When the principles behind the Welfare Reform Bill are so openly based on Iain Duncan-Smith’s Christian sense of morality, how can we be confident that progress made on mental health sits in safe hands?
The recent controversy over ‘gay cure’ posters on London buses, and the placement of interns in Parliament from the organisation Care which promotes these so-called gay ‘cures’, are two of the latest examples of extreme religious groups trying to legitimise the opinion that homosexuality is a mental disorder. They are also excellent examples of how certain strands of the Christian faith dramatically misunderstand not just abstract concepts like love and morality, but also medicine, science, and mental illness.
When an obscure American Christian preacher was found to be handing out booklets informing pupils that homosexuality is a psychiatric disorder, Michael Gove refused to take action against him on the grounds that equality laws do not cover teachings which are not part of the curriculum, suggesting that this was an equalities issue; a matter of discrimination vs free speech, not one of medical misinformation.
It’s damaging enough to have these views handed out to children in schools, without being told that they’re not coming from an authoritative source. But while the government’s policies on issues like gay rights are obviously much less regressive than the Christian extremists, the line they take on illness and welfare is rather unnerving. Those Christian values driving Iain Duncan-Smith’s welfare reform plans have, in the past, led to catastrophic horrors for mental health sufferers.
Needless to say, many Christians and Christian charities have a brilliant record on all kinds of sickness, including mental health. But it’s pointless to pretend that the religion doesn’t have an awful lot to answer for, as well. Much of the ignorance and fear that exists even today about mental illness has roots in the old ‘Christian’ notion of mental illness as a sort of devilish possession, or a punishment from God. In societies like Victorian Britain, the mentally ill were, quite literally, demonised – and tortured as a “cure” for their illness. Suffering, it was thought, would heal these diabolical inflictions.
Most modern Brits are horrified when we read about, say, dunking a patient in water repeatedly to cure auditory hallucinations, or gagging and binding a person when they experience a traumatic flashback. We are extremely unlikely to go back to stocks and chains. And yet, when an extreme Christian teaches children that homosexuality is a psychiatric disorder, watch how politicians like Gove – himself a strong Christian – treat this as a moral issue, not a medical one. It may seem like a minor semantic distinction, but it is not. What does this tell us about their understanding of what actually constitutes a psychiatric disorder?
It may be news to some, but ‘mentally ill’ is not a pejorative term to be thrown around to denigrate things you don’t like. It doesn’t mean immoral, or sinful. And it doesn’t mean stupid, or dangerous. It means just what it says: illness.
There are over 300 psychiatric disorders in the DSM (Diagnostics and Statistics Manual) IV and every single one of them has a more-or-less agreed definition, with very specific combinations of symptoms resulting in a diagnosis.
Needless to say, the DSM is far from perfect. Being compiled by the American Psychiatric Association, for example, it’s fair to be wary of its tendency to be a little too drug-led and/or insurance-led, created with one eye on the profit-motive. And of course, sometimes the medical knowledge changes, or – as is the case currently with gender dysmorphia, for example – the diagnoses can be disputed by the patients themselves. But even so, they are based on expert medical study, not personal judgments about behaviour. Homosexuality has not been included on the DSM since 1974. In fact, ever since psychiatry established itself as credible a medical field, mental health professionals have disputed the classification of it as such, with some historians even arguing that doctors never wanted it to be classed as a psychiatric disorder in the first place. Pioneers like Sigmund Freud and Havelock Ellis declared it to be a natural state. Arguably, it was only ever included in the DSM at all because religious voices dominated all discussions about medicine, with particular control over the area of mental health, because it was, and still is, far too often, considered physical health’s poor relative.
This is all history of course, but it’s easy to forget how recent some of it was. After all, according to the BBC, organisations like Mercy Ministries still perform ‘exorcisms’ for illnesses like eating disorders, and churches like Towy Community Church in Wales seem perfectly comfortable declaring themselves ‘in partnership’ with Mercy Ministries. And as David Cameron recently declared at his Easter reception, Christian values are “what this country needs.” Christianity serves as a driving force behind much of government policy – and perhaps nowhere quite so poignantly as in the Welfare Reform Bill.
