Ah, stigma. Our old friend.
This is a subject that those of us who take an interest in mental health politics are constantly banging on about, but the message still doesn’t seem to be getting through to others. The problem is, I think, that all this banging on goes on in circles of people who already know it all already. If you blog about mental health issues as a sufferer/survivor, it is almost certain you will have encountered stigma yourself. You will have faced the dilemma of whether to reveal your illness to employers, you will have avoided the subject with relatives you know will just make stupid comments. So reading the statistics just confirms what you already know.
A report, published last year by the NHS Information Commission, found that only 25% of people would trust most ex-patients of a mental hospital to babysit their child. 21% believed that anyone with a history of mental illness should be prevented from ever taking public office. 11% would not even want to live next door to somebody who has ever suffered from mental illness. People with mental illness have the highest “want to return to work” rates of all disabilities, but face the biggest unemployment rates of any category of disability. They also report difficulty in getting treatment, not only for their mental illness, but for any physical illness that may also affect them – people with severe mental illness have a life expectancy that is shortened by around 10 years.
The facts make depressing reading, and even more so when, as I once witnessed myself, they are displayed on a colourful information board in the corridor of a psychiatric ward. Right next to the door. At one point I hatched a theory that it was put there to stop us wanting to escape to the stigma filled outside world. Looking back, I was probably over thinking things a little…
This is the thing though. When we are mental in the first place, we need a bit more understanding, because we are likely to be much more vulnerable. There is no doubt that we face problems with which we are less able to cope. I’m not sure that just telling ourselves that the problems exist is really going to help much. It might make us more afraid to go out of our comfort zone, away from the people who know what it is like to be mentally ill.
Of course, there shouldn’t be stigma, but I think that we need to go beyond raising awareness that it exists and start trying to cope with it when we do see it.
I’m not saying that it shouldn’t be fought. Of course it should, and I will happily join in the fight. But, the fight will be ongoing for while, and all that time we will still have to find jobs, talk to old friends and live our lives. We can’t just write STIGMA on our front doors and not go out until it goes away.
Employment and Support Allowance is the controversial replacement for Incapacity benefit, brought in by the Labour government in 2008 for new claimants, and gradually extended to all Incapacity Benefit claimants. After the first 13 weeks of the claim, the claimant is reassessed, usually involving a medical administered by an employee of ATOS, a private company that has won the government contract but is dogged by accusations of corruption and lack of care. The claimant is then put in one of three categories – fit for work (at which point they must find a job or migrate to jobseekers allowance), work related activity group (or WRA) and support group. Only 7% of claims are awarded support group status – ie judged completely incapable of work. This is an issue for another post, but all of these claimants started off with a sicknote from their own GP, yet an unfamiliar doctor or nurse has deemed the GPs opinion invalid. 36% of claims are abandoned before the 13 week point, mostly due to recovery from a short term illness, and 39% are judged fit for work. There is a high level of successful appeals to these decisions, but for now, let’s take the word of ATOS.
17% of ESA claimants are placed in the WRA group. This amounts to over 400,000 people who are judged to be fit for work if appropriate adjustments are made or in the near future. These people are required to attend work focused interviews where they will discuss how they will get back into work, and can have their benefits docked if they fail to attend. These are the people who were described as “workshy scroungers” in certain papers when the latest set of ESA claimant data was released. Yet they are not included in the latest unemployment statistics.
“Unemployed” people are jobless, have been actively seeking work in the past four weeks and are available to start work in the next two weeks; or they are out of work, have found a job, and are waiting to start it in the next two weeks. As ESA claimants in the work related activity group are not required to actively seek work, only prepare to seek work, they are not counted. Yet they are legally required to prepare for work. So, which are they? Are they incapable of work, and so not included in unemployment statistics, just the“economically inactive” group (more on which later), or are they able to prepare for work, as they are legally required to do? This may sound like a dry statistical question, but those 400,000 people in the WRA group are facing uncertainty about their lives – the status is causing confusion and anger amongst some of the most vulnerable sectors of society.
Economically inactive group is, by the most up to date statistics, 23% of the population. These are people who are without paid work, but are not classed as unemployed. They may be sick or disabled, carers or not seeking work for some other reason. This does not mean that they don’t wish to work, only that they are not counted as seeking work. They may in fact be looking for a job, but unable to start in the next two weeks due to other responsibilities. They may wish to work, but are prevented by disability or high costs of childcare. Or they may be stay at home parents or carers. Of course, some will be rich kids living off trust finds, but somehow I doubt that counts for 23% of the population.
Another group to consider is those who are in part time work, but are looking for full time work. This figure increased by 70,000 in three months to reach 1.28 million, the highest figure since comparable records began in 1992. Here are more people who are looking for work, but unable to find it, and are not included on the unemployment statistics. Workers on low wages are still entitled to many income related benefits, and can even sometimes receive more in welfare benefits than someone out of work. Many part time jobs are unreliable and low paid, yet the workers are not counted in the unemployment statistics. In many ways, these can be the most exposed to the twists and turns of the economy, as they face placing new or changed claims if they lose the jobs they do have, but are without the small security that having an established claim can provide. They find themselves without enough work, but not “unemployed enough” to become a target for the limited amount of work finding schemes that are available.
The unemployment statistics may be awful, but they hide an even more shocking truth. There are simply not enough jobs in this country, and the statistics show more than we are being led to believe.
The popularity of this ideology has its origins in the Cold War. John Williams, founder of the RAND Corporation, began using game theory in order to predict what the Russians would do during a nuclear conflict. It wasn’t long, though, before they began applying game theory to every facet of society. Soon, the RAND Corporation began to hire mathematicians and game theorists such as John von Neumann and John Nash to work for their policy think tank.
Our approach to think tanks is especially important to understanding how this ideology became popular. Generally speaking, it is assumed that think tanks are bodies created to perform research that will inform policy decisions. Although this may be the case in some instances, a typical think tank will often be a lobbying group set up to promote special interests. They start with an answer, and then find people to tell them that answer, thus lending it greater validity.
The RAND Corporation had a serious problem. They were using game theory to reduce individuals to a numerical value. People were expected to behave in a dispassionate, rational way because the numbers said that it was the only logical way to reach a beneficial outcome. In reality, people did not behave the way that the numbers dictated.
For example, in one of Nash’s experiments, “So Long Sucker” (also known as, “Fuck You, Buddy”), the only way to win is to betray your partner. In another, two criminals are being interviewed by the police about where they stashed their loot. If they confess, they will get a reduced sentence. However, if they don’t confess, there isn’t enough evidence to convict them. The only way to win is for neither to confess.
The mindset that these experiments promote has more in common with Factor 1 of Hare’s psychopath checklist than with the way that most people behave. This includes, grandiose sense of self-worth, pathological lying, cunning or manipulative behaviour, lack of remorse or guilt, lack of empathy, and a failure to accept responsibility for your own actions.
In fact, when Nash ran his experiment, they found that people did not behave in the way that the numbers said that they would. This should be a relief as it suggests that most people are not psychopaths. Yet, what was cause for celebration then, may now be cause for concern.
As mentioned earlier, think tanks tend to promote their ideas, rather than researching a concept and then publishing the findings. This meant that those who bought into the RAND Corporation’s intoxicating beliefs saw flaws not in the pure mathematics or game theory, but in the imperfect world around them, and sought to change it.
It is no coincidence that most people refer to the decade that followed as the era of “greed is good.” Like the theoretical people in the games mentioned above, normal people were led to believe that the social conscience of post-war Britain should be relegated to the past in favour of rampant, grab-what-you-can individualism.
The media popularised these attitudes through television shows like ‘Dallas’, and catchphrases like, “This time next year, we’ll be millionaires.” The obsession with numbers and being the alpha male of the pack had found its natural play-mate at this point in the world of finance. After all, if you become obsessed with numbers, the numbers most people deal with every day are the numbers on coins and paper-money. It wasn’t much of an extension for game theory to find its way into the world of business.
We’ll jump ahead, now, to recent history, and the story of David Li. David Li was a mathematician hired to come up with an equation that would reduce the risk for investment bankers. The formula he came up with, the Gaussian copula function, essentially allowed you to make a profit on every investment. As a result, everyone started using it.
As anyone with a bit of sense would be able to tell you, you cannot have everyone profiting every time. Eventually, someone is going to realise that there is a finite amount of wealth in the world, and it is going to be revealed that the equation doesn’t work.
Which is what happened when they put their money into the American housing market, and then they found out that people couldn’t afford to pay back the loans which would have guaranteed them massive profits.
However, so limiting is the ideological belief in the purity of numbers that those in power, seduced to this way of thinking, have next to no idea how to rectify the situation aside from doing the exact same thing all over again.
The best way in which this can be highlighted is by the term, “jobless recovery.” In terms of the ideology we are looking at here, a recovery is when the numbers are balanced. The numbers being balanced does not mean that anyone will have a job, just that the numbers say what they need to say. In the real world, however, a jobless recovery would be devastating because it wouldn’t solve any of the multitude of social problems that have been caused by the recession.
The most worrying trend, though, lies with the effect that this ideology has had on society. The recent riots caused by the shooting of an unarmed man have been written off as the opportunistic looting by a criminal underclass in a staggering example of connective bias carried out by a government that coined the term, “broken Britain.”
Indeed, this political narrative makes sense when you consider that politicians have reduced the rioters to crude numbers of youths behaving in much the way that the RAND Corporation claimed that rational people should behave if given the opportunity.
There were two other worrying trends at work during the riots which really show the problems with this dominant ideology. Firstly, the coverage was quick to acquiesce to the official political line that this was an inevitable bubbling over of the darker forces of our nature, given expression by those in our society who cannot control themselves because they lack a proper upbringing. Meanwhile, in order to put this across, those people rioting and looting were reduced to a “number of masked youths”, and given no real voice to actually explain the reason for what they were doing. There was, of course, no need for an explanation. The ideology explained it for us: people should be expected to behave in this way.
Secondly, amongst this dehumanised number of youths there was enough behaviour to justify reporting the story in this way. But what is most interesting is not that they were stealing, but that the same ideology that damned them is also what seems to have motivated them. After all, what was this but rampant, grab-what-you-can individualism?
When we reduce people, groups or institutions to numbers we do so by removing everything that makes them who they are and turning them into a parody of themselves. The only thing worse than this is when we reduce them to numbers so often they begin to think of themselves as being nothing more than a parody of the person they are. In dealing with this ideology, we need to learn to treat it with the contempt it deserves. We should not look to the politicians and businessmen for an answer, but instead we should start with Patrick McGoohan: “I am not a number! I am a free man!”