Institutionalisation and oppression within the mental health system in England: Social work complicity and resistance

The chapter begins by locating institutional oppression in the English mental health system within its wider socio-political and historical context. It does so by introducing the Gramscian notion of the ‘integral state’ to examine the dialectical interaction between the coercive, disciplinary and distributive functions of the capitalist state, and how the counterbalancing of these elements, in particular force and consent, shapes and reshapes welfare regimes over time. It goes on to apply this theoretical lens to an historical overview of forms of mental health provision in England from the Victorian asylum to contemporary neoliberal services. The chapter then explores the social work profession’s engagement with these oppressive institutional systems and psychiatric practices which has ranged from complicity to resistance. This Gramscian mode of analysis is utilised to examine some of the tensions and contradictions underpinning these divergent responses.