country already doing so. This figure must, however, be considered further to establish precisely where the problems are likely to arise. It does not follow that 60 per cent in every area stay on at school; the incidence varies from about 68 per cent in Greater London and the South to some 42 per cent in the East Midlands.

The concern among practising teachers and administrators is directed towards the group of pupils who would normally leave at fifteen, and although these represent a minority of the age group there is a feeling that these “reluctant learners”, as they have come to be called, will cause disruption disproportionately to their numbers. An indication of this concern can be seen in Enquiry I, a Government Social Survey undertaken as part of the Schools Council’s programme for helping teachers prepare for the raising of the school leaving age. Around 3,000 teachers were interviewed.

The majority had some reservations about the advantages of keeping at least some of their pupils at school for the extra year, and one union — The National Association of Schoolmasters — views the plan with considerable apprehension. During the debate on the proposal at its Easter Conference, older delegates said their life expectancy was being shortened by five years by the stresses of coping with unruly teenagers in large urban schools.

Britain, of course, is not alone in this desire to extend education beyond the current school leaving age. Although there has been something of an explosion of pupils between 17-18 in schools there is still only 19 per cent of the age group getting full-time education. This compares with 24 per cent in France and Italy, some 38 per cent in the Netherlands and Belgium, over 70 per cent in Japan and nearly 90 per cent in America and higher proportions will soon be internationally commonplace. Yet some are asking if these figures are justified even by present-day standards, when one considers the type of education churned out for these increasing numbers. Does capitalist society need the technologists, and if so are the schools best fitted to train them, and should, in fact, that be the purpose of mass education? One writer, Paul Goodman, in his book Compulsory Miseducation, uses the following argument to question the value of extended education.

It is claimed that society needs more people who are technically trained. But informed labour people tell me that, for a job requiring skill but no great genius, a worker can be found at once, or quickly trained to fill it. For instance, the average job in General Motors’ most automated plant requires three weeks of training for those who have no education whatever. It used to require six weeks; for such automation has diminished rather than increased the needs for training. In the Army and Navy, fairly complicated skills e.g. radar operation and repair, are taught on the job in a year, often to practical illiterates.

The argument here is not that there should be no education for the mass of people, but rather what type of education, and to whom should it be orientated. Goodman argues that it is time we stopped using the word "education” honorifically, and that the present type of compulsory schooling under the present administrators, far from being extended, should be sharply curtailed. He feels that schools should become less institutionalised and much more flexible, with opportunities to return to education in later years as the desire or needs demand.

The purpose of this article is not to oppose the raising of the school leaving age, though it is clear that there has been a lack of preparation to meet the obvious demands this will make on an already overburdened educational system. And there are many in education today who have serious misgivings as to whether reforms like this will be an improvement. Evidence of this doubt can readily be seen in the new books dealing with the aims and values of modern schools, books such as Paul Goodman’s Compulsory Miseducation, Everett Reimer’s School is Dead, Ivan Illich’s work on the school as an institution, and many others searching for alternatives in education. So much of their description is correct, but the prescription is lacking, and while education today is restricting, limiting and narrow in every sense, putting this right can only be done in an alternative society, and for this reason we direct our efforts towards the establishing of Socialism rather than concerning ourselves with advocating or opposing reforms such as the raising of the school leaving age. As a practising teacher, very much in the front line of action, and like so many other teachers up and down the country, I shall endeavour to face the realities of the situation and work out a series of solutions and compromises, at the same time making the extra year as profitable and as enjoyable to the young people in my care as I possibly can. Perhaps one good feature about the whole scheme is that many adolescents are becoming more informed about world problems, and discussion groups within the schools are allowing them to become aware that the solutions to social problems such as war, poverty, unemployment and pollution can only be found through the establishment of a non-competitive society. (We have recently been invited to talk to groups of senior pupils within the schools, and the response to our case is encouraging).

Education in the seventies will continue to develop along the lines that it has for the past century, and to the same purpose, that is producing workers capable of manning the machinery of production and distribution, who are paid in return sufficient wages and salaries to reproduce their energies. The fact that some workers progress beyond this stage is due to their own efforts rather than the educational system, just as it was during the last century in Britain and just as it is today in many of the underdeveloped countries throughout the world. The Times "Turnover” article (29 April, 1964) pointed out that "Strictly speaking the hottest political debates about education are not about education at all. They are about national investment, national competitiveness, social justice and above all class.” The discussion, in other words, is about educational reforms within the context of capitalism. Real freedom and a truly liberal education can only come about in a cooperative and non-competitive society. Socialists look forward to the day when education will be genuinely for the individual, and when the development of creative talents will replace the pre-packeted, mass-training that sadly passes for education today.

Ronald.