tag:theconversation.com,2011:/global/topics/insights-series-71218/articlesInsights series – The Conversation2024-03-26T17:02:22Ztag:theconversation.com,2011:article/2258272024-03-26T17:02:22Z2024-03-26T17:02:22ZFor people with mental illness, drugs and alcohol can be a key survival strategy. I’ve learned they shouldn’t have to ‘get clean’ to get treatment<figure><img src="https://images.theconversation.com/files/582279/original/file-20240315-20-k4w6kp.jpg?ixlib=rb-1.1.0&rect=43%2C60%2C5708%2C3768&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption"></span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/close-on-bottles-blurred-person-drinking-1200866920">Ground Picture/Shutterstock</a></span></figcaption></figure><p>A decade ago, while working in a women’s prison, I met a young woman whose story would leave an indelible mark on me. She had endured severe abuse at the hands of men, and I was initially concerned that, as a male social worker, my presence might rekindle her trauma. Yet, through careful and considered engagement, we were able to forge a relationship of trust.</p>
<p>Jenny* confided in me that heroin had become her refuge – the only respite that quieted the relentless storm of her thoughts. But her dependency had brought dire consequences: the removal of her children and her subsequent imprisonment for possession with intent to supply. Even so, Jenny told me that before she was imprisoned: “Heroin was the only thing that helped me to cope.”</p>
<p>While inside, she experienced regular flashbacks and profound anxiety. Her treatment regime included antipsychotic medication Seroquel and heroin replacement Subutex – but Jenny didn’t use them conventionally. “The only way they help is if I grind them together and snort them,” she explained. This method provided her a fleeting, euphoric respite from her psychological torment.</p>
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<p><em>Across the world, we’re seeing unprecedented levels of mental illness at all ages, from children to the very old – with huge costs to families, communities and economies. <a href="https://theconversation.com/uk/topics/tackling-the-mental-health-crisis-147216?utm_source=TCUK&utm_medium=ArticleTop&utm_campaign=MentalHealthSeries">In this series</a>, we investigate what’s causing this crisis, and report on the latest research to improve people’s mental health at all stages of life.</em></p>
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<p>It wasn’t Jenny’s drug revelation that struck me most profoundly, but the reaction of some of my prison colleagues. Her unconventional use of the medication was labelled substance abuse, leading to her being ostracised by the prison’s mental health service, which refused to work with her until she “sorted out” her drug issues.</p>
<p>Even though I had known Jenny for a year, it was only when she was about to be released from prison that I really understood how serious her situation was. I was shocked to see her breaking the prison’s rules on purpose because she didn’t want to leave. She started smoking in places she shouldn’t, damaged her own cell and areas everyone used, attacked another prisoner, which was not like her at all, and started using spice and hooch.</p>
<p>Jenny preferred staying in jail over facing life outside, but she was let out all the same. A week after her release, I received news that she had died from a heroin overdose.</p>
<h2>My search for answers</h2>
<blockquote>
<p>Mental health problems are experienced by the majority of drug and alcohol users in community substance use treatment. Death by suicide is also common, with a history of alcohol or drug use being recorded in 54% of all suicides in people experiencing mental health problems. (<a href="https://assets.publishing.service.gov.uk/media/5a75b781ed915d6faf2b5276/Co-occurring_mental_health_and_alcohol_drug_use_conditions.pdf">Public Health England guide</a>, 2017.)</p>
</blockquote>
<p>Jenny’s tragic story left me with many questions – what were the underlying causes of mental illness? What spurred the spiral into addiction? Why did individuals turn to substance use? – that, even after six years as a mental health social worker working in prisons and psychiatric hospitals, I had neither the knowledge nor experience to answer. Talking to colleagues did not resolve them, so I sought answers by returning to academia alongside my day job.</p>
<p>A postgraduate diploma helped me better understand the theories of mental health from neuroscientific, psychiatric and pharmacological perspectives. But above all, I realised that many of the people I was now encountering in my new role, working in a crisis home treatment team (a community-based team set up to support people experiencing severe mental health issues), would never get better. Rather, they would just keep coming back with a new crisis.</p>
<p>And for a large majority of them (around four in five), substances ranging from highly addictive narcotics to potent, mind-altering chemicals would be a key part of their daily lives in addition to, or as an alternative for, their prescribed psychiatric medication.</p>
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<img alt="" src="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
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<p>Roger was one of many people I met who relied on <a href="https://theconversation.com/what-is-spice-and-why-is-the-drug-so-dangerous-60600">Spice</a>, a synthetic cannabinoid designed to mimic the effects of naturally occurring <a href="https://www.ncbi.nlm.nih.gov/books/NBK563174/#:%7E:text=Delta%2D9%2Dtetrahydrocannabinol%20(also,the%20class%20of%20cannabinoid%20medications.),%20the%20psychoactive%20ingredient%20in%20marijuana.%20Regular%20Spice%20users%20face%20severe%20health%20risks,%20in%20particular%20to%20their%20cognitive%20function,%20and%20an%20increased%20risk%20of%20%5Bpsychotic%20outcomes%5D(https://onlinelibrary.wiley.com/doi/full/10.1002/wps.20341">THC</a>. (In addition to consumption by smoking, there are increasing reports of synthetic cannabinoids being used in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5398321/">e-cigarettes or vapes</a>.)</p>
<p>Nonetheless, Roger told me Spice was the “only thing that would help sort my head out”. And, after listening to a lecture from me about the dangers of these substances, he responded:</p>
<blockquote>
<p>I know how much to take – I know when I’ve taken too much or not enough. I use it in doses now. Why would I stop if it’s the only thing that works?</p>
</blockquote>
<p>It was clear that Roger knew much more about the effects of Spice than I did. Interactions like this ignited a desire in me for deeper knowledge – not from books or universities, but directly from people with co-existing mental health and addiction problems.</p>
<p>Perhaps surprisingly, in the UK we don’t know how many people are living in this combined state. Estimates have tended to focus only on people with severe mental health problems and problematic substance use. For example, a <a href="https://www.drugsandalcohol.ie/17764/">2002 Department of Health guide</a> suggested that 8-15% of its patients had a dual diagnosis – while acknowledging that it is difficult to assess exact levels of substance use, both in the general population and among those with mental health problems.</p>
<p>A decade earlier, US research had identified that for <a href="https://psycnet.apa.org/record/2005-09774-007">people with schizophrenia</a>, substance use (non-prescribed drugs) was a significant problem relative to the general population. More recently, a 2023 global review of evidence identified that the prevalence of co-existing mental health and substance use among <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9955022/">children and adolescents treated for psychiatric conditions</a> ranged between 18.3% and 54%.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/582289/original/file-20240315-24-55mu9.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Painting of Thomas De Quincey" src="https://images.theconversation.com/files/582289/original/file-20240315-24-55mu9.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/582289/original/file-20240315-24-55mu9.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=644&fit=crop&dpr=1 600w, https://images.theconversation.com/files/582289/original/file-20240315-24-55mu9.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=644&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/582289/original/file-20240315-24-55mu9.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=644&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/582289/original/file-20240315-24-55mu9.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=810&fit=crop&dpr=1 754w, https://images.theconversation.com/files/582289/original/file-20240315-24-55mu9.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=810&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/582289/original/file-20240315-24-55mu9.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=810&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Thomas De Quincey, author of Lessons From an English Opium Eater.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Thomas_de_Quincey_by_Sir_John_Watson-Gordon.jpg">National Portrait Gallery via Wikimedia</a></span>
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</figure>
<p>But what I found particularly interesting was an analysis of the writings of Thomas De Quincey from more than 200 years ago. In his 2009 article <a href="https://www.tandfonline.com/doi/abs/10.3109/10826089009056230">Lessons From an English Opium Eater: Thomas De Quincey Reconsidered</a>, leading clinical academic, John Strang, highlighted that issues raised by De Quincey in 1821 remain causes for concern some two centuries later.</p>
<p>De Quincey was arguably the first person to document his own use of substances, in particular opium. His writing shows that he self-medicated to manage pain, including “excruciating rheumatic pains of the head and face”:</p>
<blockquote>
<p>It was not for the purpose of creating pleasure, but of mitigating pain in the severest degree, that I first began to use opium as an article of daily diet … In an hour, oh Heavens! What an upheaving, from its lowest depths, of the inner spirit! </p>
</blockquote>
<p>De Quincey’s use of non-prescribed drugs mirrors that of John, Jenny, Roger and so many other people I have met as a social worker. Clearly, we’ve known about the close relationship between mental illness and substance abuse for hundreds of years, yet are still wrestling with how best to respond.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/guide-to-the-classics-confessions-of-an-english-opium-eater-by-thomas-de-quincey-a-dense-strange-journey-through-addiction-190435">Guide to the classics: Confessions of an English Opium Eater by Thomas De Quincey – a dense, strange journey through addiction</a>
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<p>Official guidance almost always advocates for a <a href="https://www.nhsconfed.org/system/files/2022-12/NHS%20Confederation%20parliamentary%20briefing%20-%20No%20wrong%20door%20-%20a%20ten-year%20vision%20for%20mental%20health%20learning%20disability%20and%20autism%20services.pdf">“no wrong door” policy</a>, meaning that those with dual addiction and mental health issues will get help whichever service encounters them first. But from what people with lived experience were telling me, this was not the case.</p>
<p>I sent freedom of information requests to 54 mental health trusts across England, to try to discern any patterns of variation in the way their patients were being measured and treated. Some 90% of the trusts responded, of which a majority (58%) recognised the dual occurrence of mental illness and substance use. However, the estimated prevalence of this dual diagnosis varied widely – from only nine to around 1,200 patients per trust.</p>
<p>What I found most alarming was that less than 30% of the mental health trusts said they have a specialised service for addiction which accepts referrals for dual diagnosis patients. In other words, throughout England, a lot of these patients are not being appropriately supported.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/582295/original/file-20240315-22-jay1uw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Out-of-focus man holding a syringe in the foreground" src="https://images.theconversation.com/files/582295/original/file-20240315-22-jay1uw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/582295/original/file-20240315-22-jay1uw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/582295/original/file-20240315-22-jay1uw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/582295/original/file-20240315-22-jay1uw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/582295/original/file-20240315-22-jay1uw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/582295/original/file-20240315-22-jay1uw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/582295/original/file-20240315-22-jay1uw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/drug-addict-young-man-syringe-action-599693732">271 Eak Moto/Shutterstock</a></span>
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<h2>‘When I say I use heroin, people change’</h2>
<blockquote>
<p>I started using when I was around 18. Things weren’t good in my life at the time, and I got in with a crowd who offered me heroin. It was the most amazing experience; all my worries disappeared better than the antidepressants I had been taking. But the more I used, the more I needed it. Now I use it in stages, just before I go to work and at night.</p>
</blockquote>
<p>Carl had been using heroin for more than ten years when I interviewed him. When I asked if he wanted to stop, he shrugged and said no, explaining:</p>
<blockquote>
<p>I’ve tried so many times – I’ve been on methadone but that was worse, especially coming off it. I know how much to take, and no one knows I use gear – so, no. But, as soon as you tell a professional you take heroin, their whole attitude changes. I’ve seen it many times. I dress quite well and I have a job, but as soon as I say I use heroin, they change. It’s almost as if they don’t see the same person any more.</p>
</blockquote>
<p>Talking to Carl underlined that many users know far more than me about the substances they take and why they take them. Yet as soon as a professional (typically a nurse, social worker or doctor) hears they are taking an illegal substance, or are misusing a legal substance such as alcohol, they are stigmatised and often ostracised from service provision.</p>
<p>Suzanne was homeless and also using heroin, but for different reasons to Carl. I asked why she started using it:</p>
<blockquote>
<p>I’ve had a shit life – it numbs all of that. Now being homeless, it helps me to sleep and keeps me warm, but I only use it in the winter because I need to sleep.</p>
</blockquote>
<p>In summer, Suzanne explained, she would switch to taking “phet” – amphetamines. I asked her why:</p>
<blockquote>
<p>You need to be awake – there are lots of dickheads around. I’ve been beaten and raped in the summer when I was asleep, so you need to be awake more.</p>
</blockquote>
<p>Hearing the stories of people fighting their personal battles with mental health and substance use issues was at once haunting and cathartic for me. It was deeply moving to hear them, time and again, struggling with the most difficult aspect of their condition: the simple decision to ask for help. And sadly, far too often, when they did summon the courage, their requests would go unheard, unheeded, or they would be engulfed by a sprawling system that seemed unable to help.</p>
<p>Dave had been using alcohol for many years and had asked for support on several occasions – only to be passed from service to service:</p>
<blockquote>
<p>I was made redundant and, at 50, was finding it hard to get another job. I wasn’t drinking all of the time then. But as I started to get into more debt and the bailiffs were knocking on the door, I needed a drink to get me through it. It was not until I was charged with drunk driving that I knew I had a problem.</p>
</blockquote>
<p>Dave said he wasn’t shy about asking for help – at least, for a while. But he found himself caught in a downward spiral that led to more drinking, more suffering, and less support:</p>
<blockquote>
<p>So many times I’d stop drinking, but I couldn’t deal with the voices in my head. I’d ask for support, but the waiting lists were so long. The medication the doctor gave me did nothing, so I’d start drinking again, and because I’d start to drink again, mental health services wouldn’t touch me. All they kept saying was: ‘You should stop drinking first.’</p>
</blockquote>
<h2>The biggest barrier to getting support</h2>
<p>To expand my understanding, I also sought the perspectives of a dozen people working on the frontline of mental healthcare – from professionals in NHS mental health and substance use teams, to people working for charitable support groups. Their insights revealed a <a href="https://www.miragenews.com/northern-england-life-ups-death-risk-from-1195801/">frayed and fragmented network of services</a>, with the holes and inefficiencies obvious and crying out for attention and repair. As one nurse explained:</p>
<blockquote>
<p>The stress of trying to get services to help is unbelievable. You’ve got pressure from the person’s family because they are afraid they’ll end up dead. You’ve got pressure from managers to discharge the person. All I’d get is criticism which far outweighed encouragement or support. The stress made me so anxious that I almost gave it all up – and even considered suicide myself.</p>
</blockquote>
<p>Over 80% of the professionals I spoke to called for an integration of mental health and substance use teams, in part because of the huge cuts nationwide in funding to substance use services. One social worker in a substance use service explained the current situation:</p>
<blockquote>
<p>If you get someone with an alcohol addiction, it becomes quite apparent that they use drink as a way of coping with their mental health. But, because of massive waiting lists within mental health services or because they are told they need to stop drinking before [they can be treated], mental health support can’t be offered. So, the person just keeps drinking and eventually disengages from our services as there is no hope for them. We shouldn’t expect someone to stop using a substance that they perceive is helping without offering an alternative treatment.</p>
</blockquote>
<p>For all the professionals I interviewed, the most significant barrier to getting support for someone’s mental health issues was that they used substances and would not receive any treatment until they addressed this. As one mental health nurse told me:</p>
<blockquote>
<p>I had one chap who was using cocaine, mainly due to social anxiety. Initially, he’d use it when socialising with friends. But because it gave him confidence and he could talk to people, he started to use it all the time and got himself in debt. I wanted to address the root cause, the social anxiety, so I referred him to our Improving Access to Psychological Therapy service. But I was told he needed to be abstinent from cocaine for three months before they’d accept him. He eventually disengaged, and I haven’t seen him since.</p>
</blockquote>
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<a href="https://images.theconversation.com/files/582311/original/file-20240315-25-o9e0be.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="The word HELP spelled out in white powder" src="https://images.theconversation.com/files/582311/original/file-20240315-25-o9e0be.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/582311/original/file-20240315-25-o9e0be.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=363&fit=crop&dpr=1 600w, https://images.theconversation.com/files/582311/original/file-20240315-25-o9e0be.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=363&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/582311/original/file-20240315-25-o9e0be.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=363&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/582311/original/file-20240315-25-o9e0be.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=456&fit=crop&dpr=1 754w, https://images.theconversation.com/files/582311/original/file-20240315-25-o9e0be.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=456&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/582311/original/file-20240315-25-o9e0be.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=456&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption"></span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/word-help-spelled-out-by-cocaine-2289738709">Runawayphill/Shutterstock</a></span>
</figcaption>
</figure>
<h2>A seismic shift is needed</h2>
<p>In the shadows of our society, hidden behind the walls of our prisons and in the dark corners of our streets, the experiences of Jenny and countless others bear witness to the profound failings of our healthcare system to address co-existing mental health and substance use issues. For those caught in the merciless cycle of addiction and illness, these systemic inefficiencies and administrative blockades do much to intensify their torment.</p>
<p>Their often brutally honest accounts (and the insights of those who try to support them) draw a portrait of a split and underfunded service, collapsing under the weight of its contradictions. The loud calls for integrated mental health and substance addiction treatment become muffled amid the bureaucratic din of funding cuts, lengthy waiting lists and policy neglect.</p>
<p>The evidence overwhelmingly confirms the need for a model of care that is <a href="https://theconversation.com/how-to-solve-our-mental-health-crisis-214776">holistic and integrated</a> – one that shifts the narrative from stigma and isolation to awareness and support.</p>
<p>The economic case for reshaping investment in our mental health and substance misuse services is powerful. The annual cost of mental health problems to the UK economy is a staggering £117.9 billion – equivalent to <a href="https://www.england.nhs.uk/aac/wp-content/uploads/sites/50/2022/09/B1482_research-demand-signalling-national-mental-health-programme_september-2022.pdf">5% of its annual GDP</a> – with substance misuse adding a <a href="https://www.gov.uk/government/publications/review-of-drugs-phase-two-report/review-of-drugs-part-two-prevention-treatment-and-recovery#:%7E:text=There's%20a%20strong%20'invest%20to,was%20spent%20on%20drug%20treatment.">further £20 billion</a>.</p>
<p>However, these figures tell only part of the tale. While we know that <a href="https://assets.publishing.service.gov.uk/media/5a75b781ed915d6faf2b5276/Co-occurring_mental_health_and_alcohol_drug_use_conditions.pdf">70% of people in treatment for drug misuse and 86%</a> of people in treatment for alcohol misuse have a mental health diagnosis, the full financial impact of people with these co-occurring disorders is probably far greater.</p>
<p>This also includes people who often plough through a <a href="https://www.emerald.com/insight/content/doi/10.1108/ADD-11-2017-0021/full/html">punitive and bewildering series of services</a> as they navigate their intersecting problems, encountering barriers at every turn that fail to address their <a href="https://assets.publishing.service.gov.uk/media/5a75b781ed915d6faf2b5276/Co-occurring_mental_health_and_alcohol_drug_use_conditions.pdf">acute health</a> and social care needs. As their distress is amplified, the costs to <a href="https://www.emerald.com/insight/content/doi/10.1108/17570971111197175/full/html">wider society</a> escalate too – as one social worker explained to me:</p>
<blockquote>
<p>I am currently supporting a woman who is struggling with alcohol dependency, a condition that began after she endured significant domestic abuse. The cycle is devastating: her trauma cannot be effectively addressed because of her dependency on alcohol, and she cannot abandon alcohol because it’s the only solace she finds from her emotional torment. Despite several attempts at rehabilitation, none of the programmes have sufficiently tackled the mental health aspects of her trauma. Now, with cirrhosis of the liver, her health is in critical decline. It’s a heart-wrenching situation – a stark reminder of the desperate need for integrated treatment approaches that address both substance dependency and the underlying psychological trauma.</p>
</blockquote>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/582306/original/file-20240315-20-l7ky73.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Out-of-focus woman with a glass of alcohol on the table in front of her" src="https://images.theconversation.com/files/582306/original/file-20240315-20-l7ky73.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/582306/original/file-20240315-20-l7ky73.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/582306/original/file-20240315-20-l7ky73.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/582306/original/file-20240315-20-l7ky73.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/582306/original/file-20240315-20-l7ky73.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/582306/original/file-20240315-20-l7ky73.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/582306/original/file-20240315-20-l7ky73.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/alcohol-addiction-portrait-lonely-desperate-drunk-137241875">Kamira/Shutterstock</a></span>
</figcaption>
</figure>
<h2>‘I might as well be dead’</h2>
<p>In the quiet confines of a West Midlands mental health crisis centre, I’m preparing to meet someone whose story I know only from the clinical notes on my screen. The phrase “is alcohol dependent” is highlighted in bold. Behind those words is another person whose life is unravelling in the silence of a battle fought alone.</p>
<p>John walks into the room, a man living in the grip of two relentless forces – addiction and mental illness. “It was just to stop the noises,” he says of the whisky he uses as medication for his inner turmoil. His hands are trembling. This is the moment of truth – his story is no longer trapped within the clinical pages of a case file. </p>
<p>“I’ve lost everything,” he tells me. “I might as well be dead.” </p>
<p>Then John explains why he’s given up hope:</p>
<blockquote>
<p>I’ve asked for help so many times, but all I get told is that I need to stop drinking before my mental health can be treated. However, alcohol is the only thing that works for me. I’ve gone through detox, but then I had to wait months for counselling. I just can’t cope that long without any support – antidepressants don’t do anything for me. What’s the point?</p>
</blockquote>
<p>Over the past 15 years, I have met countless “Johns”, both during my day job as a mental health social worker and, latterly, in my academic research. This has led me to conclude that the health and social care system in which I work falls catastrophically short. </p>
<p>This is no mere professional critique. It is an impassioned plea for society to rediscover its collective heart; to explore the human stories that lie hidden in statistics such as that, between 2009 and 2019, <a href="https://documents.manchester.ac.uk/display.aspx?DocID=60521">53% of UK suicides</a> were among people with comorbid diagnoses of mental health and substance use.</p>
<p>Instead of viewing people through the limiting lens of labels, we should endeavour to see their humanity. Engaging in conversation, extending empathy and showing compassion are powerful actions. A kind word, an understanding nod or a gesture of support can affirm their dignity and spark a connection that resonates with their innate human spirit. Or as John, whose journey I’ve had the privilege to witness, puts it:</p>
<blockquote>
<p>It’s not about the help offered but the meaning behind it. Knowing you’re seen as a person, not just a problem to be solved – that’s what sticks with you.</p>
</blockquote>
<p><em>*All names in this article have been changed to protect the anonymity of the interviewees.</em></p>
<p><em>If you or anyone you know require expert advice about the issues raised in this article, the NHS provides this <a href="https://www.nhs.uk/nhs-services/mental-health-services/where-to-get-urgent-help-for-mental-health/">list of local helplines and support organisations</a>.</em></p>
<hr>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
</figcaption>
</figure>
<p><em>For you: more from our <a href="https://theconversation.com/uk/topics/insights-series-71218?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insights series</a>:</em></p>
<ul>
<li><p><em><a href="https://theconversation.com/insomnia-how-chronic-sleep-problems-can-lead-to-a-spiralling-decline-in-mental-health-224131?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insomnia: how chronic sleep problems can lead to a spiralling decline in mental health
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<li><p><em><a href="https://theconversation.com/existential-crisis-how-long-covid-patients-helped-us-understand-what-its-like-to-lose-your-sense-of-identity-and-purpose-in-life-211223?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Existential crisis: how long COVID patients helped us understand what it’s like to lose your sense of identity and purpose in life
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<li><p><em><a href="https://theconversation.com/ocd-is-so-much-more-than-handwashing-or-tidying-as-a-historian-with-the-disorder-heres-what-ive-learned-219281?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">OCD is so much more than handwashing or tidying. As a historian with the disorder, here’s what I’ve learned
