A mental-health crisis is sweeping the globe. Recent estimates by the World Health Organisation suggest that more than three hundred million people suffer from depression worldwide. Furthermore, twenty-three million are said to experience symptoms of schizophrenia, while approximately eight hundred thousand individuals commit suicide each year.
Within the monopoly-capitalist nations, mental-health disorders are the leading cause of life expectancy decline behind cardiovascular disease and cancer. In the European Union, 27.0 percent of the adult population between the ages of 18–65 are said to have experienced mental-health complications.
In capitalist society, biological explanations dominate understandings of mental health—such as theory of chemical imbalances in brain. Such an approach—which not only dominates the medical profession but has also infused public awareness, is largely unsupported—but is being propagated because it benefits pharma companies manufacturing anti-depressants. Another popular effort is to identify genetic abnormalities as another cause of mental-health disorders—this may explain particular cases, but cannot give a broad explanation for the widespread mental-health problems.
In all this, what is obscured is the fact that it is the social, political, and economic organisation of society that is a significant contributor to people’s mental health, with certain social structures being more advantageous to the emergence of mental well-being than others. At the root of the widespread mental-health problems today is the capitalist society. As professor of social work and social policy Iain Ferguson, a well-known socialist, has argued, the alleviation of mental distress is only possible “in a society without exploitation and oppression.”
In what follows, I briefly sketch the state of mental health in advanced capitalism, using Britain as an example and utilising the psychoanalytical framework of Erich Fromm, a German democratic socialist, which emphasises that all humans have certain needs that must be fulfilled in order to ensure optimal mental health. I argue that capitalism is crucial to determining the experience and prevalence of mental well-being, as its operations are incompatible with true human need.
Mental Health and Monopoly Capitalism
As Baran and Sweezy have argued in Monopoly Capital, the monopoly capitalist system fails “to provide the foundations of a society capable of promoting the healthy and happy development of its members”. For the majority, work is a thoroughly unsatisfactory experience, and leisure too becomes boring. Instead of fulfilling passions, it has become synonymous with idleness—with books, television, and films inducing a state of passive enjoyment rather than demanding intellectual energies. Moreover, leisure has largely coalesced around increasing consumption—as it is used by corporations as an opportunity to promote the sale of their products. With consumption basically becoming reduced to a competition to establish one’s social position, the acquisition of products also soon becomes meaningless.
With both work and leisure losing their inner content and meaning, and with the working class movements not powerful enough to challenge the system, the result is that the system continues to decay, leading to spread of psychic disorders. Modern monopoly–capitalist society continues to be characterised by an incompatibility between, on the one hand, capitalism’s ruthless pursuit of profit and, on the other, the essential needs of people. As a result, the conditions required for optimum mental health are violently undermined, with monopoly–capitalist society plagued by neuroses and more severe mental-health problems.
Fromm constructed his theory of psychoanalysis based on Marx’s theory of alienation—which says that alienation is the estrangement people feel both from themselves and the world around them, including fellow humans. Capitalism creates a distinction between human essence and existence; humans become divorced from their own nature—this is at root of mental problems.
Human nature, Marx argued, consists of dual qualities and we “must first deal with human nature in general, and then with human nature as modified in each historical epoch.” There are needs that are fixed, such as hunger and sexual desires, and then there are relative desires that originate from the historical and cultural organisation of society. While basic biological needs, such as hunger, sleep, and sexual desires, are important aspects of human nature that must be satisfied before all else, nonetheless, as humans evolve from animals to human beings, they found it increasingly easier to satisfy their basic biological needs, largely as a result of their mastery over nature. Therefore, the urgency of their satisfaction gradually became less important, with the evolutionary process allowing for the development of more complex intellectual and emotional capacities.
Fromm identified five central characteristics of the human condition:
i) Relatedness: Aware of being alone in the world, humans strenuously endeavor to establish ties of unity. Without this, it is intolerable to exist as an individual.
ii) The dominance of humans over nature allows for an easier satisfaction of biological needs and for the emergence of human aptitudes, contributing to the development of creativity – this now develops into a core human characteristic that requires fulfillment.
iii) Humans, psychologically, require a sense of belonging – which can only be achieved in a society built on solidarity.
iv) Humans crucially desire and develop a sense of identity. All individuals must establish a sense of self and an awareness of being a specific person.
v) It is psychologically necessary for humans to develop a framework through which to make sense of the world and their own experiences.
According to Fromm, the satisfaction of these drives is essential for the mental well-being of the individual. Rejecting a psychoanalytical understanding that emphasises the satisfaction of the libido and other biological drives, Fromm stated that mental health is inherently associated with the satisfaction of needs considered uniquely human. Under capitalism, however, the full satisfaction of the human psyche is thwarted.
Work and Creativity
Human beings have an instinctual desire to be creative, and this can best be expressed through work. Therefore, labor should be a fulfilling experience, allowing individuals to be freely expressive, both physically and intellectually. This requires that workers should be able to relate to the products of their labor as meaningful expressions of their essence and inner creativity. But under capitalism, workers are alienated from their labour; in the word of Marx: “labour is external to the worker, i.e., it does not belong to his essential being … therefore, he does not affirm himself but denies himself, does not feel content but unhappy, does not develop freely his physical and mental energy but mortifies (subdues/crushes) his body and ruins his mind.”
For Fromm, the realisation of creative needs are essential to being mentally healthy. Having been endowed with reason and imagination, humans cannot exist as passive beings, but must act as creators. However, under capitalism, work only leads to general unhappiness, dissatisfaction, and despondency—and therefore it causes mental problems, such as stress, depression, and anxiety.
