From shame to blame: institutionalising oppression through the moralisation of mental distress in austerity England
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From shame to blame: institutionalising oppression through the moralisation of mental distress in austerity England Joe Greener1 · Rich Moth2
© Springer Nature Limited 2020
Abstract This paper interrogates qualitative data regarding the changing experiences of mental health service and welfare state interventions for those who self-identify as experiencing long-term mental distress. We focus on austerity-related reforms in the English welfare and mental health policy architecture to explore the sociocultural and material bases of benefit claims-making in relation to long-term illness and incapacity. Recent neoliberal social policy reforms contest the ontological status of mental distress, in the effect recasting distress as a ‘moral’ status. This tendency is reinforced via three primary dynamics in contemporary mental health and welfare policy: the delegitimisation of sick role status in relation to mental distress; the foregrounding of individual responsibility and concomitant re-orientation of services towards self-help; and an increasing punitive conditionality. These intersecting processes represent an institutionalisation of ‘blame’ in various policy contexts (Scambler in Sociol Health Illn 31(3): 441–455, 2009; Sociol Rev Monogr 66(4):766–782, 2018), the moral stigmatisation of mental distress and escalating experiences of oppression for mental health service users and welfare recipients. Shifting conceptions of distress are thereby entwined with transformations in social policy regimes and political economies. Presenting distress as a personal failure legitimates austerity-related restrictions on benefit and service entitlements as part of a wider project of neoliberal welfare state transformation. Keywords Stigma · Moralisation · Welfare reform · Mental distress · Austerity · Sick role
Joe Greener and Rich Moth: Sharing co-first authorship. * Joe Greener [email protected] 1
University of Liverpool, Block 29B Tampines Avenue 1, #03‑02, Singapore 528694, Singapore
2
School of Social Sciences, Liverpool Hope University, Hope Park, Liverpool L16 9JD, UK
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J. Greener, R. Moth
Introduction Since 2008, England has experienced the most intense reorganisation and restructuring of social policy since the inception of the contemporary welfare state in the 1940s. Whyte and Cooper have described this set of changes as an attempt to ‘permanently dissemble the protection state’ (emphasis in original 2017: 1). Almost all aspects of welfare policy have undergone intense bureaucratic restructuring including cuts in expenditure, increasing involvement from the private sector and an escalating focus within services on ‘activation’ to engender labour market participation. Reform of the state’s role in social protection can be implicated in shifting experiences of mental health and distress from a number of distinct angles. In one sense, direct support in relation to mental health need has been reduced through Local Authority (LA) and National Health Service (NHS) cuts (Moth et al. 2015;
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