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<li><p><em><a href="https://theconversation.com/how-music-heals-us-even-when-its-sad-by-a-neuroscientist-leading-a-new-study-of-musical-therapy-214924?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">How music heals us, even when it’s sad – by a neuroscientist leading a new study of musical therapy
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<p><em>To hear about new Insights articles, join the hundreds of thousands of people who value The Conversation’s evidence-based news. <a href="https://theconversation.com/uk/newsletters/the-daily-newsletter-2?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK"><strong>Subscribe to our newsletter</strong></a>.</em></p><img src="https://counter.theconversation.com/content/225827/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Simon Bratt does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>This is the moment of truth. John’s story is no longer trapped in the clinical pages of a case file. ‘I’ve lost everything,’ he says. ‘I might as well be dead.’Simon Bratt, Mental Health Social Worker and PhD Candidate, Staffordshire UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2217982024-03-21T09:54:20Z2024-03-21T09:54:20ZI’ve spent time with refugees in French coastal camps and they told me the government’s Rwanda plan is not putting them off coming to the UK<figure><img src="https://images.theconversation.com/files/582207/original/file-20240315-30-4n1fo5.JPG?ixlib=rb-1.1.0&rect=188%2C970%2C5326%2C3017&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Refugees in line for food outside a 'wild camp' in Loon Plage in 2023.</span> <span class="attribution"><span class="source">Frédérique de Bels</span></span></figcaption></figure><blockquote>
<p>I was warned by a French Egyptian not to cross the channel, not to go to the UK and to try to stay in France … But I have not escaped the police brutality from my country, smugglers from Libya, the crossing of the Mediterranean and the ‘jungle’ in France for nothing. I was determined to come to the UK. DM Boss (pseudonym), Egyptian asylum seeker</p>
</blockquote>
<p>It is 7am and I’m sitting in Pierre Lascoux’s old van with his dog, Arthur, at my feet. Lascoux, a 60-year-old volunteer, has dedicated the past two years of his life to helping refugees. </p>
<p>Every morning for four weeks we have talked about the <a href="https://www.lemonde.fr/en/france/article/2023/12/16/in-calais-the-blind-spots-of-the-french-government-s-immigration-bill-are-laid-bare_6350192_7.html">plight of refugees</a> in the Loon Plage camp in Dunkirk’s industrial zone. Lascoux recently finished a 42-day hunger strike in order to raise awareness about the awful living conditions endured by the migrant population at the border. </p>
<figure class="align-left ">
<img alt="Man posing with dog and child. Child's faced blurred out so as not to identify them." src="https://images.theconversation.com/files/582601/original/file-20240318-20-fy8o7r.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/582601/original/file-20240318-20-fy8o7r.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=717&fit=crop&dpr=1 600w, https://images.theconversation.com/files/582601/original/file-20240318-20-fy8o7r.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=717&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/582601/original/file-20240318-20-fy8o7r.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=717&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/582601/original/file-20240318-20-fy8o7r.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=901&fit=crop&dpr=1 754w, https://images.theconversation.com/files/582601/original/file-20240318-20-fy8o7r.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=901&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/582601/original/file-20240318-20-fy8o7r.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=901&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Volunteer Peirre Lascoux, of Salam charity, with dog Arthur helping refugees at Loon Plage camp.</span>
<span class="attribution"><span class="source">Pierre Lascoux</span></span>
</figcaption>
</figure>
<p>I volunteered in French refugee camps in Dunkrik and Calais in the summer of 2023. It was part of my fieldwork and research around the concept of “hospitality” at different militarised border zones. </p>
<p>While I was in the camps I witnessed police violence and saw refugees cramming on a boat that was clearly not big enough to take them. I heard guns being fired and moved among the smuggling gangs and mafia in charge of the crossings, hearing stories from people who had been through hell in their own countries and on the journey to France. </p>
<p>Despite the relentless hardships and suffering, one thing appeared to unite them: they wanted to seek sanctuary in the UK. And headline-grabbing policies about <a href="https://www.theguardian.com/uk-news/2024/feb/05/the-tragedy-of-leonard-farruku-the-gifted-young-musician-whose-dream-of-a-better-life-ended-on-the-bibby-stockholm">floating prisons</a> and <a href="https://theconversation.com/even-many-critics-of-the-rwanda-deportation-policy-are-missing-the-point-of-why-its-wrong-221425">flights to Rwanda</a> were not going to stop them. They had come this far and they were determined to finish their journey.</p>
<hr>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
</figcaption>
</figure>
<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
<hr>
<h2>Loon Plage</h2>
<p>Back in Lascoux’s van, we survey the horizon for French riot police, the Compagnies Républicaines de Sécurité (CRS), who frequently come early in the morning to dismantle the camp. Faced by a mound of rubbish at the entrance (because the local authorities refuse to provide a skip), Lascoux waits every morning to provide aid to the refugees when they get thrown out. These days, the police dismantle Loon Plage every two weeks and the Calais camps every two days. </p>
<p>Lascoux lets people leave their personal belongings in his van so the cleaning company which accompanies the police doesn’t throw away all their cherished belongings. During the last evacuation the police forcibly removed Lascoux from the camp and illegally confiscated his van. </p>
<figure class="align-center ">
<img alt="A man is carried away by police." src="https://images.theconversation.com/files/582604/original/file-20240318-28-zrq5eh.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/582604/original/file-20240318-28-zrq5eh.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=840&fit=crop&dpr=1 600w, https://images.theconversation.com/files/582604/original/file-20240318-28-zrq5eh.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=840&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/582604/original/file-20240318-28-zrq5eh.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=840&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/582604/original/file-20240318-28-zrq5eh.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1055&fit=crop&dpr=1 754w, https://images.theconversation.com/files/582604/original/file-20240318-28-zrq5eh.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1055&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/582604/original/file-20240318-28-zrq5eh.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1055&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Pierre Lascoux being forcibly removed from Loon Plage camp by French police.</span>
<span class="attribution"><span class="source">Pierre Lascoux</span></span>
</figcaption>
</figure>
<p>The camp is reminiscent of the infamous <a href="https://theconversation.com/after-the-calais-jungle-is-there-a-long-term-solution-views-from-france-and-britain-67352">Calais Jungle</a>, which was shut down in 2016. I will never forget the image of a group of people, whose boat had capsized, walking back to the camp in the early hours of the morning. One couple pushed a supermarket trolley with two young children who must have been younger than five-years-old and who were drenched and haggard. They must have walked at least a dozen kilometres from the beach where they had probably stayed for days before trying to climb into the rubber dinghy. Everyone there tries several times before being successful and each time they fail they have to trudge back to the camp, exhausted.</p>
<p>Loon Plage is a series of wild camps; they cannot really be called refugee camps. Refugee camps are usually places run by state organisations or charities; places where people can seek sanctuary and, <a href="https://www.unrefugees.org/refugee-facts/camps/#:%7E:text=Food%2C%20water%20access%20points%20and,services%20of%20the%20host%20community">according to</a> the UN Refugee Agency (UNHCR), refugees have to be provided with shelter, food, water and latrines. </p>
<p>But Loon Plage really is a “jungle”. That’s what the refugees call every wild camp along the north coast. There used to be <a href="https://news.un.org/en/story/2018/04/1006481">access to water</a>, which was originally intended for use by the fire service. But because refugees used it to wash, the police blocked it. As a result, a 22-year-old <a href="https://www.lavoixdunord.fr/1215355/article/2022-08-10/loon-plage-un-migrant-meurt-noye-dans-un-canal">Sudanese man died</a> in 2022 while trying to wash in the canal which runs adjacent to the camp. In Calais, it is not uncommon to see 1,000 litre water tanks distributed by charities like <a href="https://calaisfood.wixsite.com/home/">Calais Food Collective</a> being stabbed by the police forces or disappearing overnight. According to Rachel Read, a volunteer for Calais Food Collective: </p>
<blockquote>
<p>It does not matter how hostile the state tried to make it here, they are not going to stop coming. If anything they are going to keep coming more because France is such a hostile place that they try to move through it and out.</p>
</blockquote>
<p>Lascoux works for <a href="https://www.associationsalam.org/">Salam</a>, a refugee charity which was established after the arrival of the <a href="https://www.theguardian.com/uk/2002/may/23/immigration.immigrationandpublicservices1">first Kosovar refugees</a> in the 1990s. Salam recently succeeded in obtaining a water point and a skip for the Loon Plage camp following Lascoux’s <a href="https://france3-regions.francetvinfo.fr/occitanie/tarn/albi/40-jours-sans-manger-pour-aider-les-migrants-l-ancien-boulanger-du-sud-de-la-france-obtient-gain-de-cause-2899565.html">hunger strike</a>, which ended with his hospitalisation. Lascoux is currently regaining his strength. The last time we spoke he told me: </p>
<blockquote>
<p>It is a small victory but the fight must go on. It is intolerable to see human beings treated worse than animals in France in the 21st century.</p>
</blockquote>
<h2>‘Stop the boats’</h2>
<p>I have been interested in the <a href="https://eprints.whiterose.ac.uk/98681/3/Mathieu%20Pernot%20and%20Les%20Migrants-%20Voicing%20the%20Silence%20and%20Exposing%20French%20Neo-colonial%20History%20and%20Practices..pdf">representation of migration</a> for several years, and I had already been to Calais with Franco-Swiss <a href="https://www.centrephotogeneve.ch/en/artist/elisa-larvego/">photographer Elisa Larvego</a> in January 2023 researching <a href="https://player.sheffield.ac.uk/exhibits/calais-and-out-focus">alternative representations of migration</a>. </p>
<figure class="align-center ">
<img alt="Barbed wire fencing surrounding coastal refugee camp." src="https://images.theconversation.com/files/583138/original/file-20240320-28-cw6l8h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/583138/original/file-20240320-28-cw6l8h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=316&fit=crop&dpr=1 600w, https://images.theconversation.com/files/583138/original/file-20240320-28-cw6l8h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=316&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/583138/original/file-20240320-28-cw6l8h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=316&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/583138/original/file-20240320-28-cw6l8h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=398&fit=crop&dpr=1 754w, https://images.theconversation.com/files/583138/original/file-20240320-28-cw6l8h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=398&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/583138/original/file-20240320-28-cw6l8h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=398&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Video still from ‘The Going Towards’ by Elisa Larvego, 2023. Images shows the end of the harbour that has been ‘protected’ from the refugees trying to reach the lorries.</span>
<span class="attribution"><a class="source" href="https://www.centrephotogeneve.ch/en/artist/elisa-larvego/">Elisa Larvego</a></span>
</figcaption>
</figure>
<p>I use the term “refugee” instead of the negative term of “migrant” because on the camps there are <a href="https://www.unhcr.org/uk/news/stories/unhcr-viewpoint-refugee-or-migrant-which-right">both categories</a>. But the people I met all sought refuge from desperate circumstances and should all be deserving of protection.</p>
<p>I wanted to see what was happening with my own eyes and speak with both volunteers and refugees: to hear their stories directly and gain a better understanding of these highly contentious border areas – all of which are linked to the highly <a href="https://www.theguardian.com/uk-news/2024/jan/29/uk-france-small-boats-pact-doubling-drownings-directly-linked">politicised migration argument</a> between France and the UK.</p>
<p>According to the UK government, in the year ending September 2023, <a href="https://www.gov.uk/government/statistics/irregular-migration-to-the-uk-year-ending-september-2023/irregular-migration-to-the-uk-year-ending-september-2023#:%7E:text=In%20the%20year%20ending%20September%202023%20there%20were%2037%2C556%20people,as%20shown%20in%20Figure%202">37,556 people arrived in the UK</a> in small boats which sailed from the northern coast of France. (There were 44,490 in 2022.)</p>
<p>According to Lascoux, in summer 2023, the population of Loon Plage fluctuated from around 300 in June to 2,000 in August, depending on appropriate weather conditions for attempting a crossing. These numbers were based on the number of meals that were distributed by Salam each day and Lascoux’s knowledge of the camp.</p>
<p>Since February 2003 and the <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/273239/6604.pdf">Touquet agreement</a>, the French and British governments have operated <a href="https://homeofficemedia.blog.gov.uk/2023/04/06/the-uks-juxtaposed-border-controls/">juxtaposed border controls</a>. In return for financial compensation, France agreed to take charge of border surveillance and the regulation of illegal migration flows. Then, 20 years later, at the 36th bilateral Franco-British summit in March 2023, the UK pledged <a href="https://france3-regions.francetvinfo.fr/hauts-de-france/pas-calais/calais/traversees-de-la-manche-londres-investit-541-millions-d-euros-pour-securiser-la-frontiere-2730574.html">€541 million</a> (around £460 million) to France over three years to curb illegal crossings into the UK – to stop the boats.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/letzWz7_Jqo?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>But it is not working. What I witnessed during my stay on the camps is that securing the borders does not prevent people from crossing – everyone crosses, it is just a matter of time. </p>
<p>Rather than stopping the boats the policy, which has seen the French police enforce “<a href="https://www.hrw.org/report/2021/10/07/enforced-misery/degrading-treatment-migrant-children-and-adults-northern-france">zero-fixation points</a>” to prevent refugees settling anywhere, has simply led to an increase in violence by the authorities. This, in turn, has made crossing <a href="https://alarmphone.org/en/2024/01/28/the-deadly-consequences-of-the-new-deal-to-stop-the-boats/?post_type_release_type=post">more costly, violent and dangerous</a>. But violence and danger were just a daily reality inside the camps, as I was to learn. </p>
<h2>Smugglers run the camps</h2>
<p>I soon realised that the Loon Plage was run by <a href="https://www.lavoixdunord.fr/1379909/article/2023-10-01/grande-synthe-ils-partent-en-prison-pour-une-quarantaine-de-passages-illegaux-en">Iraqi-Kurdish smugglers</a>, who have also infiltrated the town of <a href="https://webdoc.france24.com/france-first-humanitarian-camp-grande-synthe/">Grande Synthe</a> and have a monopoly on boat crossings on this part of the <a href="https://www.visitpasdecalais.com/">Pas de Calais</a> coast.</p>
<p>The mafia-like organisation they belong to is structured and runs quite smoothly. Permanent “staff” run the “shops”, maintain the camp and feed the refugees who have paid for an “all-inclusive” passage. These “permanents” are people who have decided to remain in the region to control who comes and goes. The shops are small stalls at the entrance of the camp where food and cigarettes are sold. Some people, whose families have sold everything or who have more financial means, will manage to pay for the whole journey from their country of origin to the UK. This category of people do not usually stay long in camps because their journey has already been negotiated and paid for from the outset.</p>
<p>The shops are sometimes used as payment points and also act as relays for <em>les petites mains</em>, or “little hands”, the ever-changing mafia workforce. The little hands include recruiters who generally work between Calais and Grande-Synthe to recruit refugees who have arrived alone and who want to make the crossing and the “organisers” who accompany each convoy of refugees on the beach on the night of the crossing and who stay with them while waiting for the boats.</p>
<p>I learned from my interviews that the smuggling network has many recruiters working from other towns and countries in Africa and in the Middle East. They also recruit refugees to pilot the boats. It is hard to find boat pilots, so at times they get paid in addition to getting a free crossing.</p>
<h2>The permanents</h2>
<p>So during our morning visits to the camp, Lascoux and I would talk to the permanents. They are exclusively men. When women are present they are often part of a family and they only transit via the camp – they never stay. The camp can be especially brutal for women travelling alone, so associations like <a href="https://www.dunkirkrefugeewomenscentre.com/">Refugee Women Centre</a> try to relocate them to refuge houses where they are safer like at the <a href="https://maisonsesame.org/">Maison Sésame</a> in the town of Hezeele, northern France. </p>
<p>In a supermarket trolley, which they normally use to transport belongings, the shop owners set up a wood fire and two large black cast-iron kettles and heat the water for the coffee on a blackened grate. The pungent smell from the fire is due to the hydro-alcoholic gel and plastic crates they use for fuel. They ask if we want to join them for a coffee. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/582208/original/file-20240315-18-ma9m6g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/582208/original/file-20240315-18-ma9m6g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/582208/original/file-20240315-18-ma9m6g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/582208/original/file-20240315-18-ma9m6g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/582208/original/file-20240315-18-ma9m6g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/582208/original/file-20240315-18-ma9m6g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/582208/original/file-20240315-18-ma9m6g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Camp coffee with the ‘permanents’.</span>
<span class="attribution"><span class="source">Sophie Watt</span></span>
</figcaption>
</figure>
<p>These men would often come and ask me to eat with them or join them for mugs of tea. It seems nice, but it is also to check out who I am and to figure out what I’m doing there. The shop “owners” and the little hands are suspicious of everyone. </p>
<p>Human trafficking brings in huge sums of money for smugglers operating out of Paris, London and even Baghdad. But the fact that I’m volunteering for Salam to distribute meals quells some of their suspicions. As does the fact that I’m with Lascoux, who regularly brings wood, tents, blankets and clothes.</p>
<h2>The crossings</h2>
<p>There is little freedom in the camp and each refugee is attached to a recruiter, who works for one or two smugglers. The traffickers have claimed different parts of the beaches along the coast and compete with each other in order to gain more custom. Once the refugees have paid their passage (between €800 and €4,500, depending on their nationality), the smuggler allocates them a convoy “team” which often waits in the woods near the beach for several days before attempting to cross. Kevin, from Guinea, who tried to cross while I was there and whom I interviewed both in Calais and when he arrived in the UK, told me:</p>
<blockquote>
<p>There were 55 people in my convoy and in the forest there were more than 250 people who waited for four days because there were five smugglers who had their group. In our group, there were women and children too, and we had nothing to eat for four days. It was raining, the weather was bad and the waves were rough. One of the boats overturned on departure.</p>
</blockquote>
<p>Many families and children transit via Loon Plage rather than Calais, where conditions are even more harsh due to more frequent police evacuations. DM Boss said:</p>
<blockquote>
<p>I tried three times to cross but only paid once. Each time we were waiting in the woods for hours and even days before the crossing.</p>
</blockquote>
<p>At each stage, the refugees are surrounded by the little hands, different teams for different places, who keep an eye on them and tell them what to do. The convoys are also infiltrated by the gangs to ensure that the refugees are not working for the police or informing journalists. </p>
<p>As in Loon Plage, the convoys mix nationalities and therefore prices. Sub-Saharan Africans pay less (between €800 and €1,200) than the Vietnamese or Albanians, who can pay up to €4,500 and who have arrived in the north of France as part of their own smuggling networks. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/582209/original/file-20240315-16-s9emcw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/582209/original/file-20240315-16-s9emcw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/582209/original/file-20240315-16-s9emcw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/582209/original/file-20240315-16-s9emcw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/582209/original/file-20240315-16-s9emcw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/582209/original/file-20240315-16-s9emcw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/582209/original/file-20240315-16-s9emcw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A young refugee walking with all his belongings in a shopping trolley.</span>
<span class="attribution"><span class="source">Sophie Watt</span></span>
</figcaption>
</figure>
<p>There are few sub-Saharan Africans at Loon Plage and they are often recruited as the boat pilots or as recruiters, as this pays for the crossing. Making sure that a group of sub-Saharan Africans gets on board, despite the fact that they can usually only afford minimum price, allows the pilot to remain unidentified once in Dover. The pilot is often therefore a refugee who did not have any other means to pay for the crossing and who has very limited experience in steering boats.</p>
<p>This network of people trafficking can only exist and be extremely lucrative because the French and the British governments have not agreed to establish safe passages between France and the UK and are determined to invest in “securing” the border instead.</p>
<h2>The sound of gunfire</h2>
<p>It was difficult to get close to refugees in the camp because being seen talking to me could put them at risk. A few of the interviews I undertook with refugees I met in the camp took place in the UK once they had crossed. </p>
<p>Each talked about the <a href="https://www.liberation.fr/societe/flambee-de-violences-a-loon-plage-des-migrants-a-la-merci-des-reseaux-20220916_L2TWS6SD35BUNHXFWL7X27N6OM/">violence</a> at night and the fact that the Kurdish mafia is heavily armed. While on the camp I heard gunshots several times and was told they were “just shooting rats”. DM Boss, who stayed at Loon Plage for two months, confessed:</p>
<blockquote>
<p>I could not sleep in the tent at night, I had to get out and wait in the woods because in the evenings once the NGOs and charities are gone the smugglers and little hands talk and argue and get their guns out; so I used to wait until they went to sleep.</p>
</blockquote>
<p>In May 2022, two Iraqi men <a href="https://www.lavoixdunord.fr/1184033/article/2022-05-24/grande-synthe-un-homme-tue-par-balle-et-un-autre-blesse-pres-d-un-camp-de">were shot</a> in the camp and one died from his wounds. In February 2023 another Iraqi man <a href="https://france3-regions.francetvinfo.fr/hauts-de-france/nord-0/dunkerque/un-blesse-grave-par-balle-dans-le-camp-de-migrants-de-loon-plage-2713962.html">was shot</a> and seriously injured. Many more incidents go unreported. </p>
<p>The Kurdish network is renowned for its efficacy, but due to the increasing police presence on the beaches, they are starting to take more risks. The coordinator of the charity Utopia 56 Grande Synthe, Fabien Touchard, explained that police violence has gradually moved from the camp to the beaches at night because it is harder for the associations (mainly <a href="https://utopia56.org/grande-synthe-3/">Utopia 56</a> and <a href="https://www.helloasso.com/associations/osmose-62">Osmose 62</a>) to witness everything that happens along the coast as far as Belgium. </p>
<p>Smugglers are taking risks with the lives of refugees, by forcing them in ever more dangerous numbers on to boats which cannot handle them in order to escape the French police. In fact, in the year ending September 2023, there was <a href="https://www.gov.uk/government/statistics/irregular-migration-to-the-uk-year-ending-september-2023/irregular-migration-to-the-uk-year-ending-september-2023">an average of</a> 48 people per small boat, which was higher than the previous year (37) and much higher than earlier years – in 2020 there were 13 per small boat, in 2019 11 and in 2018 the number was seven.</p>
<p>The boat crossings have become better organised, as risk levels have increased. For example, <a href="https://wedodata.fr/productions/lesjours-morts-calais/">397 refugees</a> have died since 1999 trying to cross the Franco-British border. And in one single incident on November 24, 2021, <a href="https://www.lepoint.fr/societe/calais-5-migrants-meurent-dans-un-naufrage-darmanin-sur-place-24-11-2021-2453649_23.php#11">27 refugees drowned</a>. Just after I left Calais, on August 12, <a href="https://www.nordlittoral.fr/182172/article/2023-08-13/six-nouveaux-morts-en-mer-et-des-disparus-au-large-de-calais-retour-sur-la">six people died</a> at sea, while on January 14 2024 <a href="https://calaismigrantsolidarity.wordpress.com/deaths-at-the-calais-border/">four Syrian refugees</a> (two young men and two children) were killed attempting a crossing.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/582210/original/file-20240315-30-ebnnj2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/582210/original/file-20240315-30-ebnnj2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/582210/original/file-20240315-30-ebnnj2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/582210/original/file-20240315-30-ebnnj2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/582210/original/file-20240315-30-ebnnj2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/582210/original/file-20240315-30-ebnnj2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/582210/original/file-20240315-30-ebnnj2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Graffiti in Loon Plage, near the railway line.</span>
<span class="attribution"><span class="source">Sophie Watt</span></span>
</figcaption>
</figure>
<p>The most recent victim is a seven-year-old girl, named Roula, <a href="https://news.sky.com/story/they-dont-see-us-as-humans-familys-anger-at-people-smugglers-after-daughter-dies-in-boat-tragedy-13089652">who died</a> while crossing the Channel with her pregnant mother, father and her three siblings.</p>
<p>More frequent boat crossings began in 2018 after a few successful attempts were made in 2017 following the dismantlement of the Calais Jungle in 2016. They gradually replaced the crossings in lorries which had become too dangerous and almost impossible due to new technology employed by border police.</p>
<h2>Night patrols and ‘taxi boats’</h2>
<p>I patrolled the coast around Boulogne-Sur-Mer at night with <a href="https://www.facebook.com/p/Association-Osmose62-100085195519283/">Osmose 62</a>. Charity founders and volunteers Dany Patous and Olivier Moctar Barbès patrol the coast most nights before going to work. They explained how the smugglers were changing their techniques to adjust to the increased policing. The latest technique is called “taxi boat”. </p>
<p>Instead of awaiting pick-up on the beach, refugees are told to wait in the water at different locations along the coast to stop the police from chasing them. The boats then pick up the groups at sea the same night, and end up cramming in more people and taking longer, more perilous routes to Dover.</p>
