Digital austerities? Covid-19 and cost cutting in a UK mental health service

Authors: Edward Kiely*, University of Cambridge
Topics: Medical and Health Geography
Keywords: pandemic, austerity, mental health, healthcare, responsibilization, privatization
Session Type: Virtual Paper
Day: 4/9/2021
Start / End Time: 8:00 AM / 9:15 AM
Room: Virtual 40
Presentation File: No File Uploaded


In March 2020 the mental health day centre where I was conducting fieldwork was abruptly closed. Overnight – and for the first time in its history – the centre shifted to online operations. This paper draws on participant observation of a series of psychoeducational sessions at the centre: those run in-person before the pandemic, and those taking place afterwards via Zoom.

Through this case study, I examine some of the distinctions between online and in-person mental health care, and their wider sociopolitical relevance. In particular, I argue that the online sessions evidenced a shift towards instrumental, goal-oriented forms of care. This is in contrast to more open-ended – and even subversive – forms of sociality taking place during in-person sessions at the day centre.

This instrumental approach aligns with budget-cutting imperatives that have seen the centre shrink its capacity and slash its hours of operation. The introduction of time-limited online sessions further reduced staffing costs, and were described by management as a step towards greater independence and responsibility on the part of the ‘clients’. With funding running out and the future of the service imperilled, online provision was framed as a means to extend the life of the day centre, in digitised, dematerialised form. Yet this techno-optimistic narrative can also serve as an alibi for deepening responsibilisation and further withdrawals of care. Overall I suggest that critical attention must be paid to intersections between pandemic responses, and the advancement of existing agendas of responsibilisation, privatisation and austerity.

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