Featured in our latest uManyano lwaBasebenzi publication. Contact us for a physical copy.
Written by Ferron Pedro
For most of my adult life I have struggled with periods of depression and anxiety. During those times, one of the worst aspects of going through my mental health challenges was feeling that I was failing because life was difficult for everyone and I was weak for not being able to handle it. I knew there was so much poverty and violence in our society, I did not feel I had the right to complain, let alone feel the kind of dark hopelessness that seemed inescapable. But, I failed to recognise that in many ways I was not alone. Capitalism breeds mental illness.
According to the South African Depression and Anxiety Group (SADAG) 1 in 6 people in South Africa suffer from anxiety, depression or addiction disorders. Many also suffer from bipolar disorder and schizophrenia. The common notion that mental health is not a working-class issue is upended by studies that show that poverty is strongly linked with the most common mental disorders, including depression and anxiety. Food and income insecurity creates high levels of stress, while people in these circumstances are less able to access the resources to help with traumatic events, illness and injury. Mental illness also creates more poverty with additional health expenses and lost income. It is estimated that in 2020 neuropsychiatric conditions would account for 15% of the total Disability Adjusted Life Years (DALYs) lost due to all diseases and injuries in the world.
While data is limited, the South African College of Applied Psychology notes that the state of the country’s mental wellbeing is in severe crisis. From 27% to fewer than 16% of sufferers reportedly are able to receive treatment for mental illnesses. It is reported that between 75% to 92% of people with mental illness never receive treatment. While almost 9 out of 10 people rely on state services for their mental health treatment there are only 18 hospital beds for every 100000 people available for mental health services. This crisis in care revealed itself starkly in 2017 when nearly 150 patients died after being moved to ill-equipped, unlicensed NGO facilities from the Life Esidimeni Hospital. An avoidable tragedy had the healthcare system been adequately funded and privatisation has not ravaged our already vulnerable public healthcare system.
We must fight for adequate mental health care as a priority for the working class. But how do we resolve the crisis of mental health once and for all? For this, we need to look at the roots of the crisis. The conditions for high levels of mental illness are the conditions that result from the crisis of capitalism. Insecurity, poverty, crime, unemployment, discrimination – all stem from class society and the private ownership of the commanding heights of the economy. What’s more, under capitalism, all of us who do not own the wealth in society – the factories and firms we all work for – need to work for these bosses to survive. While many are unemployed which itself creates conditions of despair, those who are working are under constant pressure from bosses who are always looking for a way to maximise profits by reducing expenses on wages, benefits, health and safety and so on. We do not have any control of what we produce or how we produce it – this lack of freedom in how we spend most of our lives creates what Marx called ‘alienation’ – the condition where we have so little control of our activities that we are left unfulfilled and mentally strained.
Capitalism also creates high levels of inequality, with South Africa being one of the most unequal countries on the planet. Inequality correlates with levels of diminished wellbeing and quality of life in a society. For these reasons, capitalism itself makes us sick.
If we think about our mental health as individuals, it is easy to fall into the trap of believing these are personal failures. This results in and reproduces the stigma we see in society and in working class communities around mental health problems. The truth is there are complicated biological, genetic, and indeed structural and systemic reasons for the strain on our mental health.
By fighting together for a socialist world, we are making sure the severe stress we face under capitalism is diminished and those who need healthcare are able to receive it. The fight against capitalism, is a fight for justice, the survival of the planet and a fight for the health of all people.