<p>The night patrols, or <em>marauds</em>, are surreal. Walking through a ghost town at night, along small roads, along the coast, as well as car parks near beaches; being on the lookout for any signs of refugees and on constant alert for the police.</p>
<p>For me it was high in adrenaline and emotion because the objective was to help refugees who had failed to cross, while at the same time making sure not to reveal their presence to the authorities.</p>
<p>Before I arrived at the rendezvous point at 4am I saw a big group of refugees roaming the streets of Boulogne and I told Barbès. It was then impossible to find them again. Barbès said: “They have learned the art of making themselves invisible because of the chase with the police forces.” After patrolling the town, we drove along the coast and stopped at different beaches where we met a group of French police. They asked us for ID and told us that they were looking for a large group that was hiding in the nearby woods.</p>
<p>That night, we stopped for a group of young Syrian men who needed hot drinks and food before going back to Calais on foot. </p>
<p>Later, we watched as 40 people crammed on a small inflatable zodiac boat leaving the coast in the early hours of the morning at around 6am. We arrived just after the boat had left but the police officers present, who had not bothered chasing them, told us that the departure had been chaotic with women and children shouting. The boat had a problem with the motor and was progressing slowly in circles. It looked so flimsy and so small and was taking so long to reach the open sea that one of the police officers said that they would never make it. </p>
<p>This boat was later rescued by the coastguard because it had started sinking. They did not reach British waters this time. According to the refugees I interviewed and some volunteers, departures are extremely traumatic, because they are all fighting to get on board as quickly as possible when there is not enough space to accommodate everyone. Marie, from <a href="https://www.osrefugeeaidteam.org/projects/refugee-womens-centre-rwc/">Refugee Women Center</a>, said: </p>
<blockquote>
<p>It is not uncommon for the little hands to throw women overboard when the boat is too crowded. </p>
</blockquote>
<p>And DM Boss told me: “I retrieved a little boy by the leg while he was being stepped on by people jumping on board.”</p>
<p>When I was in Calais I met a Sudanese refugee, a professor in political science at the University of Khartoum, with his nine-month-old baby. They had been separated from the baby’s mother and the couple’s two other children while trying to get on board a boat. He was caught by the police and had been prevented from crossing with the rest of his family. He has been staying in a refuge house ever since and has tried to cross with his baby dozens of times with no success, while his wife and other two boys are near London. </p>
<h2>The many jungles of Calais</h2>
<p>Many refugees travel between Calais and Loon Plage in order to negotiate their crossing. In Calais I interviewed around 20 volunteers and refugees in safe places but I could only interview one refugee away from the camp in Grande-Synthe and a few others in my car. </p>
<p>Since the dismantling of the big jungle, the mayor of Calais, Natasha Bouchard, has tried everything to deter refugees from arriving in the region to the extent that she managed to obtain the right to <a href="https://www.infomigrants.net/fr/post/34530/calais--larrete-interdisant-la-distribution-de-repas-aux-migrants-de-nouveau-reconduit">forbid food and water distribution</a> in September 2020. Partly because of this more arduous environment, the “jungles” in Calais are smaller and usually populated by younger men and teenagers. </p>
<p>The camps are grouped by nationality, which means that the tensions are not always as high as in Loon Plage. I informally talked with a few Afghan people who had to leave Afghanistan because they had been working for the British and American forces as translators and saw their lives put at risk after the <a href="https://www.theguardian.com/world/2023/feb/10/thousands-of-afghans-who-helped-british-forces-remain-stranded-by-uk">recent withdrawal</a> of the British forces in the region.</p>
<p>I managed to interview five people from Guinea, Chad, Iran and Sudan and found a smaller camp of Francophone Africans within the Sudanese camp who did not want to be interviewed but who were proud to show me their survival skills. They were cooking when I arrived and although their tents were deep in mud they had managed to build a common area for eating with a roof made of wood and recycled tent material. </p>
<p>Most of these young men, aged between 15 and 25, had been through Ceuta or Melilla together (Spanish enclaves in Morocco) where the living conditions were even more dangerous and precarious than on the French northern border and they were talking about their journey through Morocco like they were war veterans. They had managed to climb over the three six-metre high border fences despite being wounded and under attack from both the Moroccan and Spanish police forces. They were proud and felt invincible and spoke like an army of child soldiers ready to conquer the world. </p>
<h2>Kevin’s journey</h2>
<p>Kevin, who is from Nzérékoré, a city in Guinea’s south-eastern forest region, took me to his camp after our first interview in my car. He was proud to show me that they had built a “Francophone corner” within the Sudanese camp. He introduced me to all his friends one by one who shook my hand and asked me if I wanted to stay and eat with them. They were all from different parts of West Africa – Burkina-Faso, Cameroon, Guinea, Ivory Coast – and they were proud of their journey, but were tired of staying in Calais where they had been for several months. Kevin said:</p>
<blockquote>
<p>I managed to climb the three walls in Ceuta with a broken hand after seven years on the road and in the desert going through Mali, Algeria, Libya, Tunisia and Morocco. I should have stayed in Spain but I needed to try for the UK. </p>
</blockquote>
<p>Kevin said he came from a beautiful country, though from a <a href="https://www.hrw.org/report/2020/09/25/they-let-people-kill-each-other/violence-nzerekore-during-guineas-constitutional">persecuted ethnic group</a>; he is from the Guerzé tribe. He told me he “had to eat stale bread and cheap jam and live in a mud bath in the north of France while France was exploiting natural resources in his country”. And yet because his country is not at war, despite the most recent <a href="https://www.reuters.com/world/africa/least-two-killed-guinea-anti-junta-protests-eve-coup-anniversary-2023-09-05/">military coups</a>, it was difficult for him to make a case for political asylum in France.</p>
<p>When I first spoke to him, Kevin and his “crew” had just survived another eviction. They had managed to hide their belongings along the railway tracks within the Sudanese camp. Kevin remembers suffering from the effects of “tear gas that had been launched inside the tent” a few weeks earlier. </p>
<blockquote>
<p>I was asleep when they sprayed tear gas inside the tent and my lungs burnt for hours afterwards. I could not use the covers I had because of the smell. This smell is impossible to get rid off so I had to find another blanket.</p>
</blockquote>
<p>The mayor’s policy since 2008 is <a href="https://www.revolutionpermanente.fr/Calais-la-mairie-depose-des-rochers-sur-les-quais-pour-empecher-les-refugies-de-s-installer">ruthless and relentless</a>: evacuated every two days and chased from any public spaces, the refugees are mentally and physically exhausted.</p>
<p>“We try crossing by trucks or by boats every night so during the day we sleep but the police usually come and force you out of your tent. You have to be quick and get all your papers with you otherwise everything is destroyed. It is scary”, said Kevin. </p>
<p>Mostly from sub-Saharan Africa, refugees in Calais often don’t have the financial means to pay for a crossing with the Kurdish mafia and thus access the Calais network of smugglers who are mostly Sudanese and North-African and who are less organised and less reliable because they use cheaper, poor quality boats and motors. Kevin told me:</p>
<blockquote>
<p>This network is a lot less safe than the Kurdish one and if you fail the crossing they often keep your money.</p>
</blockquote>
<p>Kevin negotiated his passage from €1,200 to €800 with Kurdish smugglers. It took him four months to make the money he needed because he told me: “I could not work as recruiter for them because all my friends are poor, they could not pay the crossing, so I had to do small jobs to save that money.” Kevin finally crossed in August 2023 with a convoy of people which left from the beach called Graveline. They had to wait for four days before setting off.</p>
<blockquote>
<p>The weather was horrendous, the wind was very strong and another boat capsized under my eyes. I am still scarred from the crossing, the sea was so dangerous, I don’t think I will ever go back on a boat in my life. Everyone was shouting and crying especially the women and the children who were terrified because of the waves. Somebody wanted to jump and we had to stop him and someone else fell in the water, we just had time to catch him and drag him back on the boat. I stayed at the front of the boat with my friend and a lot of us wanted to go back, we were terrified. </p>
</blockquote>
<h2>Brutal evacuations</h2>
<p>Every evacuation is brutal and dehumanises the refugees a little more. Apparently, the process of dehumanisation justifies <a href="https://basta.media/controle-aux-frontieres-migrants-exiles-Calais-Briancon-couts-de-la-repression-bunkerisation-militarisation-Darmanin">the costly</a> daily harassment of refugees that was heavily criticised by the <a href="https://www.defenseurdesdroits.fr/sites/default/files/2023-10/ddd_rapport_droits-fondamentaux-etrangers_3ans-apres-calais_synthese_20181207.pdf">UN Special Rapporters in 2018</a>.</p>
<p>When I was in Loon Plage, the camp had not been evacuated for a month. One morning, I witnessed the camp evacuating itself because people could not stand the anticipation of the police forces coming to dismantle the camp. I arrived at 7am only to see a long line of people pushing supermarket trolleys full of their belongings to another part of the industrial zone along the canal.</p>
<p>They had internalised the process so much that it was just easier to “self-evacuate” instead of living with the anxiety of the police arriving in the early hours of the morning. When I asked one refugee why he was moving everything he said: </p>
<blockquote>
<p>I cannot stand it anymore. I am too tired, every morning I think they are going to come and they don’t come. I am moving so I can sleep better.</p>
</blockquote>
<p>The evacuations are performative in the sense they fulfil the role the French government plays in order to justify the sums of money being <a href="https://edition.cnn.com/2023/03/11/europe/uk-france-illegal-immigration-funding-intl-hnk/index.html">paid by the UK government</a> to secure the border – despite the fact most refugees come back to the exact same settlements after the evacuation and will cross eventually.</p>
<p>A <a href="https://www.lemonde.fr/en/france/article/2023/12/20/what-s-in-france-s-controversial-immigration-law_6361995_7.html">new anti-immigration law</a> passed by the French parliament on December 19 2023 will do little to ease the climate of suspicion and fear which surrounds the refugee debate in both the UK and France. </p>
<p>But nobody I spoke to would be deterred; not by the brutal camp evacuations; the fear of smuggling gangs, the terror of the crossings, or even the <a href="https://theconversation.com/rwanda-asylum-deportation-plan-faces-more-delays-how-did-we-get-here-226209">promise of a flight to Rwanda</a> once landing in the UK. If anything, the violence and lack of hospitality at the French border which represent unprecedented breaches
of fundamental rights of refugees further motivates people to cross. As DM Boss told me: “I could not live in the jungle any longer, I was determined to come to the UK. I had to try.”</p>
<hr>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em>For you: more from our <a href="https://theconversation.com/uk/topics/insights-series-71218?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insights series</a>:</em></p>
<ul>
<li><p><em><a href="https://theconversation.com/gp-crisis-how-did-things-go-so-wrong-and-what-needs-to-change-208197?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">GP crisis: how did things go so wrong, and what needs to change?</a></em></p></li>
<li><p><em><a href="https://theconversation.com/would-better-buildings-help-fix-the-nhs-the-story-of-britains-hospitals-from-grand-designs-to-counting-the-costs-208090?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Would better buildings help fix the NHS? The story of Britain’s hospitals, from grand designs to counting the costs</a></em></p></li>
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<li><p><em><a href="https://theconversation.com/insomnia-how-chronic-sleep-problems-can-lead-to-a-spiralling-decline-in-mental-health-224131?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insomnia: how chronic sleep problems can lead to a spiralling decline in mental health
</a></em></p></li>
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<p><em>To hear about new Insights articles, join the hundreds of thousands of people who value The Conversation’s evidence-based news. <a href="https://theconversation.com/uk/newsletters/the-daily-newsletter-2?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK"><strong>Subscribe to our newsletter</strong></a>.</em></p><img src="https://counter.theconversation.com/content/221798/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sophie Watt receives funding from the BA Leverhulme Small Grants and HEIF from the University fo Sheffield.</span></em></p>Despite the relentless hardships and suffering, one thing appeared to unite the refugees I met: they wanted to seek sanctuary in the UK, no matter what.Sophie Watt, Lecturer, School of Languages and Cultures, University of SheffieldLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2247622024-03-10T21:21:08Z2024-03-10T21:21:08Z‘I couldn’t stand the pain’: the Turkish holiday resort that’s become an emergency dental centre for Britons who can’t get treated at home<figure><img src="https://images.theconversation.com/files/579159/original/file-20240301-30-8ug5he.jpg?ixlib=rb-1.1.0&rect=48%2C175%2C3977%2C2631&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">This clinic in the Turkish resort of Antalya is the official 'dental sponsor' of the Miss England competition.</span> <span class="attribution"><span class="source">Diana Ibanez-Tirado</span>, <span class="license">Author provided</span></span></figcaption></figure><p>It’s a hot summer day in the Turkish city of Antalya, a Mediterranean resort with golden beaches, deep blue sea and vibrant nightlife. The pool area of the all-inclusive resort is crammed with British people on sun loungers – but they aren’t here for a holiday. This hotel is linked to a dental clinic that organises treatment packages, and most of these guests are here to see a dentist.</p>
<p>From Norwich, two women talk about gums and injections. A man from Wales holds a tissue close to his mouth and spits blood – he has just had two molars extracted. </p>
<p>The dental clinic organises everything for these dental “tourists” throughout their treatment, which typically lasts from three to 15 days. The stories I hear of what has caused them to travel to Turkey are strikingly similar: all have struggled to secure dental treatment at home on the NHS.</p>
<p>“The hotel is nice and some days I go to the beach,” says Susan*, a hairdresser in her mid-30s from Norwich. “But really, we aren’t tourists like in a proper holiday. We come here because we have no choice. I couldn’t stand the pain.”</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/580169/original/file-20240306-16-nf8w7v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Seaside beach resort with mountains in the distance" src="https://images.theconversation.com/files/580169/original/file-20240306-16-nf8w7v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/580169/original/file-20240306-16-nf8w7v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=224&fit=crop&dpr=1 600w, https://images.theconversation.com/files/580169/original/file-20240306-16-nf8w7v.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=224&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/580169/original/file-20240306-16-nf8w7v.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=224&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/580169/original/file-20240306-16-nf8w7v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=281&fit=crop&dpr=1 754w, https://images.theconversation.com/files/580169/original/file-20240306-16-nf8w7v.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=281&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/580169/original/file-20240306-16-nf8w7v.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=281&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The Turkish Mediterranean resort of Antalya.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/panoramic-views-antalya-mediterranean-coast-beach-1828642082">Akimov Konstantin/Shutterstock</a></span>
</figcaption>
</figure>
<p>This is Susan’s second visit to Antalya. She explains that her ordeal started two years earlier:</p>
<blockquote>
<p>I went to an NHS dentist who told me I had gum disease … She did some cleaning to my teeth and gums but it got worse. When I ate, my teeth were moving … the gums were bleeding and it was very painful. I called to say I was in pain but the clinic was not accepting NHS patients any more.</p>
</blockquote>
<p>The only option the dentist offered Susan was to register as a private patient:</p>
<blockquote>
<p>I asked how much. They said £50 for x-rays and then if the gum disease got worse, £300 or so for extraction. Four of them were moving – imagine: £1,200 for losing your teeth! Without teeth I’d lose my clients, but I didn’t have the money. I’m a single mum. I called my mum and cried.</p>
</blockquote>
<p>Susan’s mother told her about a friend of hers who had been to Turkey for treatment, then together they found a suitable clinic:</p>
<blockquote>
<p>The prices are so much cheaper! Tooth extraction, x-rays, consultations – it all comes included. The flight and hotel for seven days cost the same as losing four teeth in Norwich … I had my lower teeth removed here six months ago, now I’ve got implants … £2,800 for everything – hotel, transfer, treatments. I only paid the flights separately.</p>
</blockquote>
<p>In the UK, roughly half the adult population suffers from <a href="https://cks.nice.org.uk/topics/gingivitis-periodontitis/background-information/prevalence/">periodontitis</a> – inflammation of the gums caused by plaque bacteria that can lead to irreversible loss of gums, teeth, and bone. Regular reviews by a dentist or hygienist are required to manage this condition. But <a href="https://www.bbc.co.uk/news/health-66167563">nine out of ten dental practices</a> cannot offer NHS appointments to new adult patients, while <a href="https://www.bda.org/media-centre/ministers-remain-asleep-at-wheel-as-child-oral-health-gap-widens/">eight in ten are not accepting new child patients</a>.</p>
<p>Some UK dentists argue that <a href="https://aestheticmed.co.uk/site/shownewsdetails/turkey-teeth-trend-dental-professor-warning">Britons who travel abroad for treatment</a> do so mainly for cosmetic procedures. They warn that dental tourism is dangerous, and that if their treatment goes wrong, dentists in the UK <a href="https://www.manchestereveningnews.co.uk/news/health/real-reason-dentists-uk-wont-24577766">will be unable to help</a> because they don’t want to be <a href="https://www.walesonline.co.uk/news/uk-news/dental-tourists-warned-broken-nhs-26651354">responsible for further damage</a>. Susan shrugs this off:</p>
<blockquote>
<p>Dentists in England say: ‘If you go to Turkey, we won’t touch you [afterwards].’ But I don’t worry because there are no appointments at home anyway. They couldn’t help in the first place, and this is why we are in Turkey.</p>
</blockquote>
<h2>‘How can we pay all this money?’</h2>
<p>As a social anthropologist, I travelled to Turkey a number of times in 2023 to investigate <a href="https://profiles.sussex.ac.uk/p338901-diana-ibanez-tirado">the crisis of NHS dentistry</a>, and the journeys abroad that UK patients are increasingly making as a result. I have relatives in Istanbul and have been researching <a href="https://www.tandfonline.com/doi/full/10.1080/02634937.2022.2076654">migration</a> and <a href="https://www.tandfonline.com/doi/full/10.1080/02634937.2020.1716687">trading</a> patterns in Turkey’s largest city since 2016.</p>
<p>In August 2023, I visited the resort in Antalya, nearly 400 miles south of Istanbul. As well as Susan, I met a group from a village in Wales who said there was no provision of NHS dentistry back home. They had organised a two-week trip to Turkey: the 12-strong group included a middle-aged couple with two sons in their early 20s, and two couples who were pensioners. By going together, Anya tells me, they could support each other through their different treatments:</p>
<blockquote>
<p>I’ve had many cavities since I was little … Before, you could see a dentist regularly – you didn’t even think about it. If you had pain or wanted a regular visit, you phoned and you went … That was in the 1990s, when I went to the dentist maybe every year.</p>
</blockquote>
<p>Anya says that once she had children, her family and work commitments meant she had no time to go to the dentist. Then, years later, she started having serious toothache:</p>
<blockquote>
<p>Every time I chewed something, it hurt. I ate soups and soft food, and I also lost weight … Even drinking was painful – tea: pain, cold water: pain. I was taking paracetamol all the time! I went to the dentist to fix all this, but there were no appointments.</p>
</blockquote>
<p>Anya was told she would have to wait months, or find a dentist elsewhere:</p>
<blockquote>
<p>A private clinic gave me a list of things I needed done. Oh my God, almost £6,000. My husband went too – same story. How can we pay all this money? So we decided to come to Turkey. Some people we know had been here, and others in the village wanted to come too. We’ve brought our sons too – they also need to be checked and fixed. Our whole family could be fixed for less than £6,000.</p>
</blockquote>
<p>By the time they travelled, Anya’s dental problems had turned into a dental emergency. She says she could not live with the pain anymore, and was relying on paracetamol.</p>
<p>In 2023, about <a href="https://www.dentalhealth.org/oral-health-statistics#:%7E:text=Almost%20one%20in%20three%20(31%25)%20of%20adults%20have%20tooth%20decay.">6 million adults</a> in the UK experienced protracted pain (lasting more than two weeks) caused by toothache. Unintentional paracetamol overdose due to dental pain is a significant cause of <a href="https://www.nature.com/articles/sj.bdj.2015.706#:%7E:text=Forty%2Deight%20(41%25)%20of,further%20oral%20and%20maxillofacial%20referral.">admissions to acute medical units</a>. If left untreated, tooth infections can spread to other parts of the body and cause <a href="https://www.healthline.com/health/dental-and-oral-health/how-long-until-a-tooth-infection-kills-you#how-long">life-threatening complications</a> – and on rare occasions, death.</p>
<p>In February 2024, police were called to manage hundreds of people queuing outside a <a href="https://www.theguardian.com/society/2024/feb/05/queue-new-nhs-dental-practice-bristol-st-pauls">newly opened dental clinic in Bristol</a>, all hoping to be registered or seen by an NHS dentist. One in ten Britons <a href="https://yougov.co.uk/politics/articles/45450-one-ten-britons-have-performed-dentistry-themselve?redirect_from=%2Ftopics%2Fpolitics%2Farticles-reports%2F2023%2F03%2F22%2Fone-ten-britons-have-performed-dentistry-themselve">have admitted</a> to performing <a href="https://dentistry.co.uk/2024/02/05/diy-dentistry-rampant-across-the-uk-bda-warns/#:%7E:text=The%20respondents%20also%20reported%20cases,to%20construct%20their%20own%20dentures.">“DIY dentistry”</a>, of which 20% did so because they could not find a timely appointment. This includes people pulling out their teeth with pliers and using superglue to repair their teeth.</p>
<p>In the 1990s, dentistry was almost entirely provided through NHS services, with only around <a href="https://dentistry.co.uk/2022/06/05/a-brief-history-of-private-dentistry/">500 solely private dentists</a> registered. Today, NHS dentist numbers in England are at their <a href="https://www.theguardian.com/society/2023/may/23/nhs-dentist-numbers-in-england-at-lowest-level-in-a-decade">lowest level in a decade</a>, with <a href="https://www.nature.com/articles/s41415-023-6048-6">23,577 dentists</a> registered to perform NHS work in 2022-23, down 695 on the previous year. Furthermore, the precise division of <a href="https://publications.parliament.uk/pa/cm5803/cmselect/cmhealth/964/report.html">NHS and private work</a> that each dentist provides is not measured.</p>
<p>The COVID pandemic created longer waiting lists for NHS treatment in an already stretched public service. In Bridlington, Yorkshire, people are now reportedly having to wait <a href="https://www.bbc.co.uk/news/articles/cn49lp8y57eo">eight-to-nine years</a> to get an NHS dental appointment with the only remaining NHS dentist in the town.</p>
<p>In his book <a href="https://www.dukeupress.edu/Patients-of-the-State/">Patients of the State</a> (2012), Argentine sociologist Javier Auyero describes the “indignities of waiting”. It is the poor who are mostly forced to wait, he writes. Queues for state benefits and public services constitute a tangible form of power over the marginalised. There is an ethnic dimension to this story, too. Data suggests that in the UK, patients less likely to be effective in booking an NHS dental appointment are <a href="https://www.ethnicity-facts-figures.service.gov.uk/health/patient-experience/access-to-nhs-dental-services/latest/#:%7E:text=patients%20most%20likely%20to%20report,consistently%20above%20the%20national%20average">non-white ethnic groups and Gypsy or Irish travellers</a>, and that it is particularly <a href="https://www.bmh.manchester.ac.uk/stories/dental-care-for-refugees/">challenging for refugees and asylum-seekers</a> to access dental care. </p>
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<img alt="" src="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
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<p>In 2022, I experienced my own dental emergency. An infected tooth was causing me debilitating pain, and needed root canal treatment. I was advised this would cost £71 on the NHS, plus £307 for a follow-up crown – but that I would have to wait months for an appointment. The pain became excruciating – I could not sleep, let alone wait for months. In the same clinic, privately, I was quoted £1,300 for the treatment (more than half my monthly income at the time), or £295 for a tooth extraction.</p>
<p>I did not want to lose my tooth because of lack of money. So I bought a flight to Istanbul immediately for the price of the extraction in the UK, and my tooth was treated with root canal therapy by a private dentist there for £80. Including the costs of travelling, the total was a third of what I was quoted to be treated privately in the UK. Two years on, my treated tooth hasn’t given me any more problems.</p>
<h2>A better quality of life</h2>
<p>Not everyone is in Antalya for emergency procedures. The pensioners from Wales had contacted numerous clinics they found on the internet, comparing prices, treatments and hotel packages at least a year in advance, in a carefully planned trip to get <a href="https://www.guysandstthomas.nhs.uk/health-information/dental-implants">dental implants</a> – artificial replacements for tooth roots that help support dentures, crowns and bridges.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/579163/original/file-20240301-17-u7eeb1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Street view of a dental clinic in Antalya, Turkey" src="https://images.theconversation.com/files/579163/original/file-20240301-17-u7eeb1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/579163/original/file-20240301-17-u7eeb1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=800&fit=crop&dpr=1 600w, https://images.theconversation.com/files/579163/original/file-20240301-17-u7eeb1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=800&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/579163/original/file-20240301-17-u7eeb1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=800&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/579163/original/file-20240301-17-u7eeb1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1005&fit=crop&dpr=1 754w, https://images.theconversation.com/files/579163/original/file-20240301-17-u7eeb1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1005&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/579163/original/file-20240301-17-u7eeb1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1005&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Dental clinic in Antalya, Turkey.</span>
<span class="attribution"><span class="source">Diana Ibanez-Tirado</span>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
