The activists fighting the mental health crisis

Micha Frazer-Carroll examines the way the mental health crisis has escalated in the last five years and meets those organising to end it.

Throughout the lead up to the July general election, mental health has cropped up again and again as a political talking point. It began around March 2024, when Secretary of State for Work and Pensions Mel Stride suggested that the Conservative government might remove sickness benefits for people who experience “milder” mental health problems. This was quickly followed by the announcement of Rishi Sunak’s plans to overhaul the disability benefits system, partly due to the increased number of people claiming Personal Independence Payments (PIP) for their mental health. Now, following the launch of Labour’s 2024 election manifesto, Labour leader Keir Starmer has outlined a new mental health plan to “get people back into work”, claiming that mental health is costing the country £23 billion per year. In both the Conservatives’ and Labour’s public policy grandstanding, rising levels of mental ill health have been framed as a burden on the economy, which must be tackled by pushing people into employment.

Absent from these conversations are the people who are impacted by mental health policy. Also absent is any discussion of the causes of mental distress across Britain, many of which are traceable to Conservative policy. In 2019, journalist Emily Oliver reported for Huck on the impact of a decade of Tory rule on the nations’ mental health, discussing the impact of poverty, and a pervasive “pull yourself up by your bootstraps” mentality around recovery. In the realm of mental health treatment, she also cited cuts to services, and, relatedly, increasing numbers of people experiencing crisis and being subject to the sharp end of the mental health system. Namely, 50,000 people are detained under the Mental Health Act in England and Wales each year, legislation that makes it possible to institutionalise and forcibly treat people, a violation of bodily autonomy that often results in trauma. Many of these people may not have gotten to crisis point in the first place had their material conditions been better, or had they been able to access care when they first needed it.

Five years on, each of these issues has only become more pronounced. Gabrielle Johnson, communications and membership manager at the National Survivor User Network (NSUN), a membership organisation working to redistribute power and resource in mental health, tells me: “Five years under a Conservative government has left mental healthcare at best inaccessible, and at worst neglectful and harmful towards the people it intends to serve.” Like Emily, Gabrielle points towards entrenched structural problems in our mental health system. “We have seen repeated reports of institutional abuse and system failings, and a government that does little to repair the structural flaws that continue to exclude people made vulnerable by the state.”

Since mental health is inextricably intertwined with social and economic factors, Johnson also points towards the reams of Tory policy that have made life less liveable for people across Britain. “In less than half a decade, we have seen extreme poverty increase, vital healthcare services gutted, and communities stripped of their ability to have their basic needs met under the current Government’s oppressive policies. Mental ill-health, distress and trauma is often informed and inseparable from other and multiple forms of marginalisation and oppression, and thus by enforcing a hostile environment, cutting essential benefits and policing mental healthcare provision, we believe that the Government consciously criminalises and harms people living with mental ill-health, distress and trauma.”

NEUROMANCERS, an abolitionist organisation for and by neurodivergent people, also argues that the government has neglected what the group describes as “mad, mentally ill and neurodivergent people” (abbreviated to “MMIND”) during Covid-19 lockdowns. Writing to me as a collective, they say: “In-person services, already vastly overstretched, were stopped completely with little or no contingency planning. MMIND people were amongst those abandoned by the government, [along with] salaried support workers. If you could not access support by landline telephone, mobile phone or online, especially if you lived alone, you were completely cut off from help.” As a result, the group has plugged a vital gap. They write: “We have seen a significant increase in people needing support and community that [is not accessible] elsewhere, as well as needing to deal with the trauma of being left vulnerable and unsupported.”

Both NSUN and NEUROMANCERS adopt a radical approach to mental health, which acknowledges and targets the root causes of mass mental ill health and distress. Johnson, from NSUN, tells me that a vital part of their work has involved supporting grassroots groups through grants programmes and capacity-building work. The network has also campaigned against harmful Tory mental health policy reform, including changes to the Work Capability Assessment (WCA), which would attempt to push 424,000 people currently on disability benefit into the workforce by 2028 (the WCA has already been linked to thousands of deaths). They also have addressed harms towards various marginalised groups within the mental health system. These include data-sharing between NHS England and the Home Office, which has raised concerns about the surveillance of migrants in services; and police involvement in mental health crisis “care”.

