From associations to action: mental health and the patient politics of subsidiarity in Scotland

Mark Gallagher

doi:10.1057/s41599-018-0085-9

Abstract

In times of economic hardship public mental healthcare suffers a double disservice. On the one hand, it faces a diminution of existing resource, and on the other, it is met with vastly increased demand. The damage done to already hard-pressed public services during economic crises is often most keenly felt by those at the receiving end of statutory health and welfare provisions. When public services are deemed by its principal recipients to be no longer fit for purpose, it is unsurprising that they, along with others, look to agencies other than the state to meet their needs. In the final year of the 1970s, a decade in which Great Britain became the ‘sick man of Europe’, while Margaret Thatcher moved into 10 Downing Street, a new mental health organisation came into being in Scotland. Glasgow Association for Mental Health (GAMH) and a group of patients’ social clubs called LINK clubs joined to form LINK/GAMH. In a climate of great social and economic upheaval during the 1980s, LINK/GAMH received substantial Urban Aid funding to support those suffering from mental illness. Motivated by principles of voluntary association, self-help and mutual aid, LINK/GAMH sought to ‘cater for needs, and encourage aspirations, which are not and perhaps should not be met, or promoted by Statutory Welfare Agencies’. This article examines how the relationship between socioeconomic factors and mental health was understood by LINK/GAMH and how this informed the development of a resource centre, a rehabilitation programme and political campaigning by psychiatric patients. By focusing upon the activities of LINK/GAMH in the 1970s and 1980s, drawing on archival evidence and oral testimony, it will be argued that the concepts of solidarity and subsidiarity were embedded in the practices of patient associations. This study will show that through the development of relationships of solidarity and subsidiarity, across local, national and international boundaries, patient associations such as LINK/GAMH and their allies redefined a normative conception of the ‘sick role’, reclaiming civic selfhood and political agency for psychiatric patients.

Highlights

In the 1970s, a decade in which trade union membership peaked in the UK, Mental Patients Unions (MPUs) emerged across the country, mainly in industrial towns and cities, to challenge the ways in which those diagnosed with mental illness were treated and governed
Christine Cowan was enthusiastic about the prospect of linking up with groups from beyond Scotland and the UK at the World Federation for Mental Health (WFMH) congress to be held in Brighton in 1985, where LINK members would get to meet, for the first time, US and European patient groups involved in self-help and campaigning activities
While in many ways Huw Lloyd-Richards was responding to the structural injustices and inequalities within the statutory system of healthcare, a system which accorded a low priority to mental health and forced patients into passive and dependent roles, he was able to create spaces and foster relationships which offered patients a route out of the ‘sick role’ to civic selfhood and political agency

Summary

Introduction

In the 1970s, a decade in which trade union membership peaked in the UK, Mental Patients Unions (MPUs) emerged across the country, mainly in industrial towns and cities, to challenge the ways in which those diagnosed with mental illness were treated and governed. Mental health associations emphasized that ‘voluntary organisations offer services which tend not to be undertaken by statutory bodies’ (Maxwell, 1987, p 45) One such organization was LINK/GAMH, formed in Glasgow 1979 by a psychiatric social worker, Huw Lloyd-Richards.

Results

Conclusion