It’s difficult to draw comparisons without being hideously alarmist, but it’s an historical fact that the ideology which has preached extreme inhumane suffering as a cure for the mentally ill is ultimately the same ideology providing the mentality that says depression can now somehow be cured by the Protestant work ethic.
When the principles behind the Welfare Reform Bill are so openly based on Iain Duncan-Smith’s Christian interpretation of what morality means, how comfortable can we be that the slow but sure progress made on mental health in this country is in safe hands?
Just look at Paul Farmer from charity MIND, who resigned as charity representative on the DWP panel scrutinising the Atos Work Capability Assessments, because, according to Third Sector, “the assessments were damaging the people Mind helps and ministers had failed to address his concerns.”
And Paul Jenkins from Rethink stated in a letter to Chris Grayling that while their direct dealings with the minister left them confident that it wasn’t the government’s intention to force sick people to work, the charity was “concerned however that government communications about these reforms are already causing harm to these very people. On Newsnight last night, in an interview, you repeatedly stated that people on benefits would be expected to work.”
Perhaps most worryingly, Sonia Poulton reported in the Daily Mail – hardly a militantly pro-welfare paper of the biased left – that in an interview on Radio 5 Live, Grayling used anecdotes of individuals with a mental illness who had found being in work helped them as evidence that people with mental illnesses should be expected to work.
These concerns were voiced by Rethink Mental Illness themselves, in their analysis of the Welfare Reform Bill. The charity said there was a likelihood that time-limiting ESA for anyone in the Work Related Activity Group (WRAG) meant that people with long-term illnesses like schizophrenia could end up forced into utterly unsuitable work – and with the workfare schemes being extended to ESA recipients, they could, in theory, be not only forced to work, but forced to work for no wage.
The severity of an illness and the longevity of an illness are not the same. Sometimes there isn’t even a correlation. Just because someone is functional enough to be placed in the WRAG group by Atos – whose assessments are controversial at best in any case – it doesn’t mean they are going to be better within a year. The government’s aim, then, cannot be to support people until they are better; there would be no time-limit if this was the case. And the aim cannot be just to save money either; the £300m spent on a three-year contract for Atos to carry on performing these assessments, and the money being poured into seeing through the reforms, makes even pure, brutal cost-cutting insufficiently convincing as a motive for the reforms. It really does seem that the ultimate aim is to place people with poorly understood illnesses into work even when the patient and the doctor both say it won’t help. It really does seem as if Iain Duncan-Smith believes in the old-fashioned Christian fantasy that work itself, by its very nature, can cure people.
Not every Atos assessor is a medical expert, and Iain Duncan-Smith and Chris Grayling definitely aren’t. They are bad enough, judging by what disability activists like Kaliya Franklin say, at recognising and respecting physical conditions. What hope do those who struggle with mental illnesses, often invisible, often impossible to explain; illnesses afforded so little respect as medical conditions that people who’ve never so much as suffered a night of insomnia will comfortably pontificate at the tops of their voices on why people hear voices, or whether depression is a real illness or not. And when the main driver for the government’s policies is faith in the Protestant work ethic as a cure for all sin and sickness, keeping our eyes open to the slippery slope it could lead down may sound alarmist, but that’s because it really is alarming.
Blind faith, whether in God or the free market, can’t be used as criteria for a medical diagnosis, and neither can it be used as a cure. Mental illness is still shaky in its medical status; we must be quick to dispel any myths, arguments, or policies that risk worsening the understanding of it still further.
We hear a lot about the coalition’s policies sending women’s rights and workers’ rights back to the 1950s. It’s an equally terrifying prospect to imagine that the government’s approach to welfare could take sufferers of mental illness back, not just to the earlier part of this century, but, if we’re not careful, to sadomasochistic cruelty of the previous one.