Les Belges

info:eu-repo/semantics/publishedEdition allemande, Eupen, Grenz Echo; éditions anglaise, allemande et espagnole, Tielt, Lano

Inequalities in mental health and well-being in a time of austerity: Follow-up findings from the Stockton-on-Tees cohort study

In response to the 2007/8 financial crisis and the subsequent ‘Great Recession’, the UK government pursued a policy of austerity, characterised by public spending cuts and reductions in working-age welfare benefits. This paper reports on a case study of the effects of this policy on local inequalities in mental health and wellbeing in the local authority of Stockton-on-Tees in the North East of England, an area with very high spatial and socio-economic inequalities. Follow-up findings from a prospective cohort study of the gap in mental health and wellbeing between the most and least deprived neighbourhoods of Stockton-on-Tees is presented. It is the first quantitative study to use primary data to intensively and longitudinally explore local inequalities in mental health and wellbeing during austerity and it also examines any changes in the underpinning social and behavioural determinants of health. Using a stratified random sampling technique, the data was analysed using linear mixed effects model (LMM) that explored any changes in the gap in mental health and wellbeing between people from the most and least deprived areas, alongside any changes in the material, psychosocial and behavioural determinants. The main findings are that the significant gap in mental health between the two areas remained constant over the 18-month study period, whilst there were no changes in the underlying determinants. These results may reflect our relatively short follow-up period or the fact that the cohort sample were older than the general population and pensioners in the UK have largely been protected from austerity. The study therefore potentially provides further empirical evidence to support assertions that social safety nets matter - particularly in times of economic upheaval

From shame to blame: institutionalising oppression through the moralisation of mental distress in austerity England

This paper interrogates qualitative data regarding the changing experiences of men- tal 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 socio-cultural and material bases of benefit claims-making in relation to long-term illness and incapac- ity. Recent neoliberal social policy reforms contest the ontological status of mental distress, in 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