Mental health and the cost of living crisis
Being poor and experiencing mental ill-health don’t have to be entwined, but they are because of the ways we have set up our society and the ways we continue to run it.
The following is the text of a speech given by Mark Brown to the North East Together AGM at Gateshead Clubhouse in Gateshead on 30th January 2023.
The cost of living crisis is one that has huge implications for those of us who live with mental ill-health, distress and trauma.
The chances are: if you live with mental ill-health, trauma or distress you will be poorer than someone who does not. The chances are: if you live with mental ill-health, distress and trauma you will die sooner than someone who does not. The chances are you will live more of your life in poorer health and in less comfort and security than do not face the same challenges.
In the UK, as it is organised now, living with mental ill-health, distress and trauma is more likely to leave you exposed to the full, harsh winds of the market. You’re less likely to have savings, less likely to have accrued property of capital and less likely to be in an ongoing relationship.
Being poor and experiencing mental ill-health don’t have to be entwined, but they are because of the ways we have set up our society and the ways we continue to run it.
Being poor is more often than not a structural problem. Yes, it is possible to have enough money and make some spectacularly bad choices and end up with not enough money but it’s incredibly unlikely that you make some spectacularly good choices and end up rich.
The conclusion of what I’m saying is worth stating up front: not being able to afford the things you need to live is bad for your mental health.
It sounds ludicrously simple as a conclusion, but it’s true. The solution is ludicrously simple, too: if you want people to not get more ill, make sure they can afford the things that prevent them from getting more ill. Living a life with mental ill-health, distress and trauma is harder than living one without. Living a life where you are presented with a series of maths problems that are literally impossible to solve every day is no life at all.
Too much of the focus around mental health and mental ill-health in the last two decades has been on changing attitudes around mental health, and too little has been focused on changing the material conditions of those who experience mental ill-health.
Janet Jackson and Luther Vandross may have been of the opinion that the best things in life are free but they’re wrong. The best things in life are things that meet all of your needs at a price you can afford to pay.
We’re stuck speaking about a cost of living crisis as if it were an inconvenience, as if the crisis were not being able to have what we want, not that we can’t have what we need.
But for those of us who live with mental ill-health and distress it’s not an inconvenience but an injustice and a deep one.
It’s really easy to get lost when we’re talking about a cost of living crisis. It’s primarily spoken about as a consumer issue, to do with what we can and can’t afford to buy. What not being able to buy things means is very much a supplemental concern.
What are the costs of living, then? The cost of living is, at its very basic level, the money required to stay alive. It’s the money needed to eat enough, be warm enough, to be safe enough and to be able to make decisions that ensure these basic things happen for us and those close to us on a sustained and ongoing basis.
Cutting costs and tightening belts and living within our means have been used in conversations about national budgets and government spending for so long that it’s difficult to remember a time when they weren’t.
Beginning with the global financial crisis of 2007 and 2008, the language of Westminster politics has been about ‘living within our means’ and ‘hard working tax payers’ and ‘strivers not skivvers’. Before that it was moral panics about multigenerational worklessness and Benefits Britain.
We’ve been through two decades of well meaning and not so well meaning people trying to solve that structural problem of poverty by trying to focus on the people at the bottom of it. We’ve been told the answer to being poor is to learn to budget better. We’ve been told the answer to being poor is to try harder. We’ve been told that, in effect, the answer to being poor is to learn how not to be poor as if we were standing in a seminar filled with men with beards and Turkey teeth bellowing at us for not having a growth mindset. It’s rubbish.
You can no more budget yerself out of having nowt than you can wish yourself taller. You can spend less money, but you can’t magically produce goods and services to meet the amount of money you have to spend.
The thing is, there is an absolute floor to the cost of living. There is a point where there is no cheaper option possible for the necessities of life when looked at as a whole. You would have thought that the cost of living crisis was some kind of very mundane computer game the way that it was reported and spoken about: ‘Has the cost of living crisis began to bite? Have you considered buying cheaper butter or supermarket own brand bread?’
Sure, it can be an exciting hobby to try to shave 50p off there, 20 pence off there. It can even be rewarding when you sit in your warm home with the knowledge you can pay your bills and have insurance against emergency purchases to sit and tot up how much cheaper it was to substitute one thing for another. An exciting middle class game which generates endless discussion and endless column inches.
But once you hit the floor, there’s nowhere else to go. You aren’t making a consumer choice between cheap and more expensive, you’re making a choice of one thing instead of another. There’s nowhere to go.