</figcaption>
</figure>
<p>In Turkey, all the dentists I speak to (most of whom cater mainly for foreigners, including UK nationals) consider implants not a cosmetic or luxurious treatment, but a development in dentistry that gives patients who are able to have the procedure a much better quality of life. This procedure is not available on the NHS for most of the UK population, and the patients I meet in Turkey could not afford implants in private clinics back home.</p>
<p>Paul is in Antalya to replace his dentures, which have become uncomfortable and irritating to his gums, with implants. He says he couldn’t find an appointment to see an NHS dentist. His wife Sonia went through a similar procedure the year before and is very satisfied with the results, telling me: “Why have dentures that you need to put in a glass overnight, in the old style? If you can have implants, I say, you’re better off having them.”</p>
<p>Most of the dental tourists I meet in Antalya are white British: this city, known as the Turkish Riviera, has developed an entire economy catering to English-speaking tourists. In 2023, more than <a href="https://www.hurriyetdailynews.com/record-number-of-tourists-visit-antalya-last-year-189281#:%7E:text=British%20visitors%20increased%20by%2014.85,also%20among%20the%20foreign%20holidaymakers.">1.3 million people</a> visited the city from the UK, up almost 15% on the previous year.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/nhs-dentistry-is-in-crisis-are-overseas-dentists-the-answer-223842">NHS dentistry is in crisis – are overseas dentists the answer?</a>
</strong>
</em>
</p>
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<p>In contrast, the Britons I meet in Istanbul are predominantly from a non-white ethnic background. Omar, a pensioner of Pakistani origin in his early 70s, has come here after waiting “half a year” for an NHS appointment to fix the dental bridge that is causing him pain. Omar’s son had been previously for a hair transplant, and was offered a free dental checkup by the same clinic, so he suggested it to his father. Having worked as a driver for a manufacturing company for two decades in Birmingham, Omar says he feels disappointed to have contributed to the British economy for so long, only to be “let down” by the NHS:</p>
<blockquote>
<p>At home, I must wait and wait and wait to get a bridge – and then I had many problems with it. I couldn’t eat because the bridge was uncomfortable and I was in pain, but there were no appointments on the NHS. I asked a private dentist and they recommended implants, but they are far too expensive [in the UK]. I started losing weight, which is not a bad thing at the beginning, but then I was worrying because I couldn’t chew and eat well and was losing more weight … Here in Istanbul, I got dental implants – US$500 each, problem solved! In England, each implant is maybe £2,000 or £3,000.</p>
</blockquote>
<p>In the waiting area of another clinic in Istanbul, I meet Mariam, a British woman of Iraqi background in her late 40s, who is making her second visit to the dentist here. Initially, she needed root canal therapy after experiencing severe pain for weeks. Having been quoted £1,200 in a private clinic in outer London, Mariam decided to fly to Istanbul instead, where she was quoted £150 by a dentist she knew through her large family. Even considering the cost of the flight, Mariam says the decision was obvious:</p>
<blockquote>
<p>Dentists in England are so expensive and NHS appointments so difficult to find. It’s awful there, isn’t it? Dentists there blamed me for my rotten teeth. They say it’s my fault: I don’t clean or I ate sugar, or this or that. I grew up in a village in Iraq and didn’t go to the dentist – we were very poor. Then we left because of war, so we didn’t go to a dentist … When I arrived in London more than 20 years ago, I didn’t speak English, so I still didn’t go to the dentist … I think when you move from one place to another, you don’t go to the dentist unless you are in real, real pain.</p>
</blockquote>
<p>In Istanbul, Mariam has opted not only for the urgent root canal treatment but also a longer and more complex treatment suggested by her consultant, who she says is a renowned doctor from Syria. This will include several extractions and implants of back and front teeth, and when I ask what she thinks of achieving a “Hollywood smile”, Mariam says:</p>
<blockquote>
<p>Who doesn’t want a nice smile? I didn’t come here to be a model. I came because I was in pain, but I know this doctor is the best for implants, and my front teeth were rotten anyway.</p>
</blockquote>
<p>Dentists in the UK warn about the <a href="https://aestheticmed.co.uk/site/featuresdetails/turkey-teeth-trend-dental-professor-warning">risks of “overtreatment”</a> abroad, but Mariam appears confident that this is her opportunity to solve all her oral health problems. Two of her sisters have already been through a similar treatment, so they all trust this doctor.</p>
<figure class="align-Reception area for an Istanbul dental clinic zoomable">
<a href="https://images.theconversation.com/files/579164/original/file-20240301-26-ffkey3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Alt text" src="https://images.theconversation.com/files/579164/original/file-20240301-26-ffkey3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/579164/original/file-20240301-26-ffkey3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/579164/original/file-20240301-26-ffkey3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/579164/original/file-20240301-26-ffkey3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/579164/original/file-20240301-26-ffkey3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/579164/original/file-20240301-26-ffkey3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/579164/original/file-20240301-26-ffkey3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">An Istanbul clinic founded by Afghan dentists has a message for its UK customers.</span>
<span class="attribution"><span class="source">Diana Ibanez-Tirado</span>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
</figcaption>
</figure>
<h2>The UK’s ‘dental deserts’</h2>
<p>To get a fuller understanding of the NHS dental crisis, I’ve also conducted 20 interviews in the UK with people who have travelled or were considering travelling abroad for dental treatment. </p>
<p>Joan, a 50-year-old woman from Exeter, tells me she considered going to Turkey and could have afforded it, but that her back and knee problems meant she could not brave the trip. She has lost all her lower front teeth due to gum disease and, when I meet her, has been waiting 13 months for an NHS dental appointment. Joan tells me she is living in “shame”, unable to smile.</p>
<p>In the UK, areas with extremely limited provision of NHS dental services – known as as <a href="https://www.local.gov.uk/about/news/nhs-dental-deserts-persist-rural-and-deprived-communities-lga-analysis">“dental deserts”</a> – include densely populated urban areas such as Portsmouth and Greater Manchester, as well as many rural and coastal areas. </p>
<p>In Felixstowe, the <a href="https://www.bbc.co.uk/news/uk-england-suffolk-64545026">last dentist taking NHS patients</a> went private in 2023, despite the efforts of the activist group <a href="https://you.38degrees.org.uk/petitions/bring-our-nhs-dentist-back">Toothless in Suffolk</a> to secure better access to NHS dentists in the area. It’s a similar story in <a href="https://www.thenorthernecho.co.uk/news/23489251.patients-ripon-left-50-mile-nhs-journey-practice-closure/">Ripon, Yorkshire</a>, and in Dumfries & Galloway, Scotland, where nearly <a href="https://www.dailyrecord.co.uk/news/local-news/nearly-25000-dumfries-galloway-residents-31671964">25,000 patients have been de-registered from NHS dentists</a> since 2021. </p>
<p>Data shows that 2 million adults must <a href="https://www.dentalhealth.org/oral-health-statistics#:%7E:text=Almost%20one%20in%20three%20(31%25)%20of%20adults%20have%20tooth%20decay.">travel at least 40 miles</a> within the UK to access dental care. Branding travel for dental care as “tourism” carries the risk of disguising the elements of duress under which patients move to restore their oral health – nationally and internationally. It also hides the immobility of those who cannot undertake such journeys.</p>
<p>The <a href="https://www.itv.com/news/border/2023-05-31/dental-desert-thousands-losing-access-to-nhs-dentists-in-dumfries-and-galloway">90-year-old woman in Dumfries & Galloway</a> who now faces travelling for hours by bus to see an NHS dentist can hardly be considered “tourism” – nor the Ukrainian war refugees who travelled back from <a href="https://www.thetimes.co.uk/article/ukrainian-family-goes-home-because-dental-care-is-easier-to-find-3g6322pf0">West Sussex</a> and <a href="https://www.eveningnews24.co.uk/news/23861656.ukrainians-norwich-returning-home-visit-dentist/">Norwich</a> to Ukraine, rather than face the long wait to see an NHS dentist. </p>
<p>Many people I have spoken to cannot afford the cost of transport to attend dental appointments two hours away – or they have care responsibilities that make it impossible. Instead, they are forced to wait in pain, in the hope of one day securing an appointment closer to home.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/579165/original/file-20240301-24-oe9tww.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Billboard advertising a dental clinic in Turkey" src="https://images.theconversation.com/files/579165/original/file-20240301-24-oe9tww.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/579165/original/file-20240301-24-oe9tww.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/579165/original/file-20240301-24-oe9tww.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/579165/original/file-20240301-24-oe9tww.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/579165/original/file-20240301-24-oe9tww.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/579165/original/file-20240301-24-oe9tww.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/579165/original/file-20240301-24-oe9tww.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Dental clinics have mushroomed in recent years in Turkey, thanks to the influx of foreign patients seeking a wide range of treatments.</span>
<span class="attribution"><span class="source">Diana Ibanez-Tirado</span>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
</figcaption>
</figure>
<h2>‘Your crisis is our business’</h2>
<p>The indignities of waiting in the UK are having a big impact on the lives of some local and foreign dentists in Turkey. Some neighbourhoods are rapidly changing as dental and other health clinics, usually in luxurious multi-storey glass buildings, mushroom. In the office of one large Istanbul medical complex with sections for hair transplants and dentistry (plus one linked to a hospital for more extensive cosmetic surgery), its Turkish owner and main investor tells me:</p>
<blockquote>
<p>Your crisis is our business, but this is a bazaar. There are good clinics and bad clinics, and unfortunately sometimes foreign patients do not know which one to choose. But for us, the business is very good.</p>
</blockquote>
<p>This clinic only caters to foreign patients. The owner, an architect by profession who also developed medical clinics in Brazil, describes how COVID had a major impact on his business:</p>
<blockquote>
<p>When in Europe you had COVID lockdowns, Turkey allowed foreigners to come. Many people came for ‘medical tourism’ – we had many patients for cosmetic surgery and hair transplants. And that was when the dental business started, because our patients couldn’t see a dentist in Germany or England. Then more and more patients started to come for dental treatments, especially from the UK and Ireland. For them, it’s very, very cheap here.</p>
</blockquote>
<p>The reasons include the value of the Turkish lira relative to the British pound, the low cost of labour, the increasing competition among Turkish clinics, and the sheer motivation of dentists here. While most dentists catering to foreign patients are from Turkey, others have arrived seeking refuge from war and violence in Syria, Iraq, Afghanistan, Iran and beyond. They work diligently to rebuild their lives, careers and lost wealth.</p>
<p>Regardless of their origin, all dentists in Turkey must be registered and certified. Hamed, a Syrian dentist and co-owner of a new clinic in Istanbul catering to European and North American patients, tells me:</p>
<blockquote>
<p>I know that you say ‘Syrian’ and people think ‘migrant’, ‘refugee’, and maybe think ‘how can this dentist be good?’ – but Syria, before the war, had very good doctors and dentists. Many of us came to Turkey and now I have a Turkish passport. I had to pass the exams to practise dentistry here – I study hard. The exams are in Turkish and they are difficult, so you cannot say that Syrian doctors are stupid.</p>
</blockquote>
<p>Hamed talks excitedly about the latest technology that is coming to his profession: “There are always new materials and techniques, and we cannot stop learning.” He is about to travel to Paris to an international conference:</p>
<blockquote>
<p>I can say my techniques are very advanced … I bet I put more implants and do more bone grafting and surgeries every week than any dentist you know in England. A good dentist is about practice and hand skills and experience. I work hard, very hard, because more and more patients are arriving to my clinic, because in England they don’t find dentists.</p>
</blockquote>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/579166/original/file-20240301-26-3k65fj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Dental equipment in a Turkish treatment room" src="https://images.theconversation.com/files/579166/original/file-20240301-26-3k65fj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/579166/original/file-20240301-26-3k65fj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=800&fit=crop&dpr=1 600w, https://images.theconversation.com/files/579166/original/file-20240301-26-3k65fj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=800&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/579166/original/file-20240301-26-3k65fj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=800&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/579166/original/file-20240301-26-3k65fj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1005&fit=crop&dpr=1 754w, https://images.theconversation.com/files/579166/original/file-20240301-26-3k65fj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1005&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/579166/original/file-20240301-26-3k65fj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1005&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Dentists in Turkey boast of using the latest technology.</span>
<span class="attribution"><span class="source">Diana Ibanez-Tirado</span>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
</figcaption>
</figure>
<p>While there is no official data about the number of people travelling from the UK to Turkey for dental treatment, investors and dentists I speak to consider that numbers are rocketing. From all over the world, Turkey received <a href="https://www.bbc.com/travel/article/20240206-most-visited-cities-in-the-world-istanbul-antalya-turkey-travel-visa-requirements">1.2 million visitors for “medical tourism” in 2022</a>, an increase of 308% on the previous year. Of these, <a href="https://dentistry.co.uk/2023/08/24/beware-of-language-barriers-dental-tourists-warned/">about 250,000 patients</a> went for dentistry. One of the most renowned dental clinics in Istanbul had only 15 British patients in 2019, but that number <a href="https://www.dailymail.co.uk/health/article-12790275/Turkish-dentists-saving-British-patients-failed-NHS.html">increased to 2,200 in 2023</a> and is expected to reach 5,500 in 2024.</p>
<p>Like all forms of medical care, dental treatments carry risks. Most clinics in Turkey offer a ten-year guarantee for treatments and a printed clinical history of procedures carried out, so patients can show this to their local dentists and continue their regular annual care in the UK. Dental treatments, checkups and maintaining a good oral health is a life-time process, not a one-off event.</p>
<p>Many UK patients, however, are caught between a rock and a hard place – criticised for going abroad, yet unable to get affordable dental care in the UK before and after their return. The <a href="https://www.bda.org/news-and-opinion/news/dental-tourism-patients-need-to-know-the-risks/">British Dental Association</a> has called for more action to inform these patients about the risks of getting treated overseas – and has warned UK dentists about the legal implications of treating these patients on their return. But this does not address the difficulties faced by British patients who are being forced to go abroad in search of affordable, often urgent dental care.</p>
<h2>A global emergency</h2>
<p>The World Health Organization states that the explosion of oral disease around the world is a result of the <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/odi.14516">“negligent attitude”</a> that governments, policymakers and insurance companies have towards including oral healthcare under the umbrella of universal healthcare. It as if the health of our teeth and mouth is optional; somehow less important than treatment to the rest of our body. Yet complications from untreated tooth decay can lead to hospitalisation.</p>
<p>The <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/odi.14516">main causes of oral health diseases</a> are untreated tooth decay, severe gum disease, toothlessness, and cancers of the lip and oral cavity. Cases grew during the pandemic, when little or no attention was paid to oral health. Meanwhile, the <a href="https://www.grandviewresearch.com/industry-analysis/cosmetic-dentistry-market#:%7E:text=The%20global%20cosmetic%20dentistry%20market%20is%20expected%20to%20grow%20at,share%20of%20437.5%25%20in%202022.">global cosmetic dentistry market</a> is predicted to continue growing at an annual rate of 13% for the rest of this decade, confirming the strong relationship between socioeconomic status and access to oral healthcare.</p>
<p>In the UK since 2018, there have been more than <a href="https://www.the-dentist.co.uk/content/news/over-100-000-child-hospital-admissions-for-rotting-teeth-since-2018">218,000 admissions to hospital for rotting teeth</a>, of which more than 100,000 were children. Some 40% of children in the UK have not seen a dentist in the past 12 months. The role of dentists in prevention of tooth decay and its complications, and in the early detection of mouth cancer, is vital. While there is a <a href="https://www.the-dentist.co.uk/content/news/association-replies-to-the-rise-in-dental-sepsis-cases/">90% survival rate</a> for mouth cancer if spotted early, the lack of access to dental appointments is causing <a href="https://www.bbc.co.uk/news/health-67331885">cases to go undetected</a>.</p>
<p>The reasons for the crisis in NHS dentistry are complex, but include: the real-term <a href="https://www.bda.org/news-and-opinion/news/a-billion-in-cuts/">cuts in funding to NHS dentistry</a>; the challenges of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9838263/#CR6720">recruitment and retention of dentists</a> in rural and coastal areas; pay inequalities facing dental nurses, most of them women, who are being <a href="https://dentistry.co.uk/2022/08/10/dentistry-census-what-does-the-cost-of-living-crisis-mean-for-dental-nurses/">badly hit</a> by the cost of living crisis; and, in England, <a href="https://publications.parliament.uk/pa/cm5803/cmselect/cmhealth/964/report.html#footnote-116">the 2006 Dental Contract</a> that does not remunerate dentists in a way that encourages them to continue seeing NHS patients.</p>
<p>The UK is suffering a <a href="https://www.bda.org/media-centre/nearly-half-of-dentists-severing-ties-with-nhs-as-government-fails-to-move-forward-on-reform/">mass exodus of the public dentistry workforce</a>, with workers leaving the profession entirely or shifting to the private sector, where <a href="https://dentistry.co.uk/2022/06/05/a-brief-history-of-private-dentistry/">payments and life-work balance are better, bureaucracy is reduced</a>, and prospects for career development look much better. A <a href="https://www.bda.org/media-centre/half-of-dentists-have-cut-back-nhs-work-with-more-to-follow-as-crisis-mounts/">survey of general dental practitioners</a> found that around half have reduced their NHS work since the pandemic – with 43% saying they were likely to go fully private, and 42% considering a career change or taking early retirement.</p>
<p>Reversing the UK’s dental crisis requires more commitment <a href="https://www.bda.org/media-centre/nhs-recovery-plan-unworthy-of-the-title-say-dentists/">to substantial reform and funding</a> than the <a href="https://www.gov.uk/government/publications/our-plan-to-recover-and-reform-nhs-dentistry/faster-simpler-and-fairer-our-plan-to-recover-and-reform-nhs-dentistry#smile-for-life---taking-action-to-prevent-poor-oral-health">“recovery plan”</a> announced by Victoria Atkins, the secretary of state for health and social care, on February 7. </p>
<p>The stories I have gathered show that people travelling abroad for dental treatment don’t see themselves as “tourists” or vanity-driven consumers of the “Hollywood smile”. Rather, they have been forced by the crisis in NHS dentistry to seek out a service 1,500 miles away in Turkey that should be a basic, affordable right for all, on their own doorstep.</p>
<p><em>*Names in this article have been changed to protect the anonymity of the interviewees.</em></p>
<hr>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em>For you: more from our <a href="https://theconversation.com/uk/topics/insights-series-71218?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insights series</a>:</em></p>
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<li><p><em><a href="https://theconversation.com/gp-crisis-how-did-things-go-so-wrong-and-what-needs-to-change-208197?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">GP crisis: how did things go so wrong, and what needs to change?</a></em></p></li>
<li><p><em><a href="https://theconversation.com/would-better-buildings-help-fix-the-nhs-the-story-of-britains-hospitals-from-grand-designs-to-counting-the-costs-208090?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Would better buildings help fix the NHS? The story of Britain’s hospitals, from grand designs to counting the costs</a></em></p></li>
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<li><p><em><a href="https://theconversation.com/insomnia-how-chronic-sleep-problems-can-lead-to-a-spiralling-decline-in-mental-health-224131?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insomnia: how chronic sleep problems can lead to a spiralling decline in mental health
</a></em></p></li>
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<p class="fine-print"><em><span>Diana Ibanez Tirado receives funding from the School of Global Studies, University of Sussex.</span></em></p>The crisis in NHS dentistry is driving increasing numbers abroad for treatment. Here are some of their stories.Diana Ibanez-Tirado, Senior Lecturer in Anthropology, University of SussexLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2241312024-02-26T17:24:36Z2024-02-26T17:24:36ZInsomnia: how chronic sleep problems can lead to a spiralling decline in mental health<figure><img src="https://images.theconversation.com/files/577722/original/file-20240224-24-su6ra5.jpg?ixlib=rb-1.1.0&rect=21%2C142%2C3629%2C2310&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/man-insomnia-cannot-sleep-hand-drawn-1965734296">APIMerah/Shutterstock</a></span></figcaption></figure><blockquote>
<p>I’ll often lie awake until three or four in the morning, before drifting off for just a few hours. Then comes the dreaded alarm clock. My mind and body are exhausted all the time – there’s always this knot of anxiety in my chest, doing away with any hope of a good night’s sleep.</p>
</blockquote>
<p>Simon* is a NHS mental health nurse who, like millions of people in the UK, suffers from insomnia: a sustained difficulty in initiating and maintaining sleep. His job is to support the recovery of people with severe mental illness, but his own sleep problems have had a profoundly negative impact on his mental health.</p>
<p>Most of us experience a bad night’s sleep from time to time, but can usually get back on track within a night or two. People suffering from insomnia, by contrast, have sleep problems that last for months or years at a time, taking a major toll on their health and wellbeing.</p>
<p>Around <a href="https://jcsm.aasm.org/doi/10.5664/jcsm.26929#:%7E:text=a%20cognitive%20system.-,CONCLUSION,%2C%20social%2C%20and%20physical%20domains.">a third</a> of people will experience insomnia at some point in their life, with women and older people more often affected. Nearly 40% of sufferers <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2772563">fail to recover within five years</a>. People with insomnia have an increased risk of diabetes, high blood pressure and <a href="https://www.sciencedirect.com/science/article/abs/pii/S1556407X22000182?via%3Dihub">cardiovascular disease</a>. Insomnia is also a major risk factor for <a href="https://onlinelibrary.wiley.com/doi/10.1111/jsr.13628">mental illness</a>, and often co-occurs with mood disorders such as depression and anxiety.</p>
<hr>
<p><em>Across the world, we’re seeing unprecedented levels of mental illness at all ages, from children to the very old – with huge costs to families, communities and economies. <a href="https://theconversation.com/uk/topics/tackling-the-mental-health-crisis-147216?utm_source=TCUK&utm_medium=ArticleTop&utm_campaign=MentalHealthSeries">In this series</a>, we investigate what’s causing this crisis, and report on the latest research to improve people’s mental health at all stages of life.</em></p>
<hr>
<p>Many different life events can increase your chances of sustained sleep deprivation. Both the financial burden and confinement arising from the COVID-19 pandemic were associated with <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-14048-1">greater risk</a> of insomnia, which is in turn likely to have led to a <a href="https://www.sciencedirect.com/science/article/pii/S1389945721004196?via%3Dihub">rise in mental health problems</a>.</p>
<p>And yet, very little is known about why and how a prolonged absence of sleep gives rise to mental illness. Our team at the University of York has pioneered research into whether sleep deprivation <a href="https://www.sciencedirect.com/science/article/pii/S1364661321000577">disrupts the brain’s ability to suppress intrusive memories</a> and distressing thoughts – classic symptoms of psychiatric disturbance. </p>
<p>It has also led us to ask whether it might one day be possible to treat mental illness while patients are sleeping – for example, by using sounds to normalise irregular patterns of brain activity during rapid eye movement (REM) sleep.</p>
<h2>Why are some people so badly affected?</h2>
<blockquote>
<p>They put their hand over my face so I couldn’t breathe. Now I can’t wear anything that covers my mouth or nose for fear of reliving [that experience]. Mask wearing was a big problem for me during the pandemic – and it was always worse when I slept badly. Just the sight of other people wearing masks could bring it all back.</p>
</blockquote>
<p>Helen* is a domestic abuse survivor who suffers from post-traumatic stress disorder (PTSD), a debilitating condition characterised by flashbacks, nightmares and severe anxiety. She told us her symptoms would always get worse after a bad night’s sleep – a pattern reported by other PTSD sufferers we spoke to.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/577724/original/file-20240224-26-m8ngfp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Illustration of woman in bed covering her face with her hands" src="https://images.theconversation.com/files/577724/original/file-20240224-26-m8ngfp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/577724/original/file-20240224-26-m8ngfp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=439&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577724/original/file-20240224-26-m8ngfp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=439&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577724/original/file-20240224-26-m8ngfp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=439&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577724/original/file-20240224-26-m8ngfp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=552&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577724/original/file-20240224-26-m8ngfp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=552&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577724/original/file-20240224-26-m8ngfp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=552&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/insomnia-concept-young-woman-sitting-her-625713866">Randoms/Shutterstock</a></span>
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<p>We can all sometimes encounter intrusive and unwanted thoughts, usually in response to reminders – for example, seeing a former partner and being reminded of an unpleasant breakup. While unsettling, these thoughts are infrequent, short-lived and, usually, quickly forgotten. This is in stark contrast to the highly lucid, distressing thoughts experienced by people with PTSD. Sufferers often engage in avoidant behaviour, such as not leaving home to reduce the likelihood of having to confront reminders of their trauma. </p>
