Book Review: Understanding Mental Distress: Knowledge, Practice and Neoliberal Reform in Community Mental Health Services

Rich Moth’s book, Understanding Mental Distress, provides a fascinating insight into the operation of community mental health services. The book reports on an ethnographic research project focused on two mental health services, named, ‘Southville Community Mental Health Team’ and the ‘Rehabilitation Recovery Team’. Observations and interviews were conducted between 2009–2011 and 2018–2019.

The book uses the theoretical framework of Emergent Marxism and is concerned with the way that neoliberalism has affected the delivery of mental health services. Part 1 of the book gives an overview of how mental health policy and practice has developed from the 19th century to the present day. Part II reports on the research study. This begins with a chapter exploring Community Mental Health Team practitioners’ perspectives on policy reforms. It is then followed by a chapter looking at how mental health service users have experienced such changes. A further two chapters present case studies, reporting on the cases of ‘Manu’ and ‘Alistair’. The first of these highlights issues around risk and responsibilisation, and the second focuses on how mental distress is defined. Both chapters explore how family carers, community mental health staff and voluntary sector staff respond to mental health needs. The final chapter draws on the data collected between 2018 and 2019 and reports on staff perspectives on a major service restructure, as well as their views on austerity and welfare reform. The third and final section of the book sets out the theoretical framework of Emergent Marxism in more detail and provides analysis and conclusions.