WORLD WORLDWIDE SPAIN NEWS JOURNAL UPDATE - (en) Spain, CNT (ICL-CIT) #434: Mental health. Question of gender and class - Esther Barahona Urruchi (ca, de, it, pt, tr)[machine translation]

 With a very bad face, he enters our center one morning. She tells us

that she can't take it anymore, that she would like to disappear. She
has been chaining and combining single-hour jobs for many years, pending
notification of everything to SEPE so that they do not penalize her,
because she receives very little help and it is cut every time she finds
one more hour of work. One of the companies is not paying her the money
for the transport to the polygon, she tells us that she is losing money.
In addition, he is filled with rage when he thinks that companies may be
benefiting from his disability certificate, that this circumstance also
serves to pay him less money, based on a worse agreement. She won't stop
crying, she's shaking. We have never seen her like this, although we
have detected signs that her glass is filling up for a long time. She is
a strong woman with hard experiences behind her. We admire her and love
her because she is also affectionate and grateful to us for the support
we try to give her. That morning we can only tell her that she is right,
that there is no right and that everything is bullshit. She talks for a
while with the psychologist. She senses that she is on edge. She has
self-esteem underground.

Luckily this case had a modestly happy ending. Precarious, but happy
after all. Shortly after that morning, a job offer arrived, which she
finally got. A stable contract, almost full time. She soon stopped
needing therapy. She walks in many mornings laughing. She sometimes
rants about her salary, with good reason. She does not lose sight of the
fact that she is still precarious and poor, but the situation has
loosened a lot and, with it, the state of her mental health. There are
many discriminations that go through her, that come to be found in her
body and in her life. They will continue to go through it, but she has
had access to the small potion that she needed to continue fighting life
with strength and humor.

It is known that the greater the stigma of a person, and the stronger
their prejudices on mental health issues, the more resistance they show
to identify, recognize and accept a complex situation in their own
person or in their loved ones. . This delays the moment of asking for
help and worsens the perspective in the recovery of the quality of life.

Other cases are never unraveled. Her glass is hopelessly full and no
solution appears. No lucky break. No train to get on and that allows to
change the living conditions a little. And yes, we are calling access to
a job with a low salary and a pitiful agreement a 'lucky stroke'. But it
is that many people, especially women, are also outside of that.

At this point, it is not necessary to argue too much that everything
that has to do with health is not at all alien to questions of social
class, income and gender. And we also know that when we talk about
health, we must understand that mental health is included. However,
sending a message that strengthens the relationship between mental
health and the socio-economic situation of people can be dangerous if it
is not explained taking into account different factors. We run the risk
that people who feel included (with or without objective reasons) in the
middle or upper class categories, believe that mental health is
something totally alien, something for the poor that cannot happen to them.
The same happens with gender, we run the risk that many men think, or
continue to think, that mental illnesses are things that happen to
women. This happens due to the component of strong social stigma that
accompanies mental health problems. It is known that the greater the
stigma of a person, and the stronger their prejudices about mental
health issues, the more resistance they show to identify, recognize and
accept a complex mental health situation in their own person or in their
loved ones. This delays the moment of asking for help and therefore
worsens the perspective in the recovery of the quality of life.

But we also know that when the lower classes identify a problem and ask
for help, the public system takes months to offer them attention.
Afterwards, this attention is precarious, scarce, poorly planned and
insufficient.

After the pandemic, and thanks to the drive of a generation that has
been speaking openly about mental health, some issues related to mental
illness have become visible. But only some questions and some realities.
Stress, anxiety and depression are the three words that we have begun to
hear about in the media, social networks and other environments. But
there are other forms of mental suffering through which people continue
to tiptoe, due, again, to the stigma. A stigma that, instead of
disappearing completely, runs the risk of remaining installed in
experiences that have to do fundamentally with psychosis, and in other
invisible or ridiculed realities, such as borderline disorders or
obsessive-compulsive disorder.

The labor market is a fertile field for mental illness. It is a hostile
place for those who already suffer from them, and a factory of new
discomforts for those who have not suffered from them before.

