Book reviews

It is the economic and political system under which we live - capitalism - that is responsible for the enormously high level of mental health problems which we see in the world today.

Ferguson argues for a radical, humane, social and dialectical approach:

A model for mental distress which recognises – and provides empirical evidence for – the causal role played by early life experience, poverty, inequality, racism, sexism and other forms of oppression in the genesis of mental health problems is a huge step forward from a model which locates such problems primarily in faulty genes or biochemical deficiencies. The fact also that the new paradigm does not discount genes, brains and biochemistry but rather emphasises the interaction between our brains and our environments... allows for a much more dialectical understanding of mental distress.

The key Marxist concept for thinking about mental distress, Ferguson argues, is alienation: alienation from the products of our labour, alienation from the labour process and alienation from each other. The real value of the Marxist concept of alienation is that it helps to trace the impact of capitalism on social relations and on individual consciousness. The societal impact of four decades of neoliberalism has not only deepened economic inequality, it has induced profound sense of powerlessness disconnection and precarity. Ferguson argues that we need more than a revolution in mental health services, to counter these conditions, and concludes that:

…the priority for all of us who wish to improve our own mental health and the mental health of those around us is both to participate in collective struggles for more and better mental health services – to support the shift back from “worry lines to picket lines”– and also to fight for a world where such services are no longer required.