Marxism and mental health

Chris Burford cburford at
Sun Sep 10 09:17:08 MDT 1995

Marxism and mental health

Hans Despain on 9th Sept forwarded an alert from Dendrite, a mental health
activist network calling for action on behalf of Geraldine and Richard
Sima (sample message reproduced below).

There is probably no one marxist position on mental health, but I think
elements of a marxist approach can be clarified.

I think the human rights of people with mental health problems are a
relevant concern of marxists. Often such people are workers who have
been disabled by a number of factors including stress and the weakeness
of their support network. They have become on the margin of the workforce.
It is therefore often indicative of the quality of a society, how they
are treated.

Different access to health care according to your social class is
particularly marked in mental health. Cut backs in welfare provision for
mental health hit working people particularly hard.

State mental hospitals have a history going back over a hundred years
linking them with Poor Law type social management of what were regarded as
the "dregs" of capitalist society.

I do not know the circumstances of this case but the mechanistic processing
of poor people with mental health problems as a sort of raw material for
treatment, is a dramatic area for potential abuse of human rights, and
philosophically it is contrary to a marxist approach that would wish to
understand phenomena in the context of the clients social circumstances.

There are conceivably aspects to this case that have not been
explained to Geraldine Sima in terms danger to self or others but the
sample letter below sounds to me at first sight very reasonable, and
should trigger the response to have an enquiry to clarify exactly what the
problems are and what they are not. In the style of mental health treatment
I favour, these problems should then be discussed in specific detail with
the client and carer to clarify what options they wish to pursue to
resolve them.

Chris B, London, Community Psychiatrist.


Dear Governor Ben Nelson:

Dear Mr. Johnson and Dr. Higgins:

Please investigate the case of Geraldine and Richard Sima. For over nine
months, Geraldine has been prevented from personally visiting her husband
Richard, who is in a Nebraska psychiatric institution. Visitation,
especially with a loved one, is not only a human right. It is also a
human need.

Please respond as soon as possible. I also ask that you keep me posted
with the results of your investigation into the Sima's tragic situation,
and the general state of human rights in Nebraska Dept. of Public
Institutions. Thank you.



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