Charlotte's Editorial
Charlotte Raven

A feminist alternative to asylums?

By Charlotte Raven

This week, to coincide with the national Mental Health Awareness Week, we’re publishing a series of articles looking at feminism and mental health. Some readers may find this content distressing.

“You’ll enjoy this piece,” my daughter just said. “It’s your specialist subject.”

She’s right and this a bit of a worry. I hardly notice how much time I spend discussing theraputic modalities with friends and colleagues, or how many Google searches of the side effects of psychoactive medications.

Some of my best friends are mad. One writes self help books using an online acronym generator and another weaves. And one is in an out of the emergency psych ward of our local hospital, which really does seem like a revolving door.

Trawling through recent statistics at the start of mental health week, I was convinced that my mad friends are ‘everyday people’; mad is the new normal, in fact. 1 in 4 of us will experience some kind of mental crisis in the course of a year. It is a woman’s issue, unarguably: women are more likely to be treated for a mental health problem than men. We may be getting madder but a rational discussion is taking place about all this for the first time and nothing is off limits.

Everyone agrees; the crisis in mental health care is a gathering storm. Politicians are responding strangely and uncharacteristically. The brutal reality of care in the community has drawn criticism across the political spectrum, although the reasons are different. The Tories are worried about the sane members of the public being attacked by the mentally unstable and the left are worried about the people left in front of the TV in lonely flats for decades, with nowhere to go and nothing to do.

At Christmas I was mad as a brush; depressed and alienated with little fellow feeling. Our family home had been a war zone because of my mental crises which have all merged into each other. Until three months ago, I was chronically depressed. I wasn’t sitting quietly in front of the TV watching Friends like my other depressed friends; I couldn’t move but managed to station myself in the one spot in the house where everyone would hear my anguished perorations. I spent whole weekends on the only comfortable chair in the kitchen, complaining about the chores, my doomed existence and the internet age.

I spent 5 years wondering what to do. Having recently read Gone Girl I’m glad I didn’t relocate to a provincial town and set up a bar with an East London name. Then one day an epiphany: I should retrain as a therapist! Several of my mad friends had done this, and a few sane ones who found their skills surplus to requirements. The writer I most admired had gone down this well trodden path. Fortunately for my patients-to-be, I realised I’d be a rubbish therapist one year into a course at the Tavistock: “You’d go on about your problems and never listen to theirs,” my daughter said.

For those who made this leap, their business is sustainable, if poorly remunerated. It is recession proof; a booming industry in this crazy-making late capitalist era.

Why is anyone sane? This system is built on false promises; you are built up and knocked down. We are constantly reinventing ourselves to keep up – and failing. Jobs for life to zero hours in the blink of an eye. Poverty drives people over the edge and if they bear witness to their traumatic experiences of inform on this ‘structurally genocidal’ system, they are discredited. We are all being gaslighted all the time; capitalism dims the lights, murders our friends and relations, then tells us we are lunatics. This system is a suitable case for treatment.

The biological view of mental illness is appealing because the pharmacological answer is a quicker fix than global revolution. We are all drugged up to the eyeballs and increasingly cavalier about it. I recently read something about Ritalin that said few parents asked about the side effects, possible alternatives, what these drugs were whether these drugs are even effective. We think they’re mild because we give them to children. In fact, Ritalin was first synthesized in 1944 in an unsuccessful attempt to create a non-addictive stimulant. This amphetamine-like substance is similar in chemical structure and effects. Like speed, it keeps you awake, suppresses your appetite and makes you anxious and irritable.

I empathise with this desire for quick fix. Who the hell wants a long fix? I was in three times a week therapy for a few years, and barely scratched the surface. When I couldn’t afford it, I decided pills were the answer – I just hadn’t found the right ones. An NHS psychiatrist diagnosed double depression; major depressive episodes on top of persistent dysthymia. He prescribed two different types of anti-depressants and a mood stabilizer. It worked, in a way. I am no longer depressed, but do feel like I’m on drugs.

One recent documentary, Generation RX examines the rise in psychiatric diagnoses among American children and teens from 1980 to 2007. The producer was shocked to learn that the majority of the psychiatric drugs prescribed to kids had never been proven safe or effective. But the regulatory watchdogs colluded with drug manufacturer in supressing evidence of suicidal thoughts and other side effects before Ritalin and other stimulants came to the market. The predictable result; a spike in teen suicides and 7-year-old insomniacs. Our children are the victims of our quick fix mentality.

If not drugs and TV then what? It’s the right moment to re-imagine institutional care and thereby capitalise on public disillusion with community care, without reviving the fear of Nurse Ratched. I came across a magazine of ‘democratic psychiatry’ called Asylum, while Googling the word to find out whether anyone had reclaimed it as a place of safety. They had.

I’ve been heartened by the dialogues I’ve had with radical service users and activists. “We’ve been banging on about this for years,” they said. Now people are listening. A group called Madlove has set about creating a ‘designer asylum’, a safe space where you could go mad “in a positive way.” The project will bring together people with and without mental health experiences, artists, and academics to conceive “a unique space” where “mutual care blossoms” and madness is redeemed. Then it will be built, opened and operate as a voluntary day hospital for six weeks.

As well as model asylums there should be mental health hubs (but don’t call them that!) in the community, within walking distance, where you won’t be stared at. I have been stared at in cafes. What would I have done if my husband had bailed out to protect his sanity? Where would I have gone?

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