New book critiques the business of mental health

11 January 2017
Psychiatric Hegemony

A new book by Dr Bruce Cohen offers a comprehensive Marxist critique of the business of mental health, demonstrating how the discourse on mental illness has expanded into many previously untouched areas of public and private life, including the home, school and the workplace.

In Psychiatric Hegemony: A Marxist Theory of Mental Illness, Bruce profiles the decline of the social state and an increased focus on the individual from the 1980s onwards, suggesting that there has been an increased need for the informal control of populations beyond institutional borders through the expansion of milder forms of mental illness and the encouragement of mental health self-regulation.

“Our behaviour, personalities and lifestyles are now closely observed and judged under a psychiatric discourse which has become dominant and totalising,” he explains.

Bruce emphasises the proliferation of psychiatric labels — often with little science behind them — and the explosive parallel growth in the numbers of people who have been given psychiatric diagnoses.

He explains that the book is basically “an ideological critique of professional power.”

“I ask why mental illness classifications and mental health services have increased so dramatically in the last 35 years despite the continuing lack of evidence for causation of any mental illness or existence of any effective treatment.”

“This contemporary state of psychiatric discourse as hegemonic, I argue, is due to the needs of neoliberal capital for productive and compliant subjects. Rather than focusing on social relations, the reductionist ideology of the mental health system blames the victim and individualises problems that are fundamentally political in nature."

This argument challenges the status quo of what ‘mental illness’ appears to be and the ‘needs’ that the mental health system appears to serve.

“Fundamentally, neoliberal ideology demands that individuals be increasingly flexible and productive in school and at work, and the mental health system has been a major conduit towards achieving this goal.”

Distinguished Professor Howard Waitzkin of the University of New Mexico describes Bruce’s monograph as “the best book yet linking mental health to the central characteristics of capitalist society.”


Find out more about Psychiatric Hegemony: A Marxist Theory of Mental Illness