Heat or eat became a buzzword so cute and mimsy that it obscures the reality of what it describes: On a regular basis, people have to choose between the warmth they need in their household to be in the best health they can be and the food they need to put into their body to be in the best health they can be.
If the cost of living crisis is a crisis of living, it doesn’t affect everyone equally. The closer to the absolute floor of what it’s possible to live on, the more it screws you over.
The cost of living crisis has been broadly discussed in ways that parallel the ways that mental health is discussed. What draws people’s attention most is when people change position. We’re interested when someone can no longer afford something they previously afforded. We’re interested when someone who was doing ok suddenly finds themselves not doing ok. We talk most about stories we see as being about new occurrences, not stories that have been going on for a long time. A person who was financially comfortable who finds themselves less financially comfortable is news. A person who is not financially comfortable who becomes even more not financially comfortable is not news.
Similar to mental health, coverage always skews towards talking about people who have newly become unwell, there is a clear and obvious ‘journey’ in the story from the land where ‘normal’ people live into the terrifying unknown land of the unwell. When we talk about people who are already unwell, or already poor, that’s all just about numbers or services.
As a society, we want to hear about people who have just started to hurt, not to hear from those who have been hurting for years. We want to hear about one big event, not a lifetime of little tragedies and missed opportunities and the continual, inexorable shrinking and coarsening of life.
But, what’s all this got to do with mental health?
I was writing this speech on Saturday, the electricity down to the fifty pence of the emergency in the prepayment meter. Everything I typed had to fight its way through the knowledge that at any moment the light might go out, the fridge go off, that there wouldn’t be any chance of another of cup of tea to aid the process, and that until the morning there was no way of rectifying that.
Every single thought had to shout above the background chant that the money was going to run out. Every single paragraph has to make it through the contingency planning of ‘what will I do when the lights go out? What will I do before the shop opens?’ I’m lucky, I got to go and stick a little bit of cash on the meter in the morning. Did it affect the writing of this speech? Absolutely. People tell you that writers are meant to be poor and that struggle sharpens the senses but that’s bollocks. Thinking about anything beyond the here and now is difficult when you don’t have a full belly, a warm and safe home and a sense that the world is not likely in the immediate future to come and swallow you up.
Scarcity, even implied scarcity, eats up mental bandwidth. Eldar Shafir, a behavioral scientist, spent years looking at what happens to our thinking when we are faced with impossible choices and what he found was that it is exceptionally difficult to make ‘good’ choices when you don’t have enough resources. For him, not having enough money makes life a series of unsolvable problems and it’s really difficult to get your brain to stop trying to solve them. So difficult, in fact, that you will perform far worse in thinking tasks than people who aren’t trying to solve impossible problems.
Not having enough wears people down mentally, but it also wears people down physically.
Last week, the Daily Mirror reported on government plans to raise the state pension age to 68 by visiting Blackpool, where in some of the areas of the city men have an average life expectancy of 67 years.
In December 2022 the Institute for Fiscal Studies published a report titled ‘The number of new disability benefit claimants has doubled in a year’ which explored the fact that after remaining relatively similar for a long period, the number of successful claims for Personal Independence Payment (PIP) doubled in the period between summer 2021 and summer 2022. The stringency of the criteria still turns 60% of those that apply for PIP away, so this is twice as many people meeting the threshold for qualifying for PIP. The benefits system didn’t get easier, the number of people applying grew massively.
The IFS discarded the idea that it was one particular type of disability or health condition that was driving this doubling in the number of PIP claimants, as the proportions of conditions by age remained similar to the period of this doubling. It wasn’t covid, or mental ill-health. The IFS conclude that adults in the UK are becoming less well, but not every adult. Most of the growth in successful PIP claims was drawn from people who were already out of work becoming more unwell. As the reports authors say “In other words, it looks like a broad-based worsening of health feeding through to greater numbers of PIP applications.” So people already on benefits getting more unwell while on benefits.
I keep thinking of all the people paying through the nose to run of treadmills and gulp protein shakes and think ‘you can’t outrun the economy’. People trying to tool themselves up with optimum health to escape the existential threat of precarious living and recession.
While some people with resources have been growing healthier over the last century or so, some of us haven’t been so lucky.
Being poor is a cumulative experience. Missing a meal might not be a big deal for some people. Missing a lifetime of meals is a huge deal. Having no money wears you down, grinds you away, saps your health, prevents you making the running changes needed to look after yourself and those around you.
And shame, shame gets in your bones. I’m ashamed of my bad teeth and ravaged body. I’m ashamed to sometimes turn up somewhere hungry and tired. I currently live in an old prefab with no central heating or white goods because it’s all that I can afford. It’s shameful to be poor because you feel like you’ve failed, and in the background your mind whirrs away, trying to solve the impossible problem of not having enough money, where every single decision has a knock on effect for the days and weeks to come. Never having any breathing space is going to ruin what resilience you might have had.
Some people are lucky. They can live in a state of financial crisis for years and not buckle under the pressure. It’s a national sport to criticise other poor people for not being as good at being poor.
As soon as someone publicly says they don’t have enough money to make ends meet they’ll be surrounded by people saying ‘when we were kids we had nowt and ate soil and lived 75 to a room and it turned out ok for us’ like a flock of particularly judgemental starlings. Fine, great, you got by ok. I’m proud of you. But that doesn’t mean that other people will or that other people can.
There’s nothing virtuous in being poor. Surviving and surviving well is a great skill and I stand in admiration of people who have that skill, or the luckiness to not be prone to the challenges of mental ill-health. But I don’t stand in admiration of people who want to divide themselves off from other people who are poor by claiming that difference between being able to live like that is down to their own immense good sense and supernatural ability to deny themselves pleasures.
One of the most massive things that has happened in my adult life has been the slow erosion of dreams. Income inequality does that. It’s hard to have dreams and ambitions when the most pressing task is to get through the day, the week, the month, the year, when the task is staying alive, not having a chance to live. If you’re a good and virtuous poor person you put away your big hopes and dreams, look meek and mild when accepting help. But even then, if things worsen economically, you’ll still get criticised for not having enough money to live. You shouldn’t have to swap your dreams for some dinner.
I think we’re entering a period where the inequality between rich and poor and the cliff edge between being well and being unwell is impossible to ignore.
It blows my mind to think that in the 1930s that some people had foreign holidays and telephones and cars and central heating and made home movies on cine-cameras while other people still slept 5 to a bed and coughed themselves to death with black lung and consumption in houses with one fire.
Back then we began the process of inventing a welfare state that would remove at least some of the challenges of being poor — the challenge of being hungry, the challenge of living in poor housing, the challenge of keeping well. If were able to step out of this moment and the decades of politics since 1945, we’d probably end up suggesting that we should create something very like the original conception of the welfare state as a solution to the immense crisis we’re living through.
For my day job at the moment I’ve been doing a lot of work on our company’s local newspapers and one of the challenges is finding good new stories. We run stories about services, about local authority budgets, about the ways government policies play out at a local level. And almost completely, all of those stories make for grim reading. Inequality is growing, people are becoming more unwell and prices keep rising. Without fail, though, the good news stories come from people doing things that help other people, doing thing to look out for each other, finding ways of building machineries of hope that stand outside of direct financial transactions.
In mental health, it’s the work of groups of people like NSUN and and North East Together and Gateshead Clubhouse that make the difference.
It is not ‘just a fact of life’ or a ‘cost living crisis’ that we’re dealing with, it’s the injustice that not enough people care enough about people who live with mental health ill-health, distress and trauma to change things so people can, at the very least, have their basic needs met. Two decades of a logic that says the only way to get people to be less poor is to provide them less direct financial support via social security benefits has made us a machine for making ill people iller.
Everyone should be able to plan for a holiday, do something they enjoy, see friends and family, easily fix the niggling health problems of life, not live in places that make them sick and unsafe.
Someone needs to hold the torch for the financial wellbeing of those of us who live with mental ill-health. The people most screwed by the cost of living crisis aren’t the people having the shock of having less disposable income than they once did. It’s the people who have been poorest for longest who have least access to any means to protect themselves from rising prices.
People make better decisions when their bellies are full and there’s no unsolvable bills on the horizon. You can’t solve structural inequality by trying to engineer the people at the bottom.
The cost of living crisis is a multiplier of the problems that already exist. The quickest way to make someone less poor is to give them money. The second quickest is to make what they need less expensive.
In November 2022 The Guardian reported “Liz Truss’s disastrous mini-budget cost the country a staggering £30bn — doubling the sum that the Treasury says will have to be raised by Jeremy Hunt this week in a huge programme of tax rises and spending cuts.”
I didn’t do that, you didn’t do that. We feel like we effed up buying a custard slice in the reduced section of the supermarket or putting the heating on for an extra hour, that we should be ashamed for having needs.
Eff that. We’ll never slip up as badly as that and we’ve nothing to be ashamed of.
@markoneinfour