In Britain, there is widespread dissatisfaction with work. A recent survey in early 2018 found that 47 percent were thinking of looking for a new job during the coming year. Among the reasons given for this were: paucity of opportunities for career advancement, not enjoying work, and the feeling that they were not needed in their jobs. All this is only an expression of their alienation from work, for all these people, work had little meaning, it provided them few opportunities for personal fulfillment and expression.
In 2017–18, this discontentment with work constituted 44 percent of all work-related ill health in Britain, and 57 percent of all workdays lost to ill health. An additional study in 2017 estimated that 60 percent of British employees had suffered work-related poor mental health in the past year, with depression and anxiety being some of the most common manifestations.
With more than half the workforce suffering from mental health problems due to work, it has now become normalised, it is no longer considered as an illness.
Loneliness
There exists a close relationship between positive mental health, meaningful personal relationships in the form of both love and friendship, and expressions of solidarity. As mentioned above, building meaningful relationships to escape loneliness is a fundamental human characteristic, but under capitalism, this becomes difficult. And under monopoly capitalism, much of social interaction is typified by superficial conversation and a falsity of pleasantness.
As a mild mental disease, loneliness has debilitating consequences. Individuals may resort to alcohol and drug abuse to numb their misery, while persistent experience increases blood pressure and stress, as well as negatively impacts cardiovascular and immune-system functioning. While it is a mental health problem in its own right, loneliness leads to other mental-health problems too, and is often the root cause of depression.
In 2017, it was estimated that 13 percent of individuals in Britain had no close friends, and a further 17 percent said they had poor quality friends—meaning an essential 30 percent did not really have friends. No wonder that 18 percent people said they frequently felt lonely, and 45 percent said they felt lonely at least once in the past two weeks. Even though a loving relationship acts as a barrier to loneliness, 47 percent of people living with a partner said they felt lonely at least some of the time and 16 percent often.
Loneliness has become such a major public-health concern, that the British Government in 2018 established a Minister for Loneliness.
For capitalism, the principle of individualism has always been supreme. The notion of individual has its origins during the time when nascent capitalism was fighting the feudal mode of production, and its emphasis on greater collectivist methods of labor—such as within the family or village; in contrast to this, capitalism put forth the principle of individuals who had to be free to sell their labour power on the market. The celebration of individuality led to members of society feeling more and more lonely. Another principle of capitalism is competition; competition divides and isolates individuals—other members of society are not considered as sources of support, but rather obstacles to personal advancement; ties of social unity are therefore greatly weakened. This further exacerbates loneliness. Finally, another factor increasing loneliness is when the socialist alternative arose in opposition to capitalism; capitalism strongly opposed the ideals of collectivity and solidarity put forth by socialism. Thus, loneliness is embedded within the structure of any capitalist society as an inevitable outcome of its value system.
Consumerism
For monopoly capitalism, promoting consumption is vital for surplus absorption, and this has expanded to such an extent today that along with work, consumption can be said to have become integral to life under capitalism.
With consumer goods valued for their conspicuity rather than their intended function, people have gone from consuming use values to symbolic values. Under monopoly capitalism, consumerism is no longer about satisfying inherent biological and psychological needs, but is all about constructing a personal identity, ‘showing off’. To quote Fromm, “consumption should be a concrete human act in which our senses, bodily needs, our aesthetic taste … are involved: the act of consumption should be a meaningful … experience. In our culture, there is little of that. Consuming is essentially the satisfaction of artificially stimulated phantasies.”
And in this competition of showing off, there is no limit, therefore, the desire to consume becomes insatiable, it can never be satisfied. Therefore, the monopoly capitalist society, despite all its affluence, breeds widespread dissatisfaction—and also contributes to neurosis.
Resistance as Class Struggle
While not denying the existence of biological causes, the structural organisation of society must be recognised as having serious repercussions on people’s mental health. Monopoly capitalism functions to prevent many from experiencing mental well-being. Yet, despite this, the medical model continues to dominate, reinforcing an individualistic conception of mental health and obscuring the detrimental effects of the present mode of production.
Aware of their oppressed status, users and survivors of mental-health services are now challenging the ideological dominance of the medical model and its obfuscation of capitalism’s psychological impact. They are increasingly coalescing around and putting forward as an alternative the need to accept the socialism-inspired social model of mental health.
In 2017 in Britain, the mental-health action group National Survivor User Network unequivocally rejected the medical model and planted social justice at the heart of its campaign. As part of its call for a social approach to mental health, the group explicitly denounces neoliberalism, arguing that austerity and cuts to social security have contributed to the increasing prevalence of individuals who suffer from poor mental health as well as to the exacerbation of existing mental-health issues among the population. The action group Recovery in the Bin positions itself and the wider mental-health movement within the class struggle, pushing for a social model that recognises capitalism as a significant determinant of poor mental health. Representing ethnic minorities, Kindred Minds vigorously campaigns on an understanding that mental distress is less a result of biological characteristics and more a consequence of social problems such as racism, sexism, and economic inequality “pathologised as mental illness.” For Kindred Minds, the catalyst for deteriorating mental health is oppression and discrimination, with ethnic minorities having to suffer greater levels of social and economic inequality and prejudice.
Capitalism can never offer the conditions most conducive to achieving mental health. Oppression, exploitation, and inequality greatly repress the true realisation of what it means to be human. Opposing the brutality of capitalism’s impact on mental well-being must be central to the class struggle as the fight for socialism is never just one for increased material equality, but also for humanity and a society in which all human needs, including psychological ones, are satisfied. All members of society are affected by the inhumane nature of capitalism, but, slowly and determinedly, the fight is being led most explicitly by the most oppressed and exploited. The challenge posed must be viewed as part of the wider class struggle, as being one front of many in the fight for social justice, economic equality, dignity, and respect.
(David Matthews is a lecturer in sociology and social policy at Coleg Llandrillo, Wales, and the leader of its degree program in health and social care.)