In addition, the fact that mental health is being talked about is not
being matched by an increase in public resources. For this reason, as we
indicated above, the first consultations in psychiatry (with the
psychologist or psychiatrist) take a long time to arrive. And successive
queries too.

The bond and the context of trust and security that have to be generated
between the therapist and the affected person are science fiction, an
act of faith, when the visits are every four months. For this reason,
people whose income allows them, making a greater or lesser effort, to
resort to the private circuit, tend to do so. In this effort, many
families see their economic situation compromised. Even so, those who
resort to the private circuit become privileged beings on the other side
of the line that separates those who can treat their mental illnesses
and those who cannot. This inability to access effective therapy causes
mental health problems to drag on, sometimes for life.

With this question, in many cases, you enter a wheel. A very strong
inertia that is difficult to stop. Poverty or precariousness prevent
access to treatment, and discomfort makes it very difficult to improve
our socio-economic and employment situation. Access to employment, as
well as maintaining it over time, in the case of people with serious
mental health problems, is complex. An equation in which we must include
stigma, taboo, capitalism and productivity.

The labor market is a fertile field for mental illness. It is a hostile
place for those who already suffer from them, and a factory of new
discomforts for those who have not suffered from them before. But not
only that, unemployment and the lack of job opportunities are also.

Accepting all these premises, we are accepting that social factors have
a lot of weight in mental health. It is not something new, however in
practice there is a certain resistance, social and medical, to accept
these factors as causes, triggers or aggravating mental illness. If we
add, on the one hand, the biomedical perspective in mental health, which
puts the weight on biological factors, and on the other, a meritocratic
society, which comes to tell us that each one has what they deserve, or
what they are entitled to, the The result is a collective imagination in
which whoever gets sick or suffers is due to their own responsibility or
because of their genetic load. Not a trace of living conditions,
experiences and violence framed in socio-economic, cultural and family
structure contexts, which have little or nothing to do with the choices,
decisions and genetics of each one.
When we talk about social context we don't just talk about money. In
other words, we are not talking exclusively about poverty when we talk
about how contexts shape our mental health. Of course, living in an
environment of poverty, in childhood or in adulthood, can cause
psychological discomfort at the moment and in the future, but the social
context is also decisive when we move away from extreme poverty or
precariousness. This is so because there are many social factors, and
because of everything that influences our mental illnesses, one of the
things that seems to have the most weight is the individualistic nature
of the world in which we live.

Many people and groups are putting their efforts into generating
networks and building shelters where it is possible to express
themselves and receive support.

Many studies suggest that it is the lack of support networks that
generates or aggravates discomfort. This does not mean that the
responsibility lies with the direct environment of the person with a
mental health problem. It is not simply that someone has a family that
has known/could, or not, provide the necessary support. No, this is
about the fact that we live in a social model that places many demands
on people and very little care.

For this reason, many people and groups are putting their efforts into
generating networks. Build shelters where it is possible to express
yourself and receive the necessary support. The organizations that work
in the field of mental health (associations, collectives, Mutual Support
Groups), represent a place of trust for many people affected and for
their relatives and friends, who sometimes feel very alone in the middle
of a system that generate discomfort and that, far from offering the
tools to heal them, perpetuates them with precarious living conditions
and terrible public attention.

We have accepted that many mental illnesses are chronic pathologies,
because it is surely easier and more profitable than assuming that vital
conditions are, on many occasions, the ones that are behind the
discomfort. Changing these circumstances, on many occasions, means
blowing up some fundamental pillar of the neoliberal heteropatriarchy:
breaking with the family, the couple, the labor market, gender roles,
expectations of success... And to be honest, we know that doing
something like this is almost impossible when there is no firm net under
our feet, and a lot of hands tucking us in.

For all these reasons, while we continue to request access to dignified
and free therapies, we will continue to build a network of networks,
urban and rural, where we can meet others and ourselves, and where we
can name our discomforts while looking for alternatives.

https://www.cnt.es/noticias/salud-mental-cuestion-de-genero-y-de-clase/
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