The Ties that Unbind: Knotting in the Age of Austerity

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Theses on Mental Health Reform in Australia

 

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The Federal Government of Australia commissioned a detailed review of the country’s mental health system. (It subsequently tried to suppress the review for 12 months, and has since abandoned some of its recommendations). Now, as Australia recovers from a Federal election cempaign, discourse of mental health policy has been dominated by a small, recurring number of self-proclaimed advocates, as well as their respective research institutes. The proposal that the present Government is implementing is to expand the bureaucratic structure of GP’s Primary Health Networks (PHNs) to allow for a division between ‘complex’ and ‘low-intensity’ treatments. The former will have treatments administered and rationed by the PHNs; the latter will be diverted to self-management apps. The Headspace model, which, other than isolated, localised successes, has been a miserable and costly failure, will be retained, albeit with some minor trimming down of administrative functions. The advocates – and the most prominent are Patrick McGorry, Ian Hickie, and John Mendoza – want the app approach to be expanded at the direct expense of the existing Medicare system, which they say needs ‘reform’ (i.e. severe cuts or abolition). Meanwhile, the advocates are silent on the perilous and worsening state of public mental health systems, and the $11 billion per year that the Government spends on subsidised ‘private’ health insurance. The aim of the theses here is to provide an alternative to the dominant discourses and speakers which purport to speak for the mental health system and those who use it. Continue reading

Notes on mental health and neoliberalism

I recently read a couple of Foucault’s later lectures, namely Security, Territory, Population (1977-1978) and The Birth of Biopolitics (1978-1979). In this latter set of lectures, Foucault made a rare foray into contemporary economics, analysing various currents of neoliberalism (especially German and US varieties) and their relation to new forms of governmentality. I thought it beneficial, if only for me, to jot down a few notes on Foucault’s reconstruction of neoliberal thought, because I think it particularly pertinent in understanding contemporary knowledge and practice in mental health. I have a paper forthcoming in an academic journal on this topic, and perhaps after this post, I can move onto other things in 2016. Continue reading

A Note on ‘Wellbeing’

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I have previously had occasion to contrast the fetish for ‘wellbeing’ (and its cognates) with psychoanalysis’ emphasis on bien-dire, the well-said.

According to Foucault, the term wellbeing (bien-être) began to make an appearance in the 18th Century, specifically as an objective of policing. ‘Policing’ in this period was understood to encompass governmental functions broader than the mere detection of crime, and could relate to matters of economic, educative or medical concern. The objective of policing was ‘wellbeing’ of individuals  insofar as this was defined as “the necessary, the useful, the proper and the pleasant”, and in such a way “that the well-being of individuals is the state’s strength”.

So much for ‘wellbeing’, and its origins in policing and social control.

On Consent

A comment from a Facebook thread:
‘Consent’ is a legal fiction, an individualistic artifice derived from liberal political economy. If we affirm the existence of subjective division – of an unconscious – then the subject of ‘consent’ is self-evidently problematized from the outset. The dichotomy of consent-nonconsent proves inadequate once an unconscious is in the picture. Thus, there are plenty of examples of unethical behaviour in the realm of extortion, sexual coercion, etc, which are nonetheless sub-criminal and which involve the notional ‘consent’ of all participants. The paradigmatic example for me is that of the sweatshop, in which, despite the protestations of libertarians who point to the workers’ ’consent’, we might still have some serious objections.