The Guardian reports this morning that:
The health secretary, Wes Streeting, has ordered a clinical review of the diagnosis of mental health conditions, according to reports.
Streeting is understood to be concerned about a sharp rise in the number of people making sickness benefits claims because of diagnoses for mental illness, autism and attention deficit hyperactivity disorder (ADHD), the Times reported.
They added:
He has asked leading experts to investigate whether normal feelings have become “over-pathologised”, the newspaper said, as he seeks to grapple with the 4.4 million working-age people now claiming sickness or incapacity benefit.
Having consulted a medical expert on this issue this morning, I am advised that anxiety has no medical diagnosis, as such. A person tells a GP they are anxious. The GP then asks questions about the issues troubling them, and agrees it is likely they are anxious. That is because anxiety, like pain, is a subjective phenomenon, and as such, the doctor must accept their patient's description of reality. A doctor would never deny a patient's pain. Nor can you deny their experience of anxiety, because anxiety is a form of pain. And, it is stressed, this is not like diagnosing measles: there is no rash.
What are the likely causes of this pain? Start with this list:
- Poverty
- Insecurity
- Poor housing.
- Inability to have other medical conditions treated.
- The impossibility of meeting children's needs.
- The burden arising from caring, most especially for those for whom other help is not available.
- Alienation from a society that continually tells people their lives are inadequate and that they are failing, most especially through the medium of advertising, whose aim is to deliver this message.
I am sure you can add one or two more. The point is simple, however. This pain arises from the deliberately constructed division within society that occurs as a result of the adoption of neoliberal thinking, which has as its goal the creation of that division as a result of its desire to promote the well-being of some at cost to others. That is the explanation for what is happening.
And what of autism and ADHD? Autism and so-called attention deficit hyperactivity disorder (ADHD), as well as AuDHD (where people have both such conditions), are not "normal feelings that have become over-pathologised". These are descriptions of people who do not think in the same way that most people in society do.
Autism is a different way of experiencing the world. Social rules can feel unclear, and sensory input can be intense or unpredictable. Many autistic people find comfort in routine and immerse themselves deeply in interests that matter to them. It is not a defect but a distinct way of thinking that can bring clarity, honesty, and unique insight.
ADHD is characterised by a brain driven by curiosity and energy. Attention follows interest, not instruction, which can make organisation and waiting difficult. Ideas arrive fast, sometimes too fast, but that same quick thinking creates creativity, spontaneity, and enthusiasm.
AuDHD is when autism and ADHD coexist, which is a mix of structure-seeking and restless energy. Focus can be intense yet easily disrupted, and sensory experiences can be vivid. It brings challenges, but also originality, passion, and a perspective that sees possibilities others miss.
The fact is that the "normal feelings" of people with these conditions are simply different from those of the majority of the population, but when we have an economic system that demands uniformity, conformity and subjection without ever questioning why, those with autism, ADHD and AuDHD are those who will always question and challenge the system. They, in other words, are those who will say the system is broken, corrosive and irreparable. What is more, they are also the people most likely to come up with the alternative views that will change the system.
So what is Streeting really wanting to do? His goal is to suppress those who challenge neoliberalism, whether based on the subjective experience of the oppression inherent within it, or the refusal/inability of some for entirely natural reasons to comply with its demands, as well as their inherent ability to challenge it.
This is not a mental health review in that case. This is about thought control. And this suppression of potential dissent is, of course, inherently fascist in nature. In political economy, that is the only fair description of it.
We do, of course, need a politics of care to replace this toxicity.
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When I first started doing counselling I was amazed that many colleagues seemed to ignore the social context and focus on individual pathology. I didn’t always do as I was supposed to but things changed, thankfully, as the years passed.
With people referred by employers, I often felt the organisation needed therapy more than the people. A lot of modern management seems to use shame to discipline their workforce.
We also need more psychologically informed polices from govt. in welfare, education and housing for example.
But some anxiety emerges from the modern world in a way we probably don’t wish to reverse. We have more choice about the sort of life we lead (though being reduced by neo-liberalism ) .
20years ago fewer Asian minorities presented to counsellors and the usual explanation was their society placed expectations on them which reduces dilemmas and anxiety. But they are more aware that alternatives exist for personal relationships, education, work and gender roles. A lot of anguish goes unrecognised. The issues can be addressed with empathy and care.
Bergman in the Reith lectures asked why humans conquered the globe? He said ‘The secret of our success is…the desire to work together, to protect the weak, to recognise the inherent dignity of
everyone. This connects to my earlier point about the need to expand the moral circle.’
Care is not an optional extra ‘if we can afford it’. It is basic to our existence.
Much to agree with
No plan Streeting is following the no steer/Rachel/genius boy mantra “we can’t afford it and must cut the out of control benefits bill”.
As you write there will be no sensible review of this or anything else by no steer etc.
Puritan ethics and it’s all your personal fault still rule.
The UK is stuck in the neoliberal doom loop.
May be Streeting is also confusing cause with effect. One of the other causes of the pain of anxiety is the actions of today’s political class……
You might need to explain that very slowly to Wes
It’s another example of focusing on one particular thing (increasing benefits bill) and seeking to reduce that rather than stepping back and looking at everything that is happening (struggling to afford the necessities, job insecurity) and working to improve those for everybody.
Craig
With ADHD at least, there is a lot that’s misunderstood.
“That’s not ADHD! We all do that!”
Its not about “the thing” you’re doing that’s important.
Two things are important. 1, how often does “the thing ” occur, and 2, how much does it impact the person’s ability to manage and organise their everyday lives – or something along those lines at least. I’m a neurodivergent person, not a medical professional but that’s how I understand it at least.
TLDR; We all gotta take a p*ss too but it you’re doing it 20 times a day you should perhaps consider seeing a doctor.
If Streeting “knows” the problem is over-diagnosis, why bother setting up enquiry? Any different answer won’t be acceptable.
Agreed
He has pre-supposed the outcome.
There is a book on this topic of capitalism’s relationship to neurodivergence called “Empire of Normality: Neurodiversity and Capitalism” by Robert Chapman. I bought it but haven’t got round to reading it yet.
I have
It is good