What does mental health look like during the Covid-19 Lockdown? A new materialist understanding.

Laetitia Zeeman

The understanding that health is more than the absence of disease and instead ‘a state of complete physical, mental and social well-being’ (WHO 2006), has been comprehensively challenged as populations age and patterns of overlapping physical and mental frailty emerge (Matchtfeld 2011). However, when attempting to understand health, we recognise the limitations of dualist thinking where health and illness are structurally bound in binaries that are concerned with the body/mind and nature/culture (Fox & Alldred 2017). Instead health spans the body, the mind, nature and culture by combining a range of factors, but what does health look like for those in lockdown during a global pandemic caused by a coronavirus with its related Covid-19 disease?

 

Within neoliberal, neoconservative, national political and public health structures, the state’s responsibility is expanding due to Covid-19. Individuals are encouraged to take responsibility for preventing the spread of disease by staying at home and regular handwashing, and later to ‘stay alert, control the virus and save lives’. Where the expanding reach of the state and individual responsibility fails, the diseased body within a postpositivist frame is subjected to biomedical treatment options such as ventilation, medication, intubation and intravenous infusion. During the early parts of 2020 the guidance form the UK Government around social distancing meant that the natural flow of daily life was significantly disrupted with social interaction confined to those living in the same home environment or external connection occurring via virtual platforms and social media. These changes influenced every aspect of life including the health of human bodies with their range of physical, psychological, sociocultural and abstract relations.

 

In order to move beyond dualism with the related biomedical view of a healthy body and mind, where the failing body has limited capabilities, a materialist understanding of health frames the body with an expanding ability to form, defy and change new relations. By drawing on a Deleuzian understanding of health, the body contains the ability to make new relations that may be part of new assemblages to generate alternative options for action and engagement (Buchanan 1997). A new materialist analysis can help us think about health by linking bodies with a range of factors to show the assemblages that are created during Covid-19. New materialism supports us to form an ill-health assemblage within a relational ontology that can be defined as:

 

“…comprising the myriad physical, psychological and social relations and affects that surround a body during an episode of Il-health. An ill-health assemblage associated with an infection might look like this: respiratory track – virus – immune system – inflammation – pharmacist – pharmaceutical compound – theories – daily responsibilities – family members – social networks”.

 

(Fox & Alldred 2017:134)

 

During a pandemic with these kinds of assemblages, health is not the property of biological bodies or individuals, but health is seen as an ongoing process of evolving or becoming associated with a relational way of being (Fox & Alldred 2017). In a world disrupted by Covid-19, where does mental health fit? In the relational mental health gains significance by connecting to others, health services, broader systems, the material world and affective experiences. These experiences include the ability to sit with physical discomfort, or impaired breathing, to grieve for loved ones, to be creative and hold the hope during a period of adversity. The relational connectedness associated with mental health generates alternative options for action by calling us to question the injustice of health inequalities where black, asian and minority ethnic people and in particular NHS workers are disproportionately represented in mortality rates associated with Covid-19 (Khunti et al 2020; Siddique 2020). Whilst inequalities are embedded in histories of oppression that becomes visible in heightened risk to contract the virus (Resnick et al 2020), maintaining mental health means questioning discrimination where we unintentionally form part of, or witness systems or processes of marginalisation. In order to maintain mental health, we continue to promote and prioritise social justice whilst working with people and our students to prioritise connections with others, including the material world, during participatory and collaborative practice.

 

Laetitia Zeeman

 

 

References

 

Buchanan, I. (1997) The problem of the body in Deleuze and Guattari, or, what can a body do? Body & Society, 3(3): 73-91.

 

Fox, N. J. and P. Alldred (2017). Sociology and the new materialism: Theory, research and action. London, SAGE.

 

Khunti, K., et al. (2020). “Is ethnicity linked to incidence or outcomes of covid-19?” BMJ 369:m1548.

 

Matchtfeld, H. et al. (2011). How should we define health? BMJ 2011; 343:d4163 doi: 10.1136/bmj.d4163

 

Siddique H. (2020) UK government urged to investigate coronavirus deaths of BAME doctors. Guardian; Apr 2020. https://www.theguardian.com/society/2020/apr/10/uk-coronavirus-deaths-bame-doctors-bma

 

Resnick A, Galea S, Sivashanker K. (2020) Covid-19: the painful price of ignoring health inequities. BMJ Opinion; Mar 2020. https://blogs-bmj-com.ezproxy.brighton.ac.uk/bmj/2020/03/18/covid-19-the-painful-price-of-ignoring-health-inequities

 

World Health Organization (2006). Constitution of the World Health Organization – Basic Documents, Forty-fifth edition, Supplement, October 2006.