The therapist’s couch has replaced the pulpit

Over the years, I’ve read numerous reports that claim to detail an apparent unacknowledged ‘epidemic’ of mental disorder amongst various social groups. Generally, such reports share much in common. So when I read the headline ‘Mental health of women in crisis‘ and the claim that 60 per cent of women, equating to 15.2 million members of the UK’s female population, was so affected, I already had a fair idea of what I would find behind the eye-catching headline.

First, the report’s publishers are likely to have a vested interest in the conclusions. Sure enough, the report, titled Women and Me: Supporting Wellbeing in Girls and Women, was commissioned and published by an organisation called Platform 51, a charity that aims to ‘support girls and women as they take control of their lives’ and which places great emphasis on promoting their ‘health and wellbeing’.

Second, to arrive at such an attention-grabbing figure, the report would use a broad definition of mental disorder, preferring the more elastic term ‘mental health problem’. So it was no surprise to find that Platform 51 is concerned that standard definitions of ‘common mental health disorders… do not adequately capture the range of feelings and symptoms’ that are reported to them by their clientele. Therefore, in order to rectify this problem, the report uses the term ‘mild to moderate mental health problems’ within which it includes such things as ‘low self-esteem and self-confidence and stress’. By moving the goalposts in such a way, it is possible to reframe almost anything as a symptom of underlying mental disorder.

These tactics are very common in so-called ‘advocacy research’, where the main aim at times appears to be to promote the services provided by the organisation, often to ensure continued or additional funding, rather than to improve our understanding of the prevalence of mental disorder or other social problems. That is one reason that for many of these campaign groups the problem is always greater than we, the unenlightened public, realise. Perhaps this is understandable, particularly given the extent of government cuts; maybe such organisations are merely seeking to ensure the continuation of jobs and services, some of which may indeed be providing a valuable service to people in need of help.

Nevertheless, even before such austerity measures were announced, it is hard to imagine a situation where, for example, the NSPCC, Age Concern or Mind would announce that the problem of child abuse, adult abuse or the rate of mental-health problems is far less than they had previously announced, and that, as a consequence, in future they would only need a fraction of their current funding. Of course, there is nothing wrong with having vested interests; that, in and of itself, does not preclude researchers from finding new insights and developing both our understanding and knowledge base. However, in cases such as these, they do warrant a careful reading of the methodology behind the attention-grabbing headlines.

All this is well known to anyone with a passing interest in social policy and the culture of fear that is prevalent today. So, while it is important to highlight such cases of ‘advocacy research’, actually the most interesting aspect of Platform 51 is how its history and development highlight the changing way in which, in the contemporary period, social and moral issues are discussed within a therapeutic framework.

Platform 51 was, until December 2010, known as the Young Women’s Christian Association (YWCA). The YWCA was formed in England in 1855. Since its creation, it has provided refuge and a variety of social and educational projects both in the UK and abroad, much of them extremely worthwhile. However, the name change is significant. As our society becomes more secular, it is increasingly common for religious and moral viewpoints to be recast in psychological terms. For example, as religious groups opposed to abortion realised that arguing against abortion on moral and religious grounds held declining relevance to today’s women, they began to emphasise the ‘detrimental impact’ of abortion on women’s mental health.

This trend can also be seen with Platform 51/YWCA. It is still concerned with many aspects of women’s behaviour, including such things as promiscuity, alcohol and drug abuse. However, whereas in a more religious past such behaviours may have been blamed on the sinful, immoral ways of the individuals concerned, today such sentiments hold little resonance. In this sense, the change of name, specifically the dropping of the Christian identification, indicates that the organisation’s hierarchy is attuned to the changing discourse of the twenty-first century. For Platform 51, behaviours it disapproves of are not blamed on the individual but are seen as a symptom of her underlying mental health problems. Redemption is no longer to be found through Christ but via the counsellor or therapist, and salvation is to be found by the achievement of good mental health.

In another example of how well-attuned it is to the cultural zeitgeist, Platform 51 has appointed a new chief executive, Penny Newman. In her previous role, Newman was chief executive of the Jamie Oliver Foundation, an organisation set up by the eponymous health evangelist, whose moral crusade over the nation’s dietary habits quickly exposed his contempt for those who fail to heed his ‘wise’ words, with Oliver referring to them as ‘scrubbers’ ‘arseholes’ and ‘tossers’.

Health, both physical and mental, dominates public discourse today. Today’s sinner is the smoker, the drinker and the overweight. Government and both traditional and erstwhile religious groups are still concerned with the management of women’s behaviour, with curbing female ‘excess’ in such things as sex, alcohol and drugs. However, rather than directly condemn the behaviour, they portray it as symptomatic of an underlying pathology. This new moralism is, in many respects, worse than the old religious rhetoric. At least the ‘sinful’ woman was accorded agency and responsibility over her actions; her contemporary equivalent is instead cast as a passive victim of psychological trauma.

As church congregations decline, the YWCA may have given up on converting women to Christ. Platform 51, on the other hand, by casting 15.2million of the UK’s women as in need of professional psychological intervention, still requires them to accede to authority, only this time not to the priest but the therapist.

Ken McLaughlin is a senior lecturer in social work at Manchester Metropolitan University, England. His book Social Work, Politics and Society: From Radicalism to Orthodoxy is published by Policy Press.