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All in the Mind

Billions more on the Symptoms of Social Malaise

brain repair

In the autumn budget the UK government has just decided to pump an extra £20 billion into the struggling National Health Service. Don't get me wrong the tens of thousands of sick people on waiting lists for routine surgical operations would certainly welcome the extra funds. Not least the NHS could use the additional cash to train more nurses rather than rely on agency staff and ready-trained imported labour. We could give trainee nurses more generous grants so we can not only become self-sufficient in medical professionals, but tackle a vicious cycle of long-term welfare dependency in so many communities. We might even pay our nurses more and improve their working conditions with fewer hours and less stress by alleviating chronic overcrowding in some urban hospitals. Another idea might be to reopen or upgrade smaller provincial hospitals to reduce travel time. Here in West Fife, the Accident & Emergency department at the local Queen Margaret Hospital only treats minor injuries. For anything else you have to travel 20 miles to Kirkcaldy.

While successive governments have paid lip service to the many practical steps it could take to improve our health service in the best interests of ordinary tax payers and patients, it staggers from crisis to crisis. The NHS once had a reputation as one of the world's most efficient health services when compared with alternative insurance-based systems common in Germany, the Netherlands and Switzerland and certainly much better value for money than the profit-driven US system that incentivises hypochondria and overmedication. As a rule, the NHS works best if you need routine treatment for a well-defined condition or injury. It doesn't fare so well if you want personalised care or want a second opinion about suggested treatment options, which explains the steady growth of the private healthcare sector, often added as a bonus for well-paid jobs. If you want a flu jab, the NHS will gladly comply. Indeed they spend countless millions of tax-payer funded pounds advertising the benefits of flu vaccines. On the other hand if you need physiotherapy to treat intermittent episodes of painful sciatica or any other treatment that requires human expertise, you'll be put on a long waiting list while they advise you which painkillers to take.

Yet guess where the biggest chunk of the new NHS funding will go? I award no prizes for correctly identifying psychiatry as the destination for over £2 billion with specialist psych teams for young people in every A&E unit and in every school. Naturally in these enlightened times, we tend to say mental health to cover all ailments from mild sadness to psychopathic madness. The powers that be seem much more concerned about your mind and soul than your physical wellbeing or personal independence, which usually requires both good general health and a rewarding occupation, namely a purpose in life.

Neuropathology, as we may more accurately call this form of human surveillance, used to play a niche role in public healthcare as it affected less than one percent of the general population, but since the mid 1980s a forever wider gamut of aberrant behaviours and irregular moods have warranted medical attention. There may be nothing new about emotional challenges, misery, obsessions, drug abuse, exhibitionism, promiscuity or violence, but until recently only extreme cases of dysfunctional behaviour merited neurological analysis and, more important, we assumed most adults and even older children should be held responsible for the consequences of their actions. If you stabbed your neighbour in a drunken brawl, your actions would be subject to criminal investigation. Once in jail a criminal psychologist may investigate why some categories of people are more prone to violence than others, but the concept of free will implies not only that you may make rational choices through independent thought, but that you should bear the consequences of any bad decisions you may make especially if your actions harm others. Now if you exhibit noncompliant behaviour, such as throwing acid in someone's face, it is a mental health issue. By this logic we should view the incidence of acid attacks, not as heinous crimes that law enforcement agencies should deter with vigilant policing and harsh sentences, but rather as unfortunate manifestations of social unease in which the assailants are as much victims as the assaulted.

Alas this move should surprise nobody. Just after London's Labour Mayor, Sadiq Khan, announced that we should treat knife crime as mental health issue, the Conservative Home Secretary, Sajvid Javid, made the same claim. Labour have attempted to blame the Tories for not spending enough on police and mental health care, while asking the police to allocate more resources to tackle purported hate crimes or even just perceived hate incidents reported by third parties. By their logic low-life gang members are stabbing young Londoners, and the largest victim group is young Afro-Caribbean males, because too many people express views critical of unbalanced mass immigration on social media.

As many of us await routine operations for physical conditions, the NHS squanders more and more resources on lifestyle medicine. Last week Psychotherapist Bob Wither exposed the growing tendency of vulnerable youngsters on the autistic spectrum to embrace a new variant gender identity. In the past I've questioned the scientific validity of the extended autistic spectrum. Now many of the same awareness raisers who promoted the diagnosis of allegedly neurological disorders such as ADHD, Tourettes, Asperger's or OCD are quite happy to recontextualise the emotional distress of our younger generation as sexual dysphoria leading to lifelong medication and growing demands on public healthcare.

I've said it before and I'll say it again: The true sign of an authoritarian state is its obsession with your mind. Our rulers do not intend to respect our opinions, but seek instead to tame our minds so we comply with their brave new world of supervised underlings.