Recovery in the Bin, another UK-based group led by mental health service users, tells me that they have also been interrupting both the harms of the benefits system, and criminalisation in the mental health system. Also writing to me collectively, they say: “We supported a national network of audio recorders for DWP assessments, because [benefits companies] Capita, Maximus and Atos were trying to stop people recording and so the assessments were one-sided and misleading in favour of the DWP. We won that battle with lots of other organisations, and now anyone can require their assessment be recorded.” The group has, like NSUN, been involved in campaigns to stop people being filmed in their bedrooms on psychiatric wards, and the push to get police out of crisis response. They also have a standing offer to pay up to £200 towards anyone given a court-ordered fine when in mental health crisis, which has been known to happen to people who are suicidal.

NEUROMANCERS, meanwhile, has a primary focus on peer support and political education, in “active opposition” to a mental health system that often overlooks the root of people’s distress, and punishes them for suffering. They tell me that they work to help themselves and their members “to truly understand our material conditions and make space for an understanding of our experiences that goes beyond individualism and blanket pathologisation”.

None of the groups I spoke to are optimistic about the prospect of change under a Starmer-led Labour government. Recovery in the Bin tells me: “Based on their manifesto and political direction, we have little hope in their centrist project meaningfully changing things, to us it is simply a change of management of an oppressive state apparatus, we remain in resistance mode.” They also point towards the likely continuation of the social and economic forces that make so many of us suffer: “Their manifesto indicates austerity will continue, and the hostile environment towards benefits recipients, asylum seekers and transgender people remains.” While Starmer himself has said that the country would not see a return to austerity under Labour, he has refused to rule out more cuts.

Johnson, from NSUN, tells me that the organisation has so far not seen evidence from the main opposition of a commitment to real, structural change to mental health services, beyond Starmer’s pledge to recruit 8,500 new mental health staff. “[This] may go some way to improving waiting list lengths and tackling the effects of austerity on our health service,” they say. “However, increasing staff numbers alone will not be enough. The current mainstream focus on waiting lists, staff and bed shortages, and service underfunding does not go far enough to address cultures of abuse and neglect in mental health services.” The resignation of former Shadow Mental Health Minister Rosena Allin-Khan in September casts further doubt on Starmer’s commitment to deeper transformation of the mental health system – with Allin-Khan writing that the Labour leader “[does not see a space for a mental health portfolio in a Labour Cabinet”. Johnson does, however, hold some degree of hope regarding Starmer’s promise to modernise elements of mental health legislation, which currently disproportionately detains Black people, and was on track for reform before being scrapped by Sunak in November.

Despite this, the grassroots groups that I speak to are particularly adamant that they will continue to resist in the face of what they see as a “Tory-lite” Labour government. NEUROMANCERS tells me: “We must consistently challenge everyone in the ‘establishment’ – from Starmer, to mental health consultants, to charity CEOs.” The group emphasises the need to listen to people who are negatively affected by the current mental health system: “For everyone who might have had a good experience under these systems, there are many more who did not. As usual, poor people, the Black community, migrants, the LGBT+ community, elders and other vulnerable groups are most at risk.” On their work, they say: “We will remain steadfast, as we are doing what needs to be done outside of these institutions and the political circus.”

Recovery in the Bin tells me that organising should be a part of this. “Energy should be put into making an anti fascist, anti racist resistance,” they say. “As neoliberalism collapses into the inevitable authoritarian end stage and fascism waits in the wings, genocide spreads, the future is struggle, and more distress. Hope, love, and solidarity is what we need.

“And always ripping the ever living piss out of the pompous pricks who live in comfort off of our oppression.”

Micha Frazer-Carroll is the author of Mad World: The Politics of Mental Health, which is out now with Pluto Press. She is a trustee of NSUN, but writes in a personal capacity.