Book Review: SICK and SICKER

by Patricia Campbell – Northern Ireland

Colm O’Gorman, executive director of Amnesty International – Ireland, has condemned our mental health services as inhumane and grossly inadequate. Riot police have been deployed to quell violence in under-serviced, overcrowded facilities.

O’Gorman exclaims, “We can’t pretend this is not happening. We know. There would be outrage if this happened in cancer care and there should be outrage now.”

These problems are systemic and cannot be blamed on individual staff, most of whom are committed to providing quality care.

Susan Rosenthal’s new book, SICK and SICKER: Essays on Class Health and Health Care,  exposes the class roots of such problems.

Rosenthal argues that the primary cause of poor mental and physical health is lack of social power, and she backs this claim with international research.

As a front-line community psychiatric nurse in Belfast, a post-war zone that is one of the most deprived areas in Europe, I found the chapter, “Mental illness or Social Sickness?” particularly resonant.

Rosenthal insists that mental illness is not an individual defect but a reasonable response to unreasonable social conditions. She observes, “Those who rule society make the rules. The ruling class defines orderly behavior as that which serves its interests and disorderly behavior as that which threatens its interests.”

She concludes, “Psychiatry is…ideology disguised as science to meet capitalism’s need for social control.” Her analysis explains why riot police and security personnel are used to quell discontent in mental health facilities.

As Rosenthal observes, “Psychiatry doesn’t question the class system that generates mental distress; it targets the victims of the system and those who protest against it. Mental distress becomes the problem to be treated, not the social conditions that create distress.”

We see evidence of this statement in Belfast, where a staggering 40 percent of the population were prescribed antidepressants over the course of one year, while glaring social problems continue to be ignored.

In “The Myth of Scarcity,” Rosenthal demolishes the claim that there aren’t enough resources to resolve social problems. She explains that cries of scarcity have only one purpose; to justify not sharing the wealth. This is difficult to dispute in the context of governments bailing out banks and corrupt politicians squandering public funds.

Rosenthal encourages us to learn from what happened in Chile in the 1970s. She describes how Chilean workers began to democratize their health service and how the ruling class staged a coup to dismantle this and other working-class achievements. Many feel disheartened by such defeats, but Rosenthal sees it differently, “The achievements of Chile’s workers can inspire our own struggle. By learning the lessons of their defeat, we can go the full distance to finish what they began.”

Credit to O’Gorman for highlighting the reality we live in. Rosenthal’s book not only explains this reality but inspires a fight back and provides direction. I urge everyone, and especially health workers, to read this book.

Patricia Campbell works as a community psychiatric nurse in Belfast, Northern Ireland. She is also president of the Independent Workers Union and a co-founder of its affiliate, Universi, a health workers’ union.