The Camouflaging of Austerity: Institutional geographies of mental health in contemporary England

Change log

This thesis examines the landscapes of mental health service provision which have emerged under austerity, and the institutional geographies which work to reproduce these. While austerity is sometimes portrayed as a relatively uniform process of retrenchment, I begin by offering a forensic cultural geography of austerity, a granular survey of the uneven geographies of mental health services and spending which emerged between 2010 and 2020. I situate these in a conjunctural analysis of English politics, economics and culture. To conceptualise how these national patterns are rescaled into the everyday, I then turn to the question of austerity’s institutionalisation. How is the process of fiscal cutting made ethically and affectively tenable for those who must enact it? These empirical sections build on nine on participant observation with two groups of participants in a county in the south of England: clients and staff at a mental health day centre threatened with closure; and county council commissioners who allocate funding for services.

While bureaucrats are typically depicted as meting out austerity with indifference, the commissioners I worked with were deeply invested in the notion that they provided care. Consequently, they reimagined austerity in optimistic terms, as a hopeful process of optimisation. I map the institutional geographies within the council which enabled this austerity optimism to be embodied and felt, and the discourses and knowledge-making practices which underpinned this interpretation. I argue that these practices inculcated an anaesthetic ignorance among the commissioners – a placatory unseeing of austerity’s harms which allowed them to continue with the work of cutting. I conclude by foregrounding the voices and experiences of clients at the mental day centre, offering a countertopography which challenges claims of austerity optimism. Here, I theorise austerity and care temporally arguing that budget shortfalls were undermining expansive temporalities of care, intensifying distress and destabilising hopes for the future. In turn, they deepened commodification, tying staff and clients ever more tightly into the logics and time-spaces of the market.

This thesis makes four significant contributions to geographical literature. In response to approaches which occlude the complexity of state retrenchment, it develops a comprehensive account of mental health services and expenditure under austerity, relating these patterns to a political and economic conjuncture emergent in Britain since 2010. It furthers geographical research on ‘everyday austerity’ through a relational account of the institutional geographies which rescale austerity from fiscal policy to quotidian phenomenon, drawing on feminist theories of affective economies. It advances mental health geography by mapping landscapes of service provision under austerity and conceptualising the role of institutional actors in enacting these. And finally, it develops the concept of camouflaging, as a process integral to reproduction and legitimation of austerity. Rather than focussing on moments when austerity materialises and is felt, the thesis charts the practices through which austerity is made to disappear from everyday life.

Nally, David
Geography, Mental health, Austerity, Participant observation, Semi-structured interviews, Feminist geography, Institutional geography, Mental health geography
Doctor of Philosophy (PhD)
Awarding Institution
University of Cambridge
ESRC (1947615)
Economic and Social Research Council (1947615)
ESRC (1947615)
Economic and Social Research Council [Grant number: ES/J50003/1]