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

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.