Monday marked World Mental Health day, that one day of the year when corporations and establishments which act like corporations tell us how much mental health matters to them, how their worker’s wellbeing matters to them. Given many sectors are affected by industrial action, or balloting for industrial action, this seems like a contradiction. Could it be possible that these industries and government are causing mental ill health, while paying lip service as a PR tool? Could it be that capitalism and inequalities associated with it are both the cause of mental health conditions and the very thing that prevents recovery from it?

Capitalism, I argue, is the root of a lot of society’s problems. The climate crisis is largely caused by consumerism and our innate need for stuff. The cost of living crisis is more like a greed crisis, since the rich are getting richer and the corporations are making phenomenal profits while small business struggle to make ends meet and what used to be the middle class are relying on food banks, getting second jobs and wondering whether they can afford to put the heating on. No wonder swathes of us are suffering with anxiety, depression and other mental health conditions. Of course, I cannot argue that capitalism is to blame for all manner of mental health conditions as that is simply not the case. There are many causes of mental health conditions which simply cannot be blamed on the environment. The mental health conditions I discuss here are the depression and anxiety that so many of us suffer as a result of environmental stressors, namely capitalist embedded society.

The mental health epidemic did not start with the current ‘crises’[1] though. Yes, the COVID-19 pandemic contributes and exacerbates already existing inequalities and the UK saw an increase in adults reporting psychological distress during the first two years of the pandemic, yet fewer were being diagnosed, perhaps due to inaccessibility of GPs during this time. Even before all these things which have exacerbated mental health conditions, prevalence of common mental disorders has been increasing since the 1990s. At the same time, we have seen in the UK, neoliberal ideology and austerity politics privatise parts of the NHS and decimate funding to services which support those with needs relating to their mental health.

I am not a psychologist but I know a problem when I see or experience one. Several months ago, I was feeling a bit low and anxious so I sought help from the local NHS talking therapies service. The service was still in restrictions and I was offered a series of six DBT-based telephone appointments. After the first appointment, I realised that this was not going to help. It was suggested to have a structure in my life. I have a job, doctoral studies, dog, home educated teenager, and I go to the gym. Scheduling and structure was already an essential part of my life. Next, I was taught coping skills. ‘Get some exercise’, ‘go for a walk’. Ditto previous session – I’m gym obsessed, with a dog I walk every day, mostly in green spaces. My coping skills were not the problem either. What I realised was that I didn’t need psychological help, I needed my environment to change. I needed my workload to be reduced, my PhD to finally end, my teenage daughter not to have any teenage problems, my dog to behave, for someone to pay my mortgage off, and a DIY fairy to fix the house I don’t have time to fix. No amount of therapy could ever change these things. I realised that it wasn’t me that was the problem – it was the world around me.

I am not alone. The Mental Health Foundation have published some disturbing statistics:

• In the past year, 74% of people (in a YouGov survey of 4,619) have felt so stressed they have been overwhelmed or unable to cope.
• Of those who reported feeling stressed in the past year, 22% cited debt as a stressor.
• Housing worries are a key source of stress for younger people (32% of 18-24-year-olds cited it as a source of stress in the past year). This is less so for older people (22% for 45-54-year-olds and just 7% for over 55s).

The data show not only the magnitude of the problem, but they also indicate some of the prevalent stressors in these respondents’ lives. Over 1 in 5 people cited debt as a stressor, and this survey was undertaken long before the cost of greed crisis. It is deeply concerning, particularly considering the anticipated increase in interest rates and the cost of energy bills at the moment.

The survey also showed that young people are concerned about housing, and this will have a disproportionate impact on care leavers who may not have family to support them and working class young people who cannot afford housing.

The causes of both these issues are predominantly fat cat employers who can afford to pay sufficient and fair wages, fat cat landlords buying up property in droves to rent them out at a huge profit, not to mention the fat cat energy suppliers making billions when half the country is now in fuel poverty. All the while, our capitalism loving government plays the game, shorting the pound to raise profits for their pals while the rest of us struggle to pay our mortgages after the Bank of England raised interest rates. No wonder we’re so stressed!

For work-related stress, anxiety and depression, the Labour Force Survey finds levels at the highest in this century, with 822,000 suffering from such mental health conditions. The Health and Safety Executive show that education and human, health and social work are the industries with the highest prevalence of stress, anxiety and depression.  It is yet another symptom of neoliberalism which applies corporate values to education and public services, where students are the cash cow, and workers are exploited; and health and social work being under funded for years. Is it any wonder then that both nurses and lecturers are balloting for industrial action right now?

Despite all this, when World Mental Health Day arrives, it becomes the perfect PR exercise to pay lip service to staff wellbeing. The rail industry are in a period of industrial action, yet I have seen posts on rail companies’ social media promoting World Mental Health Day. Does the promotion of mental health initiatives include fair pay and conditions for staff? I think not.

Something needs to give, but what?

As a union member and representative, I argue for the need for employers to pay staff appropriately for the work they do, and to treat them fairly. This would at least address work and finance related stressors. Sanah Ahsan argues for a universal basic income, for safe and affordable housing and for radical change in the structural inequalities in the UK. Perhaps we could start with addressing structural inequalities. Gender, race and class all impact on mental health, with women more likely to be diagnosed with depression, Black women at an increased risk of common mental health disorders and the poor all more likely to suffer mental health conditions yet less likely to receive adequate and culturally appropriate support. In my research with women seeking asylum, there is a high prevalence of PTSD, yet therapy is difficult to access, in part due to language difficulties but also due to cultural differences. Structural inequalities then not only contribute to harm to marginalised people’s mental health, but also form a barrier to support.

I do not have a realistic solution, but I have the feeling society needs a radical social change. We need an end to structural inequalities, and we need to ensure those most impacted by inequalities get adequate and appropriate support. When I look to see who is in charge, and who could be in charge if the tides were to turn, and I don’t see this happening anytime soon.

[1] I’m hesitant to call them crises. As Canning (2017:9) explains in relation to the refugee ‘crisis’, a crisis is unforesessable and unavoidable. The climate crisis has been foreseen for decades, and the cost of living crisis is avoidable if you compare other European countries such as France where the impact has been mitigated by the government. The mental health crisis has also been growing for a long time and the extent to which we say today could be both foreseen and avoided.