<p>However, the symptoms of PTSD can also partly be explained by a breakdown of the brain mechanisms we rely on to push such intrusive thoughts out of conscious awareness. Because intrusive thoughts arise from unpleasant memories, another way people ward them off is by suppressing the offending content from their memory. But PTSD sufferers often <a href="https://journals.sagepub.com/doi/10.1177/0956797615569889">exhibit a deficit</a> in their ability to engage in this process of memory suppression, resulting in persistent unwanted patterns of thinking.</p>
<hr>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
<hr>
<p>And what if lack of sleep reduces our ability to suppress unwanted thoughts and memories? This could lead to a downward spiral of more persistent and frightening intrusive thoughts, severe anxiety, and chronic sleeplessness – culminating in psychiatric disturbance.</p>
<p>Although a <a href="https://www.nature.com/articles/nrn.2017.55">wealth of research</a> has shown that sleep deprivation leads to psychological instability, <a href="https://journals.sagepub.com/doi/10.1177/2167702620951511">our study</a> was the first study to examine how an inability to control intrusive thoughts might underpin this relationship. For this reason, we worked with young adults without a diagnosed mental health disorder, allowing us to determine how even healthy brain processes go awry when people do not get enough sleep.</p>
<h2>How sleep deprivation affects our brain</h2>
<p>Our group of young adults (aged 18–25) were asked to memorise face-image pairs, comprising a male or female face with a neutral expression next to a unique scene. They would memorise each pair over and over again, so that any face presented in isolation would serve as a powerful reminder of the scene it was paired with – in the same way a reminder of an unpleasant event in the real world can trigger a distressing thought.</p>
<p>The face-scene learning took place late in the evening – after which half the participants went to sleep in our laboratory, and the other half stayed awake for the entire night – watching movies, playing games and going for short walks outside. They could eat and drink, but psychological stimulants such as caffeine were strictly prohibited. We would wake anyone in this group who nodded off.</p>
<p>Next morning, all participants were shown the faces only, in random order, with the following instructions. If the face was inside a green frame, the participant should allow the associated scene to come into their mind. A red frame meant they should engage in memory suppression to block out the scene – in the same way we sometimes purge unwanted thoughts from our conscious experience.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/577966/original/file-20240226-24-8ldt9l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Explanation of face-image sleep and memory suppression experiment." src="https://images.theconversation.com/files/577966/original/file-20240226-24-8ldt9l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/577966/original/file-20240226-24-8ldt9l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=445&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577966/original/file-20240226-24-8ldt9l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=445&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577966/original/file-20240226-24-8ldt9l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=445&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577966/original/file-20240226-24-8ldt9l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=560&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577966/original/file-20240226-24-8ldt9l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=560&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577966/original/file-20240226-24-8ldt9l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=560&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Sleep and memory suppression experiment.</span>
<span class="attribution"><a class="source" href="https://www.epoc-york.com/research">Scott Cairney/University of York</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
</figcaption>
</figure>
<p>Our sleep-deprived participants reported having more “intrusions” (failed memory suppression attempts) than those who had slept normally. And only well-rested participants got better at suppressing the unwanted memories over time. This suggests that sleeplessness does long-term harm to our ability to suppress intrusive memories and, hence, unwanted thoughts.</p>
<p>What’s going wrong inside a sleep-deprived person’s brain? To address this question, we <a href="https://www.biorxiv.org/content/10.1101/2023.11.07.565941v1">repeated our study</a>, but this time with participants undergoing <a href="https://www.ndcn.ox.ac.uk/divisions/fmrib/what-is-fmri/introduction-to-fmri">functional magnetic resonance imaging</a> (fMRI) – a powerful neuroimaging technique that allows us to determine which brain regions are engaged during particular cognitive operations (in this case, keeping intrusive memories at bay).</p>
<p>Memory suppression <a href="https://www.sciencedirect.com/science/article/pii/S1364661314000746?via%3Dihub">relies on a brain region</a> known as the right <a href="https://en.wikipedia.org/wiki/Dorsolateral_prefrontal_cortex">dorsolateral prefrontal cortex</a> (rDLPFC). When a reminder triggers retrieval of an unwanted memory, the rDLPFC inhibits activity in the brain’s memory processing centre, the <a href="https://en.wikipedia.org/wiki/Hippocampus">hippocampus</a>, to push that memory out of the person’s mind.</p>
<p>Our fMRI study showed that, when participants were attempting to suppress unwanted memories, activity in rDLPFC was reduced after a night of sleep deprivation relative to a night of restful sleep. Moreover, activity in the hippocampus was stronger after sleep deprivation than restful sleep, suggesting that a breakdown of control by rDLPFC had allowed unsolicited memory operations to emerge with impunity, opening the door to intrusive patterns of thinking.</p>
<h2>Can better sleep improve our mental health?</h2>
<p>REM sleep, discovered by <a href="https://www.science.org/doi/10.1126/science.118.3062.273">Eugene Aserinsky and Nathaniel Kleitman</a> in 1953, is a unique stage of sleep characterised by rapid movement of the eyes and a high propensity for vivid dreaming.</p>
<p>As the brain enters REM sleep, it undergoes dramatic changes that are thought to play an important role in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2890316/">regulating our mental health</a>. For example, levels of the neurotransmitter <a href="https://www.britannica.com/science/acetylcholine">acetylcholine</a>, which modulates the processing of disturbing memories, are markedly increased in REM sleep relative to other sleep stages, mirroring levels seen in wakefulness. Abnormalities of REM sleep are <a href="https://www.annualreviews.org/doi/10.1146/annurev-clinpsy-032813-153716">linked</a> to various psychiatric mood disorders including PTSD, and associated with the intense nightmares experienced following trauma.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/a-short-history-of-insomnia-and-how-we-became-obsessed-with-sleep-211729">A short history of insomnia and how we became obsessed with sleep</a>
</strong>
</em>
</p>
<hr>
<p>So, could the brain mechanisms that allow us to control intrusive memories be especially influenced by the amount of REM sleep we obtain over the course of a night? To investigate this, our fMRI study included <a href="https://pubmed.ncbi.nlm.nih.gov/31277862/">polysomnography</a> – a sleep monitoring technique that enabled us to identify when participants were in REM sleep, based on both their eye movement and discrete brainwave patterns.</p>
<p>Among our participants who slept, those who had more REM sleep showed stronger engagement of their rDLPFC when suppressing unwanted memories the next morning. This suggests REM sleep may indeed support mental health by restoring the brain systems that help to shield us from unwelcome thoughts.</p>
<h2>The emotional intensity of our memories</h2>
<p>When we think back to a traumatic or painful life event, we get a sense of the unpleasant feelings, such as sadness or anger, that accompanied the original experience. However, the intensity of these feelings is usually much reduced, allowing us to draw on past events without being consumed by negative emotions.</p>
<p>Suppressing unwanted thoughts has been shown to <a href="https://elifesciences.org/articles/71309">weaken the memories</a> that lead to them, meaning they are less likely to intrude into our consciousness in the future. This relates not only to the content of the memories (the “what, when and who”) but also <a href="https://www.jneurosci.org/content/37/27/6423.long">their emotional charge</a> – the intensity of the emotions we felt at the time. In other words, memory suppression helps us move on from prior adversity by gradually cleansing our memories of unpleasant experiences, and the negative emotions associated with them.</p>
<p>Conversely, failing to suppress an unwanted memory is likely to cause its emotional charge to linger, meaning that emotional responses to future reminders will remain more intense. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/577728/original/file-20240224-16-qbm7dc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Illustration of exhausted man in bed, suffering with insomnia" src="https://images.theconversation.com/files/577728/original/file-20240224-16-qbm7dc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/577728/original/file-20240224-16-qbm7dc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=425&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577728/original/file-20240224-16-qbm7dc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=425&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577728/original/file-20240224-16-qbm7dc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=425&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577728/original/file-20240224-16-qbm7dc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=534&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577728/original/file-20240224-16-qbm7dc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=534&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577728/original/file-20240224-16-qbm7dc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=534&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/man-insomnia-cannot-sleep-hand-drawn-1819333274">APIMerah/Shutterstock</a></span>
</figcaption>
</figure>
<p>We tested this by showing our participants scenes that were either emotionally negative (such as a car crash) or neutral (such as a forest). In the morning, after completing the memory retrieval and suppression task (with green and red-framed faces), participants were then asked to give intensity ratings for the negative and neutral scenes again.</p>
<p>Our findings were clear – and corroborated by further tests using an objective index of emotional arousal, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695635/#:%7E:text=The%20skin%20conductance%20response%20(SCR)%20is%20an%20indirect%20measure%20of,emotional%20valence%20(Bradley%20et%20al.)">skin conductance responses</a>. Among participants who had slept, emotional responses to the suppressed negative scenes became less intense over time. But among the sleep-deprived, emotional ratings for negative scenes remained elevated, regardless of whether the scenes were suppressed or not. This suggests that a breakdown of memory suppression mechanisms after sleep loss prevented participants from being able to “deal with” these negative emotions.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/insomnia-and-mental-disorders-are-linked-but-exactly-how-is-still-a-mystery-212106">Insomnia and mental disorders are linked. But exactly how is still a mystery</a>
</strong>
</em>
</p>
<hr>
<p>In the context of psychiatric mood disorders that co-occur with chronic sleep disturbance, failure to suppress memories of emotionally disturbing events, together with an inability to reduce the unpleasant feelings embedded within those memories, could contribute to a strong tendency of mood-disordered individuals to focus on negative interpretations of the past.</p>
<p>Furthermore, anxiety arising from intrusive memories may also obstruct the sleep that is needed for recovery, leading to a vicious cycle of emotional dysregulation and sleeplessness.</p>
<h2>The importance of forgetting</h2>
<p>In the film Eternal Sunshine of the Spotless Mind (2004), the main characters have their memories of their turbulent relationship erased. Far from improving their quality of life, this leads to further complications, serving as a cautionary tale. </p>
<p>However, there are situations where aiding the forgetting process may help. For example, people who have experienced traumatic experiences can struggle to cope with unwanted memory intrusions. In these extreme cases, where the usual brain processes that allow for forgetting aren’t functioning properly, it could be beneficial to induce forgetting.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/07-QBnEkgXU?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
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<p>Generally, forgetting is thought of as “bad”, with people worrying about forgetting where they put the car keys, or when their wedding anniversary is. But far from being a problem, this is how <a href="https://theconversation.com/why-forgetting-is-a-normal-function-of-memory-and-when-to-worry-223284">memory is supposed to work</a>. Sometimes, we want to just forget information that isn’t relevant to our daily lives, to prevent it from interfering with our goals. And sometimes, we want to forget embarrassing or emotionally scarring events.</p>
<p>Ultimately, the purpose of a functioning memory system is to make sensible and accurate decisions in the present, based on our past experience. The “adaptive” nature of forgetting allows us to get rid of irrelevant memories, making sure the memories that remain are as relevant to future decisions as possible. From this perspective, forgetting is as important as remembering. Simply put, forgetting is a feature of memory, not a bug.</p>
<p>While forgetting is a catch-all term we use for the loss of a memory, it isn’t a single process in the brain. Memories can be forgotten via active processes, such as memory suppression. But this can also happen via passive processes including “decay”, where the physical trace of a memory in the brain breaks down over time, or “interference”, where new memories that are similar to previous ones lead to confusion-impaired retrieval. For example, if you park your car in a new location in the supermarket you often visit, you might forget this new location because the usual place you park comes more readily to mind.</p>
<p>Forgetting is a complex phenomenon that unfolds over different timescales and via different processes, both while awake and asleep. While some memories can fragment, others are forgotten as a whole, so that all aspects of the memory are <a href="https://psycnet.apa.org/fulltext/2019-38883-001.html">no longer accessible</a>. </p>
<p>That forgetting is likely to occur during sleep has been underappreciated by psychologists, because research on sleep has largely focused on the role it plays in strengthening memories. But <a href="https://learnmem.cshlp.org/content/29/11/401.long">we</a> and <a href="https://www.jneurosci.org/content/37/3/464">other researchers</a> have recently reasoned that if forgetting is a fundamental part of a functioning memory system, then sleep should play as much of a role in forgetting as it does in retention.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/577727/original/file-20240224-16-ist89m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Illustration of sleep-deprived man in bed, covering his head with pillows." src="https://images.theconversation.com/files/577727/original/file-20240224-16-ist89m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/577727/original/file-20240224-16-ist89m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=405&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577727/original/file-20240224-16-ist89m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=405&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577727/original/file-20240224-16-ist89m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=405&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577727/original/file-20240224-16-ist89m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=509&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577727/original/file-20240224-16-ist89m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=509&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577727/original/file-20240224-16-ist89m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=509&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/man-insomnia-cannot-sleep-hand-drawn-1936830988">APIMerah/Shutterstock</a></span>
</figcaption>
</figure>
<p>Previous <a href="https://www.science.org/doi/10.1126/science.1179013?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">research</a>, including <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(18)30153-2">our own</a>, has shown that the presentation of specific sounds during sleep can boost memory. If you were to learn the location of a cat on a computer screen, and during learning we played a “meow” sound, the presentation of the same sound during sleep would lead to better location memory following sleep. This selective boosting of a specific memory during sleep is called “targeted memory reactivation”.</p>
<p>We have <a href="https://learnmem.cshlp.org/content/29/11/401.long">recently shown</a> that this technique can also be used to induce “selective forgetting”. We asked our participants to learn pairs of words or names before going to sleep. We used famous names, location and object words to allow participants to create vivid images in their minds for each pair, so they would be more likely to remember them after a night’s sleep.</p>
<p>But we also made sure the pairs overlapped by sharing one common word. When people learn these overlapping pairs, they compete against each other, and this competition can lead to <a href="https://psycnet.apa.org/record/1995-04358-001">forgetting</a> some of the words. We thought a similar forgetting effect might be seen by using targeted memory reactivation when participants were sleeping. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-forgetting-is-a-normal-function-of-memory-and-when-to-worry-223284">Why forgetting is a normal function of memory – and when to worry</a>
</strong>
</em>
</p>
<hr>
<p>We found the presentation of the word during sleep caused reactivation and strengthening for one pair, but this had a disruptive effect for the other pair. This suggests we could use targeted memory reactivation to selectively strengthen and weaken memories during sleep, presuming we can create interference between two memories. This could be beneficial in the case of people whose brain processes aren’t functioning properly, not allowing them to “healthily forget” disturbing and intrusive memories.</p>
<p>Although such a treatment is still a long way off, our work raises the possibility of using sound cues during sleep – in combination with psychological techniques such as cognitive behavioural therapy – to decrease the crippling emotional grip a particular memory has on a patient.</p>
<h2>Modifying REM sleep to improve mental health</h2>
<p>Given the strong link between REM sleep and mental health disorders, REM sleep may represent a powerful therapeutic target for treating and preventing various psychiatric conditions. By delivering sounds in synchrony with naturally occurring brain rhythms, it is possible to modify patterns of brain activity that are associated with memory processing in REM sleep.</p>
<p>In <a href="https://academic.oup.com/sleep/article/44/4/zsaa227/5960115">one study</a>, we used a computerised algorithm to track rapidly emerging patterns of brain activity in real time while people were asleep (based on polysomnography data). When the algorithm detects the emergence of a particular brain rhythm, it delivers short bursts of sound to increase the intensity of that brain rhythm (akin to pushing a swing as it reaches the highest point of its cycle).</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/ORo-nbJ-F18?wmode=transparent&start=5" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>We have showed this technique can be used to modify distinct brain rhythms in REM sleep. In future, such auditory stimulation could potentially provide a means of renormalising aberrant patterns of brain activity in REM sleep to treat psychiatric disturbance. For example, by integrating this technology with devices that are already available for people to monitor their sleep at home, the playing of particular sounds while someone is sleeping could provide a simple and cost-effective therapy for reducing mood disturbance.</p>
<p>However, this is a long way from being a reality, and many studies would be required to evaluate the feasibility of such an approach before it could be used as a therapeutic tool.</p>
<h2>Targeting sleep in psychiatric hospitals</h2>
<blockquote>
<p>High-risk patients undergo routine observations, sometimes as regularly as every ten minutes, all night and every night. Torches are shone into their rooms – to check they’re breathing – and there’s a lot of noise as doors are open and closed. It has a terrible impact on their sleep.</p>
</blockquote>
<p>Heather* is a consultant forensic psychiatrist who works on a secure mental health ward in the North of England. She describes how the ward regime (in this case, routine welfare checks on high-risk individuals performed throughout the night) impact on patients’ sleep.</p>
<p>A number of people with severe mental illness receive treatment in secure inpatient units. Although the goal of these psychiatric hospitals is to provide a therapeutic setting to support the improvement of mental health, many features of the inpatient environment, such as noise at night or the ward regime, can worsen patients’ sleep disturbances – intensifying the symptoms of their illness, including low mood, impulsivity and aggression.</p>
<p>At the same time, chronic sleeplessness often reduces patients’ engagement with psychological therapies (due to them sleeping in the day or lacking motivation), lengthening their admission and recovery time.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/577726/original/file-20240224-22-trso72.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Illustration of a man sitting up in bed, suffering with insomnia" src="https://images.theconversation.com/files/577726/original/file-20240224-22-trso72.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/577726/original/file-20240224-22-trso72.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=426&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577726/original/file-20240224-22-trso72.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=426&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577726/original/file-20240224-22-trso72.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=426&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577726/original/file-20240224-22-trso72.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=535&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577726/original/file-20240224-22-trso72.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=535&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577726/original/file-20240224-22-trso72.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=535&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/man-insomnia-cannot-sleep-hand-drawn-1964955184">APIMerah/Shutterstock</a></span>
</figcaption>
</figure>
<p>In a recent international scoping review, we found that only a small number of non-pharmacological sleep interventions had been tested in psychiatric inpatient settings, despite <a href="https://www.medrxiv.org/content/10.1101/2023.03.03.23286483v1">clear evidence</a> that these improve both sleep and mental health outcomes.</p>
<p>New digital technologies can give a clear indication of patient welfare without the need for the noise and disruption Heather describes, providing an environment that is more conducive to healthy sleep. Future studies could test the potential for integrating these digital technologies with sleep-based therapies to speed up recovery times.</p>
<p>Achieving this goal is not only contingent on more research, but also on the capacity for carrying out scientific studies at scale. For example, all of the studies we have described were performed in tightly controlled laboratory environments, usually involving large and expensive pieces of equipment (for example, polysomnography systems). Though <a href="https://journals.sagepub.com/doi/10.1177/0956797619873344?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">recent efforts have shown promise</a> in the feasibility of moving these techniques into people’s homes, much more work needs to be done outside of the lab before digitised, sleep-focused interventions for mental illness become a reality.</p>
<p>We envisage a future in which sleep is a routine target for reducing or preventing symptoms of mental illness, both in psychiatric inpatient settings and in people’s homes. Although there is much work still to do, sleep research is at an exciting juncture between bench and bedside, and offers a viable solution to the growing global burden of mental illness.</p>
<p><em>*Some names in this article have been changed to protect the anonymity of the interviewees.</em></p>
<hr>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em>For you: more from our <a href="https://theconversation.com/uk/topics/insights-series-71218?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insights series</a>:</em></p>
<ul>
<li><p><em><a href="https://theconversation.com/the-brain-is-the-most-complicated-object-in-the-universe-this-is-the-story-of-scientists-quest-to-decode-it-and-read-peoples-minds-222458?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">The brain is the most complicated object in the universe. This is the story of scientists’ quest to decode it – and read people’s minds
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<li><p><em><a href="https://theconversation.com/unlocking-new-clues-to-how-dementia-and-alzheimers-work-in-the-brain-uncharted-brain-podcast-series-194773?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Unlocking new clues to how dementia and Alzheimer’s work in the brain – Uncharted Brain podcast series
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<p><em>To hear about new Insights articles, join the hundreds of thousands of people who value The Conversation’s evidence-based news. <a href="https://theconversation.com/uk/newsletters/the-daily-newsletter-2?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK"><strong>Subscribe to our newsletter</strong></a>.</em></p><img src="https://counter.theconversation.com/content/224131/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Scott Cairney has received funding from the Medical Research Council</span></em></p><p class="fine-print"><em><span>Aidan Horner receives funding from the Economic and Social Research Council and the Leverhulme Trust. </span></em></p>We envisage a future in which sleep is a routine target for reducing or preventing symptoms of mental illness, both in psychiatric settings and people’s homesScott Cairney, Associate Professor of Psychology, University of YorkAidan Horner, Associate Professor in Psychology and Neuroscience, University of YorkLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2189692024-02-18T20:27:34Z2024-02-18T20:27:34ZHistory’s crisis detectives: how we’re using maths and data to reveal why societies collapse – and clues about the future<figure><img src="https://images.theconversation.com/files/571889/original/file-20240129-23-swxurx.jpg?ixlib=rb-1.1.0&rect=42%2C76%2C1673%2C1082&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The Death of Julius Caesar, an 1806 painting by Vincenzo Camuccini. </span> <span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Vincenzo_Camuccini_-_La_morte_di_Cesare.jpg">Wikipedia</a></span></figcaption></figure><p>American humorist and writer Mark Twain is believed to have once said, “History doesn’t repeat itself, but it often rhymes.”</p>
<p>I’ve been working as a historian and complexity scientist for the better part of a decade, and I often think about this phrase as I follow different strands of the historical record and notice the same patterns over and over.</p>
<p>My background is in ancient history. As a young researcher, I tried to understand why the <a href="https://brill.com/display/title/36003">Roman Empire became so big</a> and what ultimately led to its downfall. Then, during my doctoral studies, I met the evolutionary biologist turned historian <a href="http://peterturchin.com/">Peter Turchin</a>, and that meeting had a profound impact on my work. </p>
<p>I joined Turchin and a few others who were establishing a new field – a new way to investigate history. It was called <a href="https://peterturchin.com/cliodynamics-history-as-science/">cliodynamics</a> after Clio, the ancient Greek muse of history, and dynamics, the study of how complex systems change over time. Cliodynamics marshals scientific and statistical tools <a href="https://doi.org/10.1038/454034a">to better understand the past</a>. </p>
<p>The aim is to treat history as a “natural” science, using statistical methods, computational simulations and other tools adapted from evolutionary theory, physics and <a href="https://complexityexplained.github.io/">complexity science</a> to understand why things happened the way that they did.</p>
<figure class="align-right ">
<img alt="Mosiac of a Roman muse." src="https://images.theconversation.com/files/571892/original/file-20240129-25-u1q0qd.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/571892/original/file-20240129-25-u1q0qd.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=784&fit=crop&dpr=1 600w, https://images.theconversation.com/files/571892/original/file-20240129-25-u1q0qd.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=784&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/571892/original/file-20240129-25-u1q0qd.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=784&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/571892/original/file-20240129-25-u1q0qd.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=985&fit=crop&dpr=1 754w, https://images.theconversation.com/files/571892/original/file-20240129-25-u1q0qd.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=985&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/571892/original/file-20240129-25-u1q0qd.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=985&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Mosaic representing the Greek muse Clio from the Severian period, coming from the villa located near the Baccano woods, and exhibited at the Palazzo Massimo alle Terme in Rome.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:0_Mosa%C3%AFque_repr%C3%A9sentant_%27Clio%27_-_Pal._Massimo_%C3%A0_Rome_.JPG">Jean-PolGRANDMONT/Wikimedia Commons</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
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<p>By turning historical knowledge into scientific “data”, we can run analyses and test hypotheses about historical processes, just like any other science.</p>
<h2>The databank of history</h2>
<p>Since 2011, my colleagues and I have been compiling an enormous amount of information about the past and storing it in a unique collection called the <a href="https://seshatdatabank.info">Seshat: Global History Databank</a>. Seshat involves the contribution of over 100 researchers from around the world. </p>
<p><a href="https://seshatdatabank.info/methods">We create</a> structured, analysable information by surveying the huge amount of scholarship available about the past. For instance, we can record a society’s population as a number, or answer questions about whether something was present or absent. Like, did a society have professional bureaucrats? Or, did it maintain public irrigation works?</p>
<p>These questions get turned into numerical data – a present can become a “1” and absent a “0” – in a way that allows us to examine these data points with a host of analytical tools. Critically, we always combine this “hard” quantitative data with more qualitative descriptions, explaining why the answers were given, providing nuance and marking uncertainty when the research is unclear, and citing relevant published literature.</p>
<p>We’re focused on gathering as many <a href="https://seshatdatabank.info/seshat-projects/crisis-and-recovery-database">examples of past crises</a> as we can. These are periods of social unrest that often result in major devastation — <a href="https://seshat-db.com/">things like</a> famine, disease outbreaks, <a href="https://www.penguinrandomhouse.com/books/624156/how-civil-wars-start-by-barbara-f-walter/">civil wars</a> and even <a href="https://www.routledge.com/How-Worlds-Collapse-What-History-Systems-and-Complexity-Can-Teach-Us/Centeno-Callahan-Larcey-Patterson/p/book/9781032363219#">complete collapse</a>.</p>
<p><a href="http://so-dy.org/">Our goal</a> is to find out what drove these societies into crisis, and then what factors seem to have determined whether people could course-correct to stave off devastation.</p>
<p>But why? Right now, we are living in an <a href="https://omega.ngo/2023/05/the-global-polycrisis-reflects-a-civilizational-crisis-that-calls-for-systemic-alternatives/">age of polycrisis</a> – a state where social, political, economic, environmental and other systems are not only deeply interrelated, but nearly all of them are under strain or experiencing some kind of disaster or extreme upheaval.</p>
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<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption"></span>
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
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<p>Examples today include the lingering social and economic effects of the COVID-19 pandemic, volatility in global food and energy markets, wars, political instability, ideological extremism and climate change. </p>
<p>By looking back at past polycrises (and there were many) we can try and figure out which societies coped best.</p>
<p>Pouring through the historical record, we have started noticing some very important themes rhyming through history. Even major ecological disasters and unpredictable climates are nothing new. </p>
<h2>Inequality and elite infighting</h2>
<p>One of the most <a href="https://doi.org/10.1098/rstb.2022.0402">common patterns that has jumped out</a> is how extreme inequality shows up in nearly every case of major crisis. When big gaps exist between the haves and have-nots, not just in material wealth but also access to positions of power, this breeds <a href="https://doi.org/10.21237/C7clio8237450">frustration, dissent and turmoil</a>.</p>
<p>“<a href="https://peterturchin.com/books/ages-of-discord">Ages of discord</a>”, as Turchin dubbed periods of great social unrest and violence, produce some of history’s most devastating events. This includes the <a href="https://theconversation.com/what-really-started-the-american-civil-war-205281">US civil war</a> of the 1860s, the early 20th-century <a href="https://theconversation.com/what-was-russias-october-revolution-for-and-does-it-matter-any-more-84533">Russian Revolution</a>, and the Taiping rebellion against the Chinese Qing dynasty, often said to be the <a href="https://www.penguinrandomhouse.com/books/131825/autumn-in-the-heavenly-kingdom-by-stephen-r-platt/">deadliest civil war in history</a>. </p>
<p>All of these cases saw people become frustrated at extreme wealth inequality, along with lack of inclusion in the political process. Frustration bred anger, and eventually erupted into fighting that killed millions and affected many more. </p>
<p>For example, the 100 years of civil fighting that <a href="https://doi.org/10.1017/CCOL0521807948.005">felled the Roman republic</a> was propelled by widespread unrest and poverty. Different political camps were formed, took increasingly extreme positions, and came to vilify their opponents with progressively more intense language and vitriol. This animosity spilled over into the streets, where mobs of armed citizens got into huge brawls and even lynched a popular leader and reformer, <a href="https://www.unrv.com/empire/gracchi-brothers.php">Tiberius Gracchus</a>.</p>
<figure class="align-center ">
<img alt="An oil painting depicting the fall of the Roman Empire." src="https://images.theconversation.com/files/571886/original/file-20240129-15-3n6dj5.jpg?ixlib=rb-1.1.0&rect=0%2C1188%2C7675%2C4325&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/571886/original/file-20240129-15-3n6dj5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=372&fit=crop&dpr=1 600w, https://images.theconversation.com/files/571886/original/file-20240129-15-3n6dj5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=372&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/571886/original/file-20240129-15-3n6dj5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=372&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/571886/original/file-20240129-15-3n6dj5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=468&fit=crop&dpr=1 754w, https://images.theconversation.com/files/571886/original/file-20240129-15-3n6dj5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=468&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/571886/original/file-20240129-15-3n6dj5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=468&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">‘Destruction’ from the The Course of Empire by Thomas Cole, 1836.</span>
<span class="attribution"><a class="source" href="https://en.wikipedia.org/wiki/File:Cole_Thomas_The_Course_of_Empire_Destruction_1836.jpg">Wikipedia/ThomasCole</a></span>
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<p>Eventually, this fighting spiralled into full-blown civil warfare with highly trained, well-organised armies meeting in pitched battles. The underlying tensions and inequalities weren’t addressed during all this fighting, though, so this process repeated itself from about the 130s BC until 14AD, when the republican form of government <a href="https://www.cambridge.org/core/books/abs/cambridge-companion-to-the-roman-republic/crisis-of-the-republic/818E82A5A659A2A3B149AC9AFCDA5BEC">came crashing down</a>. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/cliodynamics-can-science-decode-the-laws-of-history-8626">Cliodynamics: can science decode the laws of history?</a>
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</em>
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<p>Perhaps one of the most surprising things is that inequality seems to be just as corrosive for the elites themselves. This is because the accumulation of so much wealth and power leads to intense infighting between them, which ripples throughout society. </p>
<p>In the case of Rome, it was the wealthy and powerful senators and military leaders <a href="https://yalebooks.yale.edu/book/9780300126891/caesar/">like Julius Caesar</a> who seized on the anger of a disaffected populace and led the violence. </p>
<p>This pattern also appears at other moments, such as the hatred between southern landowners and northern industrialists in <a href="https://peterturchin.com/books/ages-of-discord">the run up to the US civil war</a> and the struggles between the Tsarist rulers and <a href="https://www.routledge.com/Russia-in-the-Age-of-Reaction-and-Reform-1801-1881/Saunders/p/book/9780582489783#:%7E:text=David%20Saunders%20examines%20Russia%27s%20failure,piece%20of%20sustained%20historical%20analysis.">Russia’s landed nobility</a> during the late 1800s. </p>
<p>Meanwhile, the 1864 Taiping rebellion was <a href="https://doi.org/10.1371/journal.pone.0289748">instigated by well educated young men</a>, frustrated at being unable to find prestigious positions in government after years of toiling away at their studies and passing the civil service exams.</p>
<p>What we see time and again is that wealthy and powerful people try to grab bigger shares of the pie to maintain their positions. Rich families become desperate to secure prestigious posts for their children, while those aspiring to join the ranks of the elite scratch and claw their way up. And typically, wealth is related to power, as elites try to secure top positions in political office.</p>
<p>All this competition leads to increasingly drastic measures, including breaking rules and social taboos to stay ahead of the game. And once the taboo of refraining from civil violence falls – as it too often does – the results are typically devastating.</p>
<h2>Fighting for the top spot</h2>
<p>These patterns probably sound familiar. Consider the <a href="https://www.nytimes.com/news-event/college-admissions-scandal">college admissions scandal</a> in the US in 2019. That scandal broke when a few well-known American celebrities were caught having bribed their children’s way into prestigious Ivy League universities like Stanford and Yale. </p>
<p>But it wasn’t only these celebrities who broke the rules trying to secure their children’s future. Dozens of parents <a href="https://www.businessinsider.com/college-admissions-scandal-full-list-people-sentenced-2019-9#sentencings-are-still-ongoing-for-the-college-admissions-scandal-in-which-federal-prosecutors-say-parents-paid-about-25-million-to-get-their-students-into-elite-schools-like-the-university-of-southern-california-stanford-and-yale-1">were prosecuted for such bribes</a>, and the investigations are still ongoing. This scandal provides a perfect illustration of what happens when elite competition gets out of hand. </p>
<p>In the UK, you could point to the honours system, which generally seems to reward key allies of those in charge. This was the case in 2023, when former prime minister Boris Johnson <a href="https://www.bbc.co.uk/news/uk-politics-65861936">rewarded his inner circle</a> with peerages and other prestigious honours. He wasn’t the first prime minister to do so, and he won’t be the last.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1667214913989689374"}"></div></p>
<p>One of the really common historical patterns is that as people accumulate wealth, they generally seek to translate this into other types of “<a href="https://peterturchin.com/on-social-power/">social power</a>”: political office, positions at top firms, military or religious leadership. Really, <a href="https://www.theguardian.com/books/2023/jun/10/how-to-avoid-a-civil-war-by-the-man-who-predicted-trump">whatever is valued most</a> at that time in their specific society.</p>
<p>Donald Trump is only one recent and fairly extreme version of this motif that pops up time and again <a href="https://www.salon.com/2020/11/21/what-lies-ahead-after-the-damage-of-the-trump-era-can-america-avoid-disaster/">during ages of discord</a>. And if something isn’t done to relieve the pressure of such competition then these frustrated elites can find masses of supporters. </p>
<p>Then the pressures continue to build, igniting anger and frustration within more and more people, until it requires some release, usually in the form of violent conflict.</p>
<p>Remember that intra-elite competition usually rises when inequality is high, so these are periods when large numbers are feeling frustrated, angry, and ready for a change – even if they have to fight and perhaps die for it, as it seemed some were when they <a href="https://theconversation.com/uk/topics/january-6-us-capitol-attack-128973">stormed the US Capitol</a> on January 6, 2021.</p>
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<p>Put together, fiercely competitive elites alongside scores of poor and marginalised people create an extremely combustible situation.</p>
<h2>When the state can’t ‘right the ship’</h2>
<p>As inequality takes root and conflict among elites ramps up, it usually ends up hampering society’s ability to right the ship. This is because elites tend to capture the lion’s share of wealth, often at the expense of both the majority population and state institutions. This is a crucial aspect of rising inequality, today just as much as in the past.</p>
<p>So vital public goods and welfare programmes, like initiatives to provide food, housing or healthcare to those in need, become underfunded and eventually cease to work at all. This exacerbates the gap between the wealthy who can afford these services and the growing number who cannot. </p>
<p>My colleague, political scientist Jack Goldstone, came up with a <a href="https://www.routledge.com/Revolution-and-Rebellion-in-the-Early-Modern-World-Population-Change-and/Goldstone/p/book/9781138222120">theory to explain this in the early 1990s</a>, called structural demographic theory. He took an in-depth look at the French Revolution, often seen as the archetypal popular revolt. Goldstone was able to show that a lot of the fighting and grievances were driven by frustrated elites, not only by the “masses”, as is the common understanding.</p>
<p>These elites were finding it harder and harder to get a seat at the table with the French royal court. Goldstone noted that the reason these tensions became so inflamed and exploded is because the state had been losing its grip on the country for decades due to mismanagement of resources and from all of the entrenched privileges that the elites were fighting so hard to retain. </p>
<figure class="align-center ">
<img alt="A woman of the people (personifying the concept of Liberty) amid the bodies of the fallen, holding aloft the tricolour flag." src="https://images.theconversation.com/files/571896/original/file-20240129-19-oq7fb2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/571896/original/file-20240129-19-oq7fb2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=481&fit=crop&dpr=1 600w, https://images.theconversation.com/files/571896/original/file-20240129-19-oq7fb2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=481&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/571896/original/file-20240129-19-oq7fb2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=481&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/571896/original/file-20240129-19-oq7fb2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=605&fit=crop&dpr=1 754w, https://images.theconversation.com/files/571896/original/file-20240129-19-oq7fb2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=605&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/571896/original/file-20240129-19-oq7fb2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=605&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">‘Liberty Leading the People’ is a painting by Eugène Delacroix commemorating the July Revolution of 1830, which toppled King Charles X.</span>
<span class="attribution"><a class="source" href="https://en.wikipedia.org/wiki/Liberty_Leading_the_People">Wikipedia</a></span>
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<p>So just when a society most needs its leaders in government and the civil service to step up and turn the crisis around, it finds itself at its weakest point and is unfit for the challenge. This is one of the main reasons that so many historical crises turn into major catastrophes.</p>
<p>As my colleagues and I have pointed out, <a href="https://www.noemamag.com/welcome-to-the-turbulent-twenties/">this is disturbingly similar</a> to trends we are seeing in the US, the UK and Germany, for example. Years of deregulation and privatisation in the US, for instance, have rolled back many of the gains made during the postwar period and <a href="https://www.nytimes.com/2021/11/11/opinion/reagan-social-welfare.html">gutted a variety of public services</a>.</p>
<p>Meanwhile in the UK, the National Health Service has been said to be “<a href="https://www.theguardian.com/society/2023/jul/03/locked-in-a-death-spiral-state-of-the-nhs-at-75">locked in a death spiral</a>” due to years of cuts and underfunding.</p>
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Read more:
<a href="https://theconversation.com/its-like-being-in-a-warzone-aande-nurses-open-up-about-the-emotional-cost-of-working-on-the-nhs-frontline-194197">'It's like being in a warzone' – A&E nurses open up about the emotional cost of working on the NHS frontline</a>
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<p>All the while, <a href="https://www.theguardian.com/inequality/2024/jan/15/worlds-five-richest-men-double-their-money-as-poorest-get-poorer">the rich have got richer and the poor have got poorer</a>. According <a href="https://wir2022.wid.world/www-site/uploads/2023/03/D_FINAL_WIL_RIM_RAPPORT_2303.pdf">to recent statistics</a> the richest 10% of households now control over 75% of the total wealth in world. </p>
<p>Such stark inequality leads to the sort of tension and anger we see in all the cases mentioned above. But without adequate state capacity or support from elites and the general public alike, it is unlikely that these countries will have what it takes to make the sort of reforms that could decrease tension. This is why some <a href="https://www.penguinrandomhouse.com/books/624156/how-civil-wars-start-by-barbara-f-walter">commentators</a> have even claimed a second US civil war is looming.</p>
<h2>Our age of polycrisis</h2>
<p>There is no doubt that we’re facing certain novel challenges today that people in the past did not. Not just in terms of the frequency and scale of ecological disasters, but also in the way that so many of our systems (global production, food and mineral supply chains, economic systems, the international political order) are more <a href="https://dx.doi.org/10.2139/ssrn.4483556">hopelessly entangled</a> than they ever have been. </p>
<p>A shock to one of these systems almost inevitably reverberates into the others. The war in Ukraine, for example, has affected global food supply chains and the price of gas across the world. </p>
<p><a href="https://cascadeinstitute.org/wp-content/uploads/2023/06/The-Causal-Mechanisms-of-Global-Polycrisis-v1.1-11July2023.pdf">Researchers at the Cascade Institute</a>, some of the leading authorities working to understand and track our current polycrisis, present a truly terrifying (and not exahuastive) list of crises the world is facing today, including:</p>
<ul>
<li>the lingering health, social, and economic effects of COVID-19</li>
<li>stagflation (a persistent combination of inflation and low growth)</li>
<li>volatility in global food and energy markets</li>
<li>geopolitical conflict</li>
<li>political instability and civil unrest arising from economic insecurity</li>
<li>ideological extremism</li>
<li>political polarisation</li>
<li>declining institutional legitimacy</li>
<li>increasingly frequent and devastating weather events generated by climate heating</li>
</ul>
<p>Each of these on its own would wreak significant devastation, but they all interact, each one propelling the others and offering no signs of relief.</p>
<h2>There were polycrises in the past too</h2>
<p>Many of the same sorts of threats <a href="https://papers.ssrn.com/abstract=4593383">occurred in the past too</a>, perhaps not on the global scale we see today, but certainly on a regional or even trans-continental scale.</p>
<p>Even environmental threats have been a challenge that humans have had to <a href="https://doi.org/10.1088/1748-9326/ac8faa">deal with</a>. There have been ice ages, decades-long droughts and famines, unpredictable weather and severe ecological shocks. </p>
<p>The “<a href="https://www.hachettebookgroup.com/titles/brian-fagan/the-little-ice-age/9781541618572/">little ice age</a>,”, a period of abnormally cold temperatures that lasted for centuries from the 14th to early 19th centuries, inflicted mass devastation in Europe and Asia. This poor climate regime caused a number of ecological disasters, including recurrent famine in many places.</p>
<p>During this period, there were major disruptions in economic activity exacerbating food insecurity in places reliant on trade to feed their populations. For example, Egypt experienced what academics <a href="https://archiv.ub.uni-heidelberg.de/volltextserver/17711/1/Chalyan-Daffner.pdf">now refer to as a “great crisis”</a> in the late 14th century during Mamluk Sultanate rule, as a plague outbreak combined with local flooding that ruined domestic crops while conflict in east Asia disrupted trade into the region. This caused a major famine throughout Egypt and, eventually, an armed revolt including the assassination of the Mamluk sultan, An-Nasir Faraj. </p>
<p>There was also a notable rise in uprisings, protests, and conflicts <a href="https://www.nature.com/articles/s41599-020-00661-1">throughout Europe and Asia</a> under these harsh environmental conditions. And the bubonic plague broke out during this period, as the infection found a welcome home among the large numbers of people left hungry and cold in harsh conditions.</p>
<h2>How different countries handled the pandemic</h2>
<p>Looking at the historical data, one thing gives me hope. The same forces that conspire to leave societies vulnerable to catastrophe can also work the other way.</p>
<p>The COVID-19 outbreak is a good example. This was a devastating disease hitting nearly the entire globe. However, as <a href="https://doi.org/10.1038/s41562-020-01009-0">my colleagues have pointed out</a>, the impact from the disease was not the same in every country or even among different communities.</p>
<p>This was due to many factors including how quickly the disease was identified, the effectiveness of various public health measures, and the demographic make-up of countries (proportion of elderly and more vulnerable communities in the population, for example). Another major factor, not always recognised, was how social stressors had been building up in the years before the disease struck. </p>
<p>But in some countries, <a href="https://www.theguardian.com/books/2022/may/11/preventable-by-devi-sridhar-review-a-resolutely-global-view-of-covid">such as South Korea and New Zealand</a>, inequality and the other pressures had been kept largely at bay. Trust in government and social cohesion was also generally higher. When the disease appeared, people in these countries were able to pull together and respond more effectively than elsewhere.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/100-days-without-covid-19-how-new-zealand-got-rid-of-a-virus-that-keeps-spreading-across-the-world-143672">100 days without COVID-19: how New Zealand got rid of a virus that keeps spreading across the world</a>
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<hr>
<p><a href="https://theconversation.com/the-secret-to-south-koreas-covid-success-combining-high-technology-with-the-human-touch-170045">They quickly managed to implement</a> an <a href="https://theconversation.com/100-days-without-covid-19-how-new-zealand-got-rid-of-a-virus-that-keeps-spreading-across-the-world-143672">array of strategies</a> to fight the disease, like masking and physical distancing guidelines, that were supported and followed by large numbers of people. And generally, there was a fairly swift response from leaders in these countries with the state providing financial support for missed work, organising food drives and setting up other crucial programmes to help people manage with all of the disruptions COVID brought.</p>
<p>In countries like the US <a href="https://theconversation.com/coronavirus-one-year-on-two-countries-that-got-it-right-and-three-that-got-it-wrong-155923">and the UK</a>, however, pressures like inequality and partisan conflict were already high and growing in the years before the first outbreak. </p>
<p>Large numbers of people in these places were impoverished and <a href="https://doi.org/10.1073/pnas.2020685118">made particularly vulnerable to the disease</a>, as <a href="https://theconversation.com/boris-johnson-at-the-covid-inquiry-sullen-evasive-and-a-danger-to-democracy-219261">political in-fighting</a> left government response slow, communication poor, and often resulted in confusing and contradictory advice.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/P_i87lDC4M0?wmode=transparent&start=2" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>The countries that responded poorly just didn’t have the social cohesion and trust in leadership needed to effectively implement and manage strategies to manage the disease. So, instead of bringing people together, tensions were further inflamed and <a href="https://www.nature.com/immersive/d41586-022-01647-6/index.html">preexisting inequalities widened</a>. </p>
<h2>Sometimes societies do right the ship</h2>
<p>These pressures have played out in similar ways <a href="https://doi.org/10.1098/rstb.2022.0402">in the past</a>. Unfortunately, by far the most common outcome has been major devastation and destruction. Our current research catalogues almost 200 cases of past societies experiencing a period of high risk, what we call a “crisis situation”. Over half of these situations turn into civil war or major uprising, about 35% involve the assassination of a ruler, and almost 40% involve the society losing control over territory or completely collapsing. </p>
<p>But our research has also found examples where societies were able to stop political infighting, harness their collective energy and resources to boost resilience, and make positive adaptations in the face of crisis. </p>
<p>For instance, during <a href="https://doi.org/10.1080/14767058.2021.2025357">a “plague” in ancient Athens</a> (probably a typhoid or smallpox outbreak), officials helped organise quarantines and gave public support for medical services and food distribution. Even without our modern understanding of virology, they did what they could to get through a difficult time.</p>
<figure class="align-center ">
<img alt="A painting of crowds of ill and dying people during a plague in ancient Athens." src="https://images.theconversation.com/files/571905/original/file-20240129-27-vls6l3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/571905/original/file-20240129-27-vls6l3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=417&fit=crop&dpr=1 600w, https://images.theconversation.com/files/571905/original/file-20240129-27-vls6l3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=417&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/571905/original/file-20240129-27-vls6l3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=417&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/571905/original/file-20240129-27-vls6l3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=524&fit=crop&dpr=1 754w, https://images.theconversation.com/files/571905/original/file-20240129-27-vls6l3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=524&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/571905/original/file-20240129-27-vls6l3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=524&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">‘Plague in an Ancient City’, by Michael Sweerts (circa 1652) is believed to be referring to the plague of Athens.</span>
<span class="attribution"><a class="source" href="https://picryl.com/media/plague-in-an-ancient-city-lacma-ac1997101-1-of-2-23d5b3">LACMA/wikemedia</a></span>
</figcaption>
</figure>
<p>We see also amazing feats of engineering and collective action taken by ancient societies to produce enough food for their growing populations. Look at the irrigation channels that kept the Egyptians fed for thousands of years during the <a href="https://doi.org/10.1093/oxfordhb/9780195188318.013.0003">time of the Pharaohs</a>, or the terraced fields built high in the Andes mountains <a href="https://press.umich.edu/Books/H/How-the-Incas-Built-Their-Heartland">under the Inca empire</a>.</p>
<p>The Qing and other imperial dynasties in China constructed <a href="https://press.umich.edu/Books/N/Nourish-the-People2">a huge web of granaries</a> throughout their vast territory, supported by public funds and managed by government officials. This required a massive amount of training, oversight, financial commitment and significant investment in infrastructure to produce and transport foodstuff all over the region. </p>
<p>These granaries played a major role in providing relief when harsh climate conditions such as major floods, droughts, locust invasions, or warfare, threatened the food supply. My colleagues and I have argued recently that the <a href="https://doi.org/10.1371/journal.pone.0289748">breakdown of this granary system in the 19th century</a> — driven by corruption among the managers and the strain on state capacity — was in fact a major contributor in the collapse of the Qing, China’s final imperial dynasty. </p>
<h2>Elites in Chartist England</h2>
<p>One of the most prominent examples of a country that faced crisis but managed to avoid the worst, is England during the 1830s and 1840s. This was the so-called Chartist period, <a href="https://www.cambridge.org/core/books/social-unrest-and-popular-protest-in-england-17801840/381C31E1F98A417A89A0DD3E538E24DD">a time of widespread unrest and revolt</a>. </p>
<p>From the end of the 1700s, many of England’s farmers had seen profits diminish. On top of this, England was right in the middle of the industrial revolution, with rapidly swelling cities filling with factories. But <a href="https://www.bbc.co.uk/bitesize/guides/zkxrxyc/revision/2">conditions in these factories were atrocious</a>. There was virtually no oversight or protections to ensure worker safety or to compensate anyone injured on the job, and employees were often forced to work long hours with minuscule pay.</p>
<p>The first few decades of the <a href="https://escholarship.org/uc/item/2rf8c7zk">1800s saw a number of revolts throughout England and Ireland</a>, several of which became violent. Workers and farmers together charted their demands for more equitable and fair treatment in a series of pamphlets, which is where the period gets its name. </p>
<p>Many of England’s powerful political elite came to support these demands as well. Or at least there were enough to allow for the passing of <a href="https://doi.org/10.2307/4054773">some significant reforms</a>, including regulations about worker safety, increased representation for the less wealthy, working class people in parliament, and the establishment of public welfare support for those unable to find work.</p>
<figure class="align-center ">
<img alt="Copy of a poster advertising a demonstration in 1848." src="https://images.theconversation.com/files/571907/original/file-20240129-27-zeir1s.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/571907/original/file-20240129-27-zeir1s.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=753&fit=crop&dpr=1 600w, https://images.theconversation.com/files/571907/original/file-20240129-27-zeir1s.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=753&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/571907/original/file-20240129-27-zeir1s.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=753&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/571907/original/file-20240129-27-zeir1s.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=946&fit=crop&dpr=1 754w, https://images.theconversation.com/files/571907/original/file-20240129-27-zeir1s.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=946&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/571907/original/file-20240129-27-zeir1s.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=946&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Poster advertising the ‘Monster’ Chartist Demonstration, held on April 10 1848.</span>
<span class="attribution"><a class="source" href="https://snl.no/chartismen">Rodney Mace, British Trade Union Posters: An Illustrated History.</a></span>
</figcaption>
</figure>
<p>The reforms resulted in marked improvement in the <a href="https://escholarship.org/uc/item/2rf8c7zk">wellbeing of millions of people in the subsequent decades</a>, which makes this a remarkable example. Although it needs to be noted that women were completely left out of the suffrage advances until years later. But many commentators point to this period as setting the stage for the <a href="https://www.penguinrandomhouse.ca/books/246249/the-dignity-of-chartism-by-dorothy-thompson/9781781688489">modern welfare systems</a> that those of us living in the developed world tend to take for granted. And crucially, the path to victory was made much easier, and considerably less bloody, by having elite support.</p>
<p>In most cases, where tensions mount and popular unrest explodes into violent protests, the wealthy and powerful tend to double down on maintaining their own privileges. But in Chartist England, a healthy contingent of progressive, “<a href="https://www.resilience.org/stories/2022-11-07/david-sloan-wilson-on-evolutionary-science-and-prosocial-behavior/">prosocial</a>” elites were willing to sacrifice some of their own wealth, power, and privilege.</p>
<h2>Finding hope</h2>
<p>If the past teaches us anything, it is that trying to hold on to systems and policies that refuse to appropriately adapt and respond to changing circumstances — like climate change or growing unrest among a population – usually end in disaster. Those with the means and opportunity to enact change must do so, or at least to not stand in the way when reform is needed. </p>
<figure class="align-center ">
<img alt="Volunteers at building site laying bricks." src="https://images.theconversation.com/files/571909/original/file-20240129-29-yer1oj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/571909/original/file-20240129-29-yer1oj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/571909/original/file-20240129-29-yer1oj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/571909/original/file-20240129-29-yer1oj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/571909/original/file-20240129-29-yer1oj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/571909/original/file-20240129-29-yer1oj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/571909/original/file-20240129-29-yer1oj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Volunteers rebuilding a school in Trishuli, Nepal, that was destroyed by the earthquake in 2016.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/trishuli-nepal-october-20th-2016-view-525447154">Shutterstock/Mihai Speteanu</a></span>
</figcaption>
</figure>
<p>This last lesson is a particularly hard one to learn. Unfortunately, there are many signs around the world today that the mistakes of the past are being repeated, especially by our political leaders and those aspiring to hold power. </p>
<p>Just in the past few years, we have witnessed a pandemic, increasing ecological disasters, mass impoverishment, political gridlock, the return of authoritarian and xenophobic politics, and atrocious warfare.</p>
<p>This global polycrisis shows no signs of letting up. If nothing changes, we can expect these crises to worsen and spread to more places. We may discover — too late — that these are indeed “<a href="https://www.penguinrandomhouse.com/books/703238/end-times-by-peter-turchin/">end times</a>”, as Turchin has written. </p>
<p>But we also are in a unique position, because we know more about these forces of destruction and about how they played out <a href="https://www.newscientist.com/article/2406477-why-reports-that-western-civilisation-will-soon-collapse-are-premature/">in the past than ever before</a>. This sentiment serves as the foundation for all of the work we have done compiling this massive amount of historical information. </p>
<p>Learning from history means that we have the ability to do something different. We can relieve the pressures that are creating violence and making society more fragile.</p>
<p>Our goal as cliodynamicists is to uncover patterns – not just to see how what we are doing today rhymes with the past – but to help find better ways forward.</p>
<hr>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
</figcaption>
</figure>
<p><em>For you: more from our <a href="https://theconversation.com/uk/topics/insights-series-71218?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insights series</a>:</em></p>
<ul>
<li><p><em><a href="https://theconversation.com/my-home-city-was-destroyed-by-war-but-i-will-not-lose-hope-how-modern-warfare-turns-neighbourhoods-into-battlefields-211627?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">‘My home city was destroyed by war but I will not lose hope’ – how modern warfare turns neighbourhoods into battlefields
</a></em></p></li>
<li><p><em><a href="https://theconversation.com/how-disappearance-became-a-global-weapon-of-psychological-control-50-years-on-from-chiles-us-backed-coup-213014?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">How disappearance became a global weapon of psychological control, 50 years on from Chile’s US-backed coup
</a></em></p></li>
<li><p><em><a href="https://theconversation.com/conscientious-objectors-in-the-second-world-war-little-known-stories-of-pacifists-plagued-by-doubt-but-willing-to-risk-their-lives-209178?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Conscientious objectors in the second world war: little-known stories of pacifists plagued by doubt but willing to risk their lives
</a></em></p></li>
</ul>
<p><em>To hear about new Insights articles, join the hundreds of thousands of people who value The Conversation’s evidence-based news. <a href="https://theconversation.com/uk/newsletters/the-daily-newsletter-2?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK"><strong>Subscribe to our newsletter</strong></a>.</em></p><img src="https://counter.theconversation.com/content/218969/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Daniel Hoyer receives funding from the V. Kann Rasmussen Foundation. He is affiliated with the Complexity Science Hub, Vienna as associate faculty in the Social Complexity & Collapse Working Group, as senior researcher and Managing Director of Seshat: Global History Databank project, and as research scientist with the SocialAI Research Group at the University of Toronto
</span></em></p>Historian and complexity scientist, Dan Hoyer, examines why past societies collapsed when faced with crisis, while others founds ways to survive and flourish.Daniel Hoyer, Senior Researcher, Historian and Complexity Scientist, University of TorontoLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2224582024-02-07T17:30:26Z2024-02-07T17:30:26ZThe brain is the most complicated object in the universe. This is the story of scientists’ quest to decode it – and read people’s minds<figure><img src="https://images.theconversation.com/files/573721/original/file-20240206-26-8guoy5.jpg?ixlib=rb-1.1.0&rect=299%2C119%2C3586%2C2874&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">HuthLab researchers (l-r) Alex Huth, Shailee Jain and Jerry Tang behind an fMRI scanner in the University of Texas's Biomedical Imaging Center.</span> <span class="attribution"><a class="source" href="https://cns.utexas.edu/news/podcast/brain-activity-decoder-can-reveal-stories-peoples-minds">Nolan Zunk/UT Austin</a></span></figcaption></figure><p>In the middle of 2023, a <a href="https://news.utexas.edu/2023/05/01/brain-activity-decoder-can-reveal-stories-in-peoples-minds/">study</a> conducted by the HuthLab at the University of Texas sent shockwaves through the realms of neuroscience and technology. For the first time, the thoughts and impressions of people unable to communicate with the outside world were translated into continuous natural language, using a combination of artificial intelligence (AI) and brain imaging technology.</p>
<p>This is the closest science has yet come to reading someone’s mind. While advances in neuroimaging over the past two decades have enabled non-responsive and minimally conscious patients to control a computer cursor with their brain, HuthLab’s research is a significant step closer towards accessing people’s actual thoughts. As Alexander Huth, the neuroscientist who co-led the research, <a href="https://www.nytimes.com/2023/05/01/science/ai-speech-language.html">told the New York Times</a>:</p>
<blockquote>
<p>This isn’t just a language stimulus. We’re getting at meaning – something about the idea of what’s happening. And the fact that’s possible is very exciting.</p>
</blockquote>
<p>Combining AI and brain-scanning technology, the team created a non-invasive brain decoder capable of <a href="https://www.biorxiv.org/content/10.1101/2022.09.29.509744v1">reconstructing continuous natural language</a> among people otherwise unable to communicate with the outside world. The development of such technology – and the parallel development of <a href="https://iopscience.iop.org/article/10.1088/2516-1091/ac23e6/meta">brain-controlled motor prosthetics</a> that enable paralysed patients to achieve some renewed mobility – holds tremendous prospects for people suffering from neurological diseases including <a href="https://www.ninds.nih.gov/health-information/disorders/locked-syndrome#:%7E:text=Locked%2Din%20syndrome%20is%20a,communicate%20with%20blinking%20eye%20movements">locked-in syndrome</a> and <a href="https://www.britannica.com/science/quadriplegia">quadriplegia</a>.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/9YLvDAqDJAE?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Report on HuthLab’s ‘mind reading’ research by CBS Austin.</span></figcaption>
</figure>
<p>In the longer term, this could lead to wider public applications such as fitbit-style <a href="https://insider.fitt.co/a-50k-fitbit-for-your-brain/">health monitors for the brain</a> and <a href="https://link.springer.com/chapter/10.1007/978-3-319-94544-6_4">brain-controlled smartphones</a>. On January 29, Elon Musk <a href="https://twitter.com/elonmusk/status/1752098683024220632">announced</a> that his Neuralink tech startup had implanted a chip in a human brain for the first time. He had previously told followers that Neuralink’s first product, <a href="https://twitter.com/elonmusk/status/1752118131579867417">Telepathy</a>, would one day allow people to control their phones or computers “just by thinking”.</p>
<p>But alongside such technological developments come major <a href="https://theconversation.com/mri-scans-and-ai-technology-really-could-read-what-were-thinking-the-implications-are-terrifying-205503">ethical and legal concerns</a>. It’s not only privacy but the <a href="https://theconversation.com/freedom-of-thought-is-being-threatened-by-states-big-tech-and-even-ourselves-heres-what-we-can-do-to-protect-it-220266">very identity of people</a> that may be at risk. As we enter this new era of so-called <a href="https://www.newscientist.com/article/2408019-mind-reading-ai-can-translate-brainwaves-into-written-text/#:%7E:text=Using%20only%20a%20sensor%2Dfilled,person's%20thoughts%20into%20written%20words.">mind-reading technology</a>, we will also need to consider how to prevent its potential to help people being outweighed by its potential to do harm.</p>
<h2>Humanity’s greatest mapping challenge</h2>
<p>The brain is the <a href="https://today.uconn.edu/2018/03/complicated-object-universe/">most complicated object in the universe</a>. It contains more than 89 billion neurons, each connected to around 7,000 other neurons that send between ten and 100 signals every second. The development of AI was based on the brain and the <a href="https://theconversation.com/ai-will-soon-become-impossible-for-humans-to-comprehend-the-story-of-neural-networks-tells-us-why-199456">concept of neurons working together</a>. Now, the way AI works with deep learning is helping us understand much more clearly how the brain works.</p>
<p>By fully mapping the structure and function of a healthy human brain, we can determine with great precision what goes awry in diseases of the brain and mind. In 2009, <a href="https://humanconnectome.org/">the Human Connectome Project</a> was launched by the US National Institute of Health with the goal of building a map of the structure and function of a healthy human brain. Similar initiatives were launched in Europe in 2013 (<a href="http://www.humanbrainproject.eu/">the Human Brain Project</a>) and China in 2016 (<a href="https://www.sciencedirect.com/science/article/pii/S0896627316308005?via%3Dihub">the China Brain Project</a>).</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/Ud8gOmkxI7E?wmode=transparent&start=4" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Human Connectome video by BrainFacts.org.</span></figcaption>
</figure>
<p>This daunting endeavour may still take generations to complete – but the scientific ambition of mapping and reading people’s brains dates back more than two centuries. With the world having been circumnavigated many times over, Antarctica discovered and much of the planet charted, humanity was ready for a new (and even more complicated) mapping challenge – the human brain.</p>
<p>These efforts began in earnest in the late 18th century with the development of a systematic framework for scientists to ask how the brain and its regions produce psychological experiences – our thoughts, feelings and behaviour. One of the earliest attempts was <a href="https://www.britannica.com/topic/phrenology">phrenology</a>, pioneered by the Austrian physician and anatomist Franz Joseph Gall.</p>
<p>While this long-discredited science may now be best known for the <a href="https://artsci.case.edu/dittrick/online-exhibits/explore-the-artifacts/phrenology-bust-1850/">decorative busts</a> sold in flea markets, it was all the rage by the early 19th century. Gall and his assistant Johann Spurzheim suggested that the brain was organised along 35 psychological functions, each linked to a different underlying region.</p>
<hr>
<p><em>Across the world, we’re seeing unprecedented levels of mental illness at all ages, from children to the very old – with huge costs to families, communities and economies. <a href="https://theconversation.com/uk/topics/tackling-the-mental-health-crisis-147216?utm_source=TCUK&utm_medium=ArticleTop&utm_campaign=MentalHealthSeries">In this series</a>, we investigate what’s causing this crisis, and report on the latest research to improve people’s mental health at all stages of life.</em></p>
<hr>
<p>Just as you might start lifting dumbbells if you want larger biceps, phrenology argued that the more you use a particular psychological function, the more the brain region underlying it should grow – leading to a corresponding lump in your skull. <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1445-2197.2005.03426.x">According to Gall and Spurzheim</a>, some of these functions (including memory, love of offspring and the instinct to kill) were shared with animals, whereas others (such as wit, poetic ability and morality) were uniquely human.</p>
<p>Throughout the British empire and later in the US, phrenology was used to justify classism, colonialism, slavery and white supremacy. Queen Victoria had readings done on her children, but Napoleon Bonaparte was not a fan. When Gall moved to Paris in 1807 to perform much of his phrenological theorising, France’s emperor pronounced: “It is an ingenious fable which might seduce the <em>gens du monde</em>, but could not stand the scrutiny of the anatomist.”</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/572529/original/file-20240131-15-j86pu0.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="An old shop window with a large phrenology sign" src="https://images.theconversation.com/files/572529/original/file-20240131-15-j86pu0.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/572529/original/file-20240131-15-j86pu0.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=470&fit=crop&dpr=1 600w, https://images.theconversation.com/files/572529/original/file-20240131-15-j86pu0.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=470&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/572529/original/file-20240131-15-j86pu0.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=470&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/572529/original/file-20240131-15-j86pu0.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=591&fit=crop&dpr=1 754w, https://images.theconversation.com/files/572529/original/file-20240131-15-j86pu0.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=591&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/572529/original/file-20240131-15-j86pu0.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=591&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A phrenology shop in New Orleans in 1936.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Phrenology_Shop_in_New_Orleans_1936_by_Peter_Sekaer.jpg">Peter Sekaer/Wikimedia Commons</a></span>
</figcaption>
</figure>
<p>In the 1860s, “locationist” views of how the brain worked made a comeback – though the scientists leading this research were keen to distinguish their theories from phrenology. French anatomist Paul Broca discovered a region of the left hemisphere responsible for producing speech – thanks in part to his patient, Louis Victor Leborgne, who at age 30 <a href="https://blogs.scientificamerican.com/literally-psyched/the-man-who-couldnt-speakand-how-he-revolutionized-psychology/">lost the ability to say anything</a> other than the syllable “tan”. Today, <a href="https://link.springer.com/referenceworkentry/10.1007/978-0-387-79948-3_655">Patient Tan</a> remains one of psychology’s most famous case studies, and <a href="https://www.hopkinsmedicine.org/news/media/releases/brocas_area_is_the_brains_scriptwriter_shaping_speech_study_finds">Broca’s area</a>, in the frontal cortex, is one of the most important language regions of the brain, playing a critical part in putting our thoughts into words.</p>
<p>Similarly, German neuroanatomist Korbinian Brodmann’s <a href="https://www.nature.com/articles/461884a#:%7E:text=Korbinian%20Brodmann's%20Localisation%20in%20the,cell%20type%20and%20laminar%20structure.">map of 52 distinct regions of the cerebral cortex</a>, first published in 1909, is still an important tool of contemporary neuroscience – and today’s neuroscientists continue to ask <a href="https://psu.pb.unizin.org/psych425/chapter/locationist-and-one-network-views-of-emotions-in-the-brain/">some of the same questions</a> as these pioneers: are our thoughts, feelings and behaviour produced by the collective action of the brain, or specific brain regions?</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/572528/original/file-20240131-15-6poatr.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A map of different areas of the brain" src="https://images.theconversation.com/files/572528/original/file-20240131-15-6poatr.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/572528/original/file-20240131-15-6poatr.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=763&fit=crop&dpr=1 600w, https://images.theconversation.com/files/572528/original/file-20240131-15-6poatr.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=763&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/572528/original/file-20240131-15-6poatr.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=763&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/572528/original/file-20240131-15-6poatr.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=959&fit=crop&dpr=1 754w, https://images.theconversation.com/files/572528/original/file-20240131-15-6poatr.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=959&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/572528/original/file-20240131-15-6poatr.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=959&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Brodmann’s brain map.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Brodmann_areas.jpg">Vysha/Wikimedia</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>In modern neuroscience studies, hi-tech scanning tools such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) allow researchers to map the brain by measuring changes in local blood flow that are linked to changes in local neural activity. This approach depends on <a href="https://academic.oup.com/brain/article-abstract/51/3/310/309681?redirectedFrom=fulltext">the findings</a> of American physiologist John Fulton almost a century ago. Fulton was treating Walter K, a 26-year-old sailor suffering from headaches and vision failure. When using his eyes after leaving a dark room, the patient sensed a noise in the back of his head, located over the visual cortex. This stronger pulse of activity was not replicated by other sensory inputs, for example when smelling tobacco or vanilla.</p>
<p>Over the remainder of the 20th century, this first observation of the link between local cerebral blood flow and brain function was built on by neuroscientists including American <a href="https://dm5migu4zj3pb.cloudfront.net/manuscripts/101000/101994/JCI48101994.pdf">Seymour Kety</a> and Swedish collaborators <a href="https://karger.com/ced/article-pdf/11/1/71/2335730/000047614.pdf">David Ingvar</a> and <a href="https://www.jstor.org/stable/24955823">Neils Lassen</a>. Their pioneering work paved the way for modern brain mapping, led by the ground-breaking work of <a href="https://www.braingate.org/about-braingate/">BrainGate</a> – a multidisciplinary research unit originating in the neuroscience department at Brown University in the US state of Rhode Island.</p>
<h2>The first clinical trial</h2>
<p>Prototype brain-computer interfaces (BCIs) record and decode a patient’s brain activity, translating it into actions that can be carried out by a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8979628/">neural cursor, prosthetic limb or powered exoskeleton</a>. The ultimate goal is wireless, non-invasive devices that help patients communicate and move with precision in the real world. AI is critical to this goal, and is <a href="https://www.cell.com/trends/cognitive-sciences/fulltext/S1364-6613(21)00096-6#secst0015">already being used to help BCI systems</a> produce finely controlled, rapid <a href="https://iopscience.iop.org/article/10.1088/1741-2552/abfaaa/meta">motor movements</a>.</p>
<p>In 2004, <a href="https://www.braingate.org/about-braingate/">BrainGate</a> began the first clinical trial using BCIs to enable patients with impaired motor systems (including spinal cord injuries, <a href="https://pubmed.ncbi.nlm.nih.gov/32809731/#:%7E:text=Brainstem%20infarction%20is%20an%20area,provide%20precise%20diagnosis%20and%20management.">brainstem infarctions</a>, locked-in syndrome and muscular dystrophy) control a computer cursor with their thoughts.</p>
<hr>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
</figcaption>
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
<hr>
<p><a href="https://www.patientcareonline.com/view/paralyzed-man-thinks-robotic-devices-motion">Patient MN</a>, a quadriplegic since being stabbed in the neck in 2001, was the trial’s first patient. After neuroscientist Leigh Hochberg’s team implanted electrodes over the hand-arm region of the patient’s primary motor cortex, they <a href="https://www.nature.com/articles/nature04970">reported</a> that Patient MN was able to open emails, draw figures using a paint program, and operate a television using a cursor. In addition, brain activity was linked to the patient’s prosthetic hand and robotic arm, enabling rudimentary actions including grasping and transporting an object. What’s more, these tasks could be done while the patient was having a conversation, suggesting they did not even demand the full concentration of the patient.</p>
<p>Other quadriplegic patients subsequently used BCI devices connected to multi-joint robotic arms to <a href="https://www.nature.com/articles/nature11076">pick up and drink from a cup</a> – and in <a href="https://journals.sagepub.com/doi/10.1177/1545968314554624">2015</a>, a patient with locked-in syndrome was shown operating a point-and-click keyboard five years after the device’s implantation. Advanced decoding algorithms saw their cursor control <a href="https://www.nature.com/articles/nm.3953">improve</a> such that patients went from typing <a href="https://www.science.org/doi/10.1126/scitranslmed.aac7328">24 characters per minute</a> in 2015 to <a href="https://elifesciences.org/articles/18554">39 characters per minute</a> two years later.</p>
<p>Also in 2017, BrainGate clinical trials reported the first evidence that BCIs could be used to <a href="https://www.sciencedirect.com/science/article/abs/pii/S0140673617306013?via%3Dihub">help patients regain movement</a> of their own limbs by bypassing the damaged portion of the spinal cord. One patient with a <a href="https://www.spinalinjury101.org/details/levels-of-injury">high-cervical</a> spinal cord injury was able to reach and grasp a cup eight years after sustaining his injury.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/cg5RO8Qv6mc?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">BrainGate breakthrough video by Brown University.</span></figcaption>
</figure>
<p>Then in 2021, the Braingate team reported that quadriplegic patients were now using a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8218873/">wireless system in their own homes</a> to control a tablet computer – an important first step toward a future where BCI devices can help people move and communicate outside the confines of the hospital or laboratory. Furthermore, the researchers said they anticipate “significant advances and paradigm shifts in neural signal processing, decoding algorithms and control frameworks” in the quest to make such devices available to the wider public.</p>
<p>Beyond Braingate’s successes, another team led by American neurosurgeon Edward Chang <a href="https://www.nature.com/articles/s41586-023-06443-4">recently reported</a> using surgically implanted <a href="https://www.jneurosci.org/content/jneuro/39/22/4299.full.pdf">electrocorticogram</a> electrodes to create a “digital avatar” that could convey what a paralysed patient wants to say. With the help of AI, the BCI decoded muscle movements related to speech the patients were thinking in their minds (as opposed to decoding the actual semantic content).</p>
<p>Activity patterns emerging from the specific brain region that is critical for speech are the key focus for this type of BCI. One expert not involved in the research <a href="https://www.theguardian.com/society/2023/aug/23/paralysed-woman-able-to-speak-through-digital-avatar-for-first-time">told the Guardian</a>: “This is quite a jump from previous results. We’re at a tipping point.”</p>
<h2>A new era of ‘mind reading’ technology</h2>
<p>Brain activity has long been recorded by non-invasive imaging methods such as fMRI and electroencephalography (EEG). But having been primarily envisaged as a tool for diagnostics and monitoring, it is now also a core element of the latest neural communication and prosthetic devices.</p>
<p>A landmark moment came in 2012, when a team led by Canada-based neuroscientist <a href="https://www.youtube.com/watch?v=lvUvY_JrUgA">Adrian Owen</a> used neuroimaging to establish a <a href="https://cris.maastrichtuniversity.nl/ws/portalfiles/portal/75999517/Sorger_2012_Brain_computer_interfaces_for_communcication_with.pdf">line of communication</a> with people suffering from <a href="https://www.nhs.uk/conditions/disorders-of-consciousness/">disorders of consciousness</a>. Despite being behaviourally non-responsive and minimally conscious, these patients were able to answer yes-or-no questions just by using their minds. For patients unable to communicate via facial or eye movements (methods that had been available to locked-in patients for many years), this was a very promising evolution.</p>
<p>Now, a decade on, the <a href="https://www.biorxiv.org/content/10.1101/2022.09.29.509744v1.full">HuthLab research</a> at the University of Texas constitutes a paradigmatic shift in the evolution of communication-enabling neuroimaging systems.</p>
<p>In the study’s first stage, participants were placed in an fMRI scanner and their brain activity was recorded while they listened to 16 hours of podcasts (the model training dataset consisted of 82 five to 15-minute stories taken from the <a href="https://themoth.org/radio-hour">Moth Radio Hour</a> and <a href="https://www.nytimes.com/column/modern-love-podcast">Modern Love)</a>. This brain activity data was then linked to audio fragments the participants were listening to, in order to map what their brain activity patterns looked like when they had specific semantic content in their minds.</p>
<p>Next, the same participants were exposed to new audio fragments they had never heard before, or alternatively were asked to imagine a story. The decoder was then applied to this new set of brain activity data, to “reconstruct” the stories the participants had been listening to or imagining – with some <a href="https://www.biorxiv.org/content/10.1101/2022.09.29.509744v1.full">striking results</a>. For instance, when a patient was played this audio:</p>
<blockquote>
<p>I don’t have my driver’s licence yet and I just jumped out right when I needed to, and she says: ‘Well, why don’t you come back to my house and I’ll give you a ride?’ I say OK.</p>
</blockquote>
<p>… the decoder reconstructed it as follows:</p>
<blockquote>
<p>She is not ready – she has not even started to learn to drive, yet I had to push her out of the car. I said: ‘We will take her home now’ and she agreed.</p>
</blockquote>
<p>While there were also a considerable number of mistakes over the entirety of the trial, the reconstruction of continuous language solely on the base of brain activity patterns, including some exact word matches, is arguably the closest we have yet come to truly reading someone’s thoughts.</p>
<p>Whereas the brain’s capacity to produce motor intentions is shared across species, the ability to produce and perceive language is uniquely human. Thus, decoding actual semantic content from brain activity in regions used in language perception (primarily the <a href="https://www.ncbi.nlm.nih.gov/books/NBK11109/#:%7E:text=The%20association%20cortices%20include%20most,and%20the%20generation%20of%20behavior.">association</a> and <a href="https://www.ncbi.nlm.nih.gov/books/NBK499919/">prefrontal</a> regions of the brain’s cortex) seems more fundamental to what makes us human.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/572526/original/file-20240131-19-2rcmmf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Columns of text comparing actual words with those decoded by the HuthLab brain technology" src="https://images.theconversation.com/files/572526/original/file-20240131-19-2rcmmf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/572526/original/file-20240131-19-2rcmmf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=201&fit=crop&dpr=1 600w, https://images.theconversation.com/files/572526/original/file-20240131-19-2rcmmf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=201&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/572526/original/file-20240131-19-2rcmmf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=201&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/572526/original/file-20240131-19-2rcmmf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=252&fit=crop&dpr=1 754w, https://images.theconversation.com/files/572526/original/file-20240131-19-2rcmmf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=252&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/572526/original/file-20240131-19-2rcmmf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=252&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Semantic examples from the HuthLab study.</span>
<span class="attribution"><span class="source">UT Austin</span></span>
</figcaption>
</figure>
<p>Also, the HuthLab study used non-invasive fMRI technology – a form of neuroimaging that measures oxygen levels of blood in the brain in order to make inferences on brain activity. The disadvantage of fMRI is that it can only take slow measurements of brain signals (typically, one brain volume every two or three seconds). The study overcame this by using <a href="https://en.wikipedia.org/wiki/Generative_artificial_intelligence">generative AI</a> language models (akin to ChatGPT) that predict the probability of word sequences, and thus what words are most likely to come next in someone’s thoughts.</p>
<p>The researchers also worked with patients watching silent short film clips. They demonstrated that the system could be used not only to decode semantic content entertained through auditive perception, but also through visual perception.</p>
<p>Importantly, they also explicitly addressed the potential threat to a person’s mental privacy posed by this kind of technology. Jerry Tang, one of the study’s lead researchers, <a href="https://cns.utexas.edu/news/podcast/brain-activity-decoder-can-reveal-stories-peoples-minds">stated</a>:</p>
<blockquote>
<p>We take very seriously the concerns that it could be used for bad purposes and have worked to avoid that. We want to make sure people only use these types of technologies when they want to and that it helps them.</p>
</blockquote>
<p>The very fact this semantic decoder has to be trained on each person separately, with their cooperation over a long period of time, constitutes a robust safeguard. In other words, one of the major hurdles in the development of language decoders – the fact they are not universally applicable – constitutes one of the strongest safeguards against privacy violations.</p>
<p>However, while there is no risk of a malevolent company being able to read the thoughts of a random person in the street any time soon, there are nonetheless important ethical, legal and data protection concerns that must be considered as this technology develops.</p>
<p>We have already seen the <a href="https://www.nytimes.com/2018/04/04/us/politics/cambridge-analytica-scandal-fallout.html">consequences</a> of unfettered corporate access to personal data and online behaviour. Although we are a long way off from neural data being collected and processed at such scale, it is important to consider burgeoning ethical questions in the early stages of technological progress.</p>
<h2>The ethical implications are immense</h2>
<p>Losing the ability to communicate is a <a href="https://www.tandfonline.com/doi/abs/10.1080/17483107.2022.2146217">deep cut to one’s sense of self</a>. Restoring this ability gives the patient greater control over their lives and their ability to navigate the world – but it could also give other entities, such as corporations, researchers and other third parties, an uncomfortable degree of insight into, or even control over, the lives of patients.</p>
<p>Even other types of intimate biological data, such as that about our genomes or our biometrics, do not come as close to approximating our private inner lives as neural data. The ethical implications of providing access to such data to scientific and corporate entities are potentially immense.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/572536/original/file-20240131-25-g07hqb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Text of UN resolution 51/3" src="https://images.theconversation.com/files/572536/original/file-20240131-25-g07hqb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/572536/original/file-20240131-25-g07hqb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=532&fit=crop&dpr=1 600w, https://images.theconversation.com/files/572536/original/file-20240131-25-g07hqb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=532&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/572536/original/file-20240131-25-g07hqb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=532&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/572536/original/file-20240131-25-g07hqb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=668&fit=crop&dpr=1 754w, https://images.theconversation.com/files/572536/original/file-20240131-25-g07hqb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=668&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/572536/original/file-20240131-25-g07hqb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=668&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">UN resolution 51/3.</span>
<span class="attribution"><a class="source" href="https://documents-dds-ny.un.org/doc/UNDOC/GEN/G22/525/01/PDF/G2252501.pdf?OpenElement">UNHRC</a></span>
</figcaption>
</figure>
<p>This is reflected in <a href="https://www.ohchr.org/en/calls-for-input/2023/call-inputs-study-human-rights-council-advisory-committee-neurotechnology-and#:%7E:text=At%20its%20fifty%2Dfirst%20session,promotion%20and%20protection%20of%20all">Resolution 51/3</a> of the UN Human Rights Council, which commissioned a study on “the impact, opportunities and challenges of neurotechnology with regard to the promotion and protection of all human rights” in time for the council’s 57th session in September 2024. However, whether the introduction of novel human rights is warranted to address the challenges posed by neurotechnology remains a hotly debated issue among human rights experts and advocacy groups.</p>
<p>The <a href="https://neurorightsfoundation.org/mission">NeuroRights Foundation</a>, based at Columbia University in New York, argues that novel rights surrounding neurotechnologies will be needed for all humans to preserve their privacy, identity, and free will. The potential vulnerability of disabled patients makes this a particularly important problem. For example, Parkinson’s disease, a neurodegenerative disease that affects movement, is co-morbid with dementia, which affects the ability to reason and think clearly.</p>
<p>In line with this approach, <a href="https://spectrum.ieee.org/neurotech-neurorights">Chile was the first country</a> that adopted legislation to address the risks inherent to neurotechnology. It not only <a href="https://courier.unesco.org/en/articles/chile-pioneering-protection-neurorights">introduced a new constitutional right</a> to mental integrity, but is also in the process of adopting a bill that bans selling neurodata, and subjects all neurotech devices to be regulated as medical devices, even those intended for the general consumer. The proposed legislation recognises the intensely personal nature of neural data and considers it <a href="https://restofworld.org/2021/chile-neuro-rights/">akin to organ tissue</a> which cannot be bought or sold, only donated. But this legislation has also faced criticism, with legal scholars <a href="https://www.sciencedirect.com/science/article/abs/pii/S2589295921000059?casa_token=A9_9ASQthlMAAAAA:FXJiHZARnjPp6IjA7jHBqHzrHCAxoTY0s9um1nWWi9rE5so52ssahLBwwwkb5YTQGKR-sznGAg">questioning</a> the need for new rights and <a href="https://link.springer.com/article/10.1007/s12152-022-09504-z#Sec1">pointing out</a> that this regime could stifle beneficial BCI research for disabled patients.</p>
<p>While the legal action taken by Chile is the most impactful and far-reaching to date, <a href="https://spanish-presidency.consilium.europa.eu/en/news/leon-declaracion-european-neurotechnology-human-rights/">other countries</a> are considering following suit by updating existing laws to address the developments in neurotechnologies.</p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/ybUnmQ05vX4?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Chile’s pioneering neurotechnology regulation – report by Al Jazeera English.</span></figcaption>
</figure>
<p>One of the cornerstones of ethical research is the <a href="https://www.ncbi.nlm.nih.gov/books/NBK430827/#:%7E:text=Introduction,undergo%20the%20procedure%20or%20intervention.">principle of informed consent</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/26497727/">Particular attention</a> must be paid to the capacity of paralysed patients and their family members to understand and consent to novel experimental therapies. Patients with a very limited ability to communicate may not be able to answer more extensive questions associated with the obtaining of informed consent, which is often more complex than a simple opt-in procedure. Also, not all potential risks and side-effects (both physical and mental) can be foreseen, making it difficult for physicians to adequately inform their patients.</p>
<p>At the same time, it is important <a href="https://link.springer.com/article/10.1007/s11948-015-9712-7">to keep in mind</a> that denying treatment to a patient whose only hope may be communicating through BCI presents a significant opportunity cost, such as a lifetime without communication, that may be very well greater than the costs of participation in experimental treatments. The appropriate balance to strike for clinicians and researchers will be challenging to determine.</p>
<p>In a burgeoning new era of big (brain) data, longstanding ethical concerns about the hacking, leaking, unauthorised use or commercial exploitation of personal data will be amplified in the case of sensitive data on a person’s thoughts or movements (as controlled through neuroprosthetics). Paralysed patients may be particularly vulnerable to neurodata theft given their reliance on caregivers, and increasingly, the BCI technologies themselves, to communicate and move around the world. Care must be taken to ensure that information disclosed by a BCI represents a patient’s true and consensual thoughts.</p>
<p>And while it is likely that the first advances in neurotech will be therapeutic in nature, such as for disabled and neurodivergent patients, future advances are likely to involve consumer applications such as <a href="https://bci.games/">entertainment</a>, as well as for <a href="https://theconversation.com/brain-computer-interfaces-could-allow-soldiers-to-control-weapons-with-their-thoughts-and-turn-off-their-fear-but-the-ethics-of-neurotechnology-lags-behind-the-science-194017#:%7E:text=For%20example%2C%20a%20soldier%20in,more%20rapid%20response%20to%20threats.">military and security</a> purposes. The growing availability of neurotechnology in a commercial context that is generally subject to far less regulation only amplifies these ethical and legal concerns.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/freedom-of-thought-is-being-threatened-by-states-big-tech-and-even-ourselves-heres-what-we-can-do-to-protect-it-220266">Freedom of thought is being threatened by states, big tech and even ourselves. Here’s what we can do to protect it</a>
</strong>
</em>
</p>
<hr>
<p>Data protection laws should be assessed on their ability to account for the new risks arising from increasing access to and collection of neurodata by organisations and entities of different types. Take the example – for the time being completely hypothetical – of using BCI to infer the thoughts of suspects in police interrogations.</p>
<p>One might say that BCI cannot be used in police interrogations as the error rate of misinterpreting a person’s neural data is currently unacceptably high, although accuracy could improve in the future. Or, one might say that BCI should never be used to “read” a person’s brain without their consent, regardless of the technology’s accuracy. Or, one might say that using BCI for interrogations is justified under certain extreme circumstances, such as when crucial information is needed to save someone’s life, and the suspect is refusing to cooperate.</p>
<p>Different people, societies, and cultures will disagree on where to draw the line. We are at an early stage of technological development and as we begin to uncover the great potential of BCI, both for therapeutic applications and beyond, the need to consider these ethical questions and their implications for legal action becomes more pressing.</p>
<h2>Decoding our neuro future</h2>
<p>This is a groundbreaking moment in our quest to understand the inner workings of our brains and minds. In the past year alone, neuroscientists have <a href="https://www.nature.com/articles/s41586-023-06094-5">reversed spinal disabilities</a>, translated MRI data into text to <a href="https://www.nature.com/articles/s41593-023-01304-%209.epdf">understand what someone is thinking</a>, and begun to <a href="https://twitter.com/neuralink/status/1661857379460468736?cxt=HHwWgMDSoeqejZAuAAAA">conduct clinical trials</a> to help people interact with objects using thoughts alone, something already seen in <a href="https://www.youtube.com/watch?v=Zcz-Hq1NP98">trials with monkeys</a> two years ago. Such developments could all lead to transformative impacts on people’s lives.</p>
<p>At the same time, it’s important to note that research such as the HuthLab study uses a very small sample, and that the training process for its semantic decoder is complex, time-consuming and expensive. Add to this the fact that fMRI, although non-invasive, is a non-wearable neuro-imaging technique, and it is clear these methods are not set to leave a strictly organised laboratory setting any time soon.</p>
<p>However, the HuthLab researchers <a href="https://cns.utexas.edu/news/podcast/brain-activity-decoder-can-reveal-stories-peoples-minds">suggest</a> that in time, fMRI could be replaced by functional near-infrared spectroscopy (fNRIS) which, by “measuring where there’s more or less blood flow in the brain at different points in time”, could give similar results to fMRI using a wearable device.</p>
<p>Certainly, the <a href="https://www.neurotech.com/investment-digest">exponential global investment</a> in the development of neurotechnologies such as this, by governments and private actors alike, shows that the world is eager to create accessible BCIs that are suited to function as medical devices, but also as commercial consumer goods. By the middle of 2021, the total investment in neurotechnology companies amounted to just over US$33 billion (around £26 billion).</p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/M-slagG1OKE?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Neuralink’s first human brain implant – report by Sky News.</span></figcaption>
</figure>
<p>One of the most high-profile companies is Musk’s <a href="https://neuralink.com/">Neuralink</a>. “Initial results show promising neuron spike detection,” Musk tweeted on January 29, of his neurotech startup’s <a href="https://www.npr.org/2024/01/30/1227850900/elon-musk-neuralink-implant-clinical-trial">first implanted chip in a human brain</a>. The implant is said to include 1,024 electrodes, yet is only slightly larger than the diameter of a red blood cell. <a href="https://twitter.com/neuralink/status/1716973591684653555">According to Neuralink</a>: “Its small size allows threads to be inserted with minimal damage to the [brain] cortex.”</p>
<p>While this wireless implant is currently being developed as a medical device, aiming at enhancing the quality of life for patients suffering from various neurological diseases (Neuralink’s clinical trial has enlisted people aged 22 and above living with quadriplegia), Musk <a href="https://twitter.com/elonmusk/status/1752119586470949056">stated on X-Twitter</a> that the ultimate aim is to create a device that “enables control of your phone or computer, and through them almost any device, just by thinking”.</p>
<p>Indeed, commercial neuro-imaging devices are already on the market. The <a href="https://www.spiedigitallibrary.org/journals/journal-of-biomedical-optics/volume-27/issue-07/074710/Kernel-Flow--a-high-channel-count-scalable-time-domain/10.1117/1.JBO.27.7.074710.full?webSyncID=cc96715c-8678-b272-ce9d-a31d41322dc9&sessionGUID=467762ac-1ce5-a61d-96e9-9042d3bc6d99&_ga=2.177093349.1194737154.1696754253-1060044912.1696754253&cm_mc_uid=86756417056816967542535&cm_mc_sid_50300000=84585101696754253521&SSO=1">Kernel Flow</a>, for example, is a commercially available, wearable headset that uses fNRIS technology to monitor brain activity. Another prominent player in commercial neuro-imaging, Emotiv, has developed <a href="https://www.emotiv.com/?campaignid=17057185126&adgroupid=138768698289&network=g&device=c&utm_term=emotiv%20eeg&utm_source=google&utm_medium=ppc&utm_content=644974459432&utm_campaign=Brand&hsa_acc=5401365090&hsa_cam=17057185126&hsa_grp=138768698289&hsa_ad=644974459432&hsa_src=g&hsa_tgt=kwd-343485221404&hsa_kw=emotiv%20eeg&hsa_mt=p&hsa_net=adwords&hsa_ver=3&gad=1&gclid=Cj0KCQjwpompBhDZARIsAFD_Fp9Pf4GC78tnxQw2h90QpHzibYCJenjkzWEsTArqRrXxCWkfdVmK1VkaAjeREALw_wcB">earpods incorporating EEG technology</a> that are able to monitor brain activity for signs of focus, attention and stress – with the stated ambition of boosting the wearer’s productivity at work.</p>
<p>While the era of big data has enabled increasingly personalised and complex approximations of people’s inner lives through our biometrics, genetics and online presence, nothing has been so powerful as to capture the inner workings of our minds – yet.</p>
<p>But as HuthLab’s research suggests, and Musk’s pronouncements claim, this may now not be so very far away. The dawn of a new era of brain-computer interfaces should be treated with great care and great respect – in acknowledgement of its immense potential to both help, and harm, our future generations.</p>
<hr>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em>For you: more from our <a href="https://theconversation.com/uk/topics/insights-series-71218?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insights series</a>:</em></p>
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<p><em>To hear about new Insights articles, join the hundreds of thousands of people who value The Conversation’s evidence-based news. <a href="https://theconversation.com/uk/newsletters/the-daily-newsletter-2?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK"><strong>Subscribe to our newsletter</strong></a>.</em></p><img src="https://counter.theconversation.com/content/222458/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Stephanie Sheir received funding from the EPSRC (grant number EP/V026518/1). </span></em></p><p class="fine-print"><em><span>Timo Istace receives funding from Fonds Wetenschappelijk Onderzoek Vlaanderen.</span></em></p><p class="fine-print"><em><span>Nicholas J. Kelley does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>As Elon Musk’s Neuralink begins inserting chips into human brains, we trace the history of ‘mind reading’ technology and assess the potential risks and rewardsNicholas J. Kelley, Assistant Professor in Social Psychology, University of SouthamptonStephanie Sheir, Research Associate, Trustworthy Autonomous Systems Hub, University of BristolTimo Istace, PhD Researcher in Neurotechnology and the Law, University of AntwerpLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2209862024-01-30T12:31:12Z2024-01-30T12:31:12Z‘We miners die a lot.’ Appalling conditions and poverty wages: the lives of cobalt miners in the DRC<figure><img src="https://images.theconversation.com/files/569013/original/file-20240112-27-c98vr0.jpg?ixlib=rb-1.1.0&rect=620%2C178%2C3127%2C1977&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Labourers load sacks of cobalt onto bicycles at Mutoshi mine in July 2021.
</span> <span class="attribution"><span class="source">Roy Maconachie</span></span></figcaption></figure><p>It was a cool, dusty morning in July 2021, when I first visited the Kamilombe cobalt mine in Lualaba Province in south-eastern Democratic Republic of Congo. Situated just outside Kapata on the south-west outskirts of Kolwezi, a mining town that has historically served as an important centre for copper and cobalt, Kamilombe is now one of hundreds of spontaneously emerging cobalt mining sites in the region, where an enormous workforce of artisanal miners, called “creuseurs”, extract and process cobalt ore using rudimentary hand tools.</p>
<p>Estimates suggest that as many as <a href="https://www.faircobaltalliance.org/blog/the-fatal-toll-of-artisanal-cobalt-mining-continues-is-responsible-asm-even-possible/">11,000 men and women</a> work on the site, the majority of whom have no other means of deriving a livelihood.</p>
<p>Risking their lives, they tunnel deep into the red earth, excavating cobalt in shafts that descend as deep as 100 metres, and yet they receive almost none of the profits. Instead, they endure <a href="https://humantraffickingsearch.org/resource/modern-slavery-the-true-cost-of-cobalt-mining/#:%7E:text=Thousands%20of%20artisanal%20miners%20dig,shield%20toxic%20dust%20or%20shoes.">perilous working conditions</a>, <a href="https://www.amnesty.org/en/wp-content/uploads/2021/05/AFR6231832016ENGLISH.pdf">human rights abuses</a>, and are paid <a href="https://www.theguardian.com/global-development/2021/nov/08/cobalt-drc-miners-toil-for-30p-an-hour-to-fuel-electric-cars">poverty wages</a> by agents and buyers who source small amounts from each miner at so called “buying houses”. </p>
<p>This story of labour exploitation and unequal exchange in Africa has become an all-too-familiar one to me. For the last 20 years, I’ve dedicated my <a href="https://researchportal.bath.ac.uk/en/persons/roy-maconachie">academic career</a> to researching the social, political and economic aspects of natural resources extracted or grown in sub-Saharan Africa. </p>
<figure class="align-center ">
<img alt="Close up of hands washing ore." src="https://images.theconversation.com/files/569049/original/file-20240112-25-va5dfq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/569049/original/file-20240112-25-va5dfq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/569049/original/file-20240112-25-va5dfq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/569049/original/file-20240112-25-va5dfq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/569049/original/file-20240112-25-va5dfq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/569049/original/file-20240112-25-va5dfq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/569049/original/file-20240112-25-va5dfq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Women washers handling raw cobalt ore display dangerously high levels of heavy metals in their bloodstreams, increasing the risk of having still born babies or children with birth defects.</span>
<span class="attribution"><span class="source">Roy Maconachie</span></span>
</figcaption>
</figure>
<p>My first visit to the Kamilombe cobalt mine had a dramatic impact on me. I was eager to visit the site because I had heard many encouraging things about it. Since 2004, Kamilombe has been run by a mining cooperative called la <a href="https://www.cmds.network/">Coopérative Minière pour le Développement Social</a> (CMDS), which has partnered with the <a href="https://www.faircobaltalliance.org/">Fair Cobalt Alliance