Fired up for change

Mental Health in Crisis by Joel Vos, Ron Roberts & James Davies (Sage Swifts; £45) reviewed by Stuart Hillston.

02 December 2019

Before reading this book I thought the crisis in mental health was due to a lack of funding, lack of focus and a dogged dependence on cognitive behavioural therapy. The book did not dispel any of these thoughts. It simply placed them in a larger landscape surrounded by, and connected to, a topography of mental health crises, significantly expanding my understanding of how far-reaching the issues are. For a small book, it packs quite a punch.

The authors set out their research and explanations for two crises in mental health. Why two crises? The book presents a crisis in our own mental health with a wide range of causes, and a crisis in the delivery of care to the people who need it. They argue that the ‘McDonaldisation’ of provision makes mental health a personal crisis for the population at large and those expected to meet commercial targets in the provision of care. Even the definition of typical and atypical mental health seems to have been distorted by commercial interest.

Some chapters are easier to read than others, and the authors’ styles vary. The two chapters by James Davies (‘Biomedical and Drug Crisis’ and ‘Diagnostic Crisis’) are particularly effective – my view of the DSM 5 and the medicalisation of mental health changed significantly for the worse on reading these. Ron Roberts’ style is denser, sometimes convoluted. However, perseverance is rewarded, particularly in the chapter on Crisis in Academia. His closing remarks regarding the subversion and coercion of academia by political and commercially motivated parties are fiery, determined and direct.

Joel Vos offers his own thoughts in six of the ten main chapters, concluding with a glimmer of hope. The final chapter sets out Vos’s vision for the future of mental health care with a call for a more holistic approach. All we need now is a societal and political will for change.

Psychologists for Social Change contributed a chapter on the effects of austerity on mental health, particularly for those marginalised or oppressed. It is a strong call for action against discrimination and injustice.

After finishing the book, I realised how little I had known about the macro issues of mental health. My new understanding of the scale, diagnosis and resolution of mental health issues has left me fired up for change. The impact of this book far exceeds its stature; I expect it to provoke debate and preferably action. The evidence is so compelling that I find myself asking, ‘What can we do about this and when will we start?’.

Reviewed by Stuart Hillston, Coach and Counsellor, The Mindful Entrepreneur Ltd.