Saturday, April 27, 2024

Overmedicalisation is a problem, but not for the reasons Rishi Sunak thinks

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The Guardian published a number of letters in response to the prime minster's claim that Britain is suffering from a "sicknote culture".

One of them, from the associate professor of psychology and medical anthropology, Dr James Davies, got it exactly right:

Rising distress may not be a medical problem, as Sunak claims, but it is certainly a social one, as Sunak ignores.

We need to stop overmedicalising mental distress. As a psychological therapist, I know first-hand that most people seeking help aren’t suffering from “mental illnesses” in any biologically verifiable sense, but from understandable reactions to life and work conditions that are harming and holding them back; conditions that medicine was never designed to treat. 

By misrepresenting socially caused distress as a medical issue, we run the risk of wrongly individualising, pathologising and ultimately depoliticising that distress, and so exonerating social conditions from responsibility.

Overmedicalisation is indeed a problem, but not for the reasons Sunak thinks.

I've not read the book, but Dr Davies is the author of the book Sedated: How Modern Capitalism Created Our Mental Health Crisis.


Peter M B English said...

Whether or not the distress people experience is "social" or "medical" is an argument for academics.

In practical terms, however, the issue is about whether they should be signed off work because they are unable to work, or to do so would harm them.

And, in practice, the only way to do that in the current system is to provide a medical note saying they are not fit for work (a "sick note" - although this term was retired in 2010).

So your suggestion that it is not a medical issue seems to suggest that none of the people with distress or mental illness (depending on your definition) should be signed off work because of it, but should be required to work, or financially penalised for being unable to do so.

Not a very Liberal content IMO.

Jonathan Calder said...

Whether or not we treat mental distress as social or medical is far from academic, because this decision can point to quite different policy responses.

If we see the distress as social, then a likely policy response would be increasing welfare benefits. If we see it as medical, then increasing the prescription of antidepressants is a likely response.

My instinct is that the former will be of more use than the latter in most cases, but at the very least, this is a question worth investigating.

Your argument risks being the weary fallacy that anyone who questions how we account for or describe mental distress is denying that mental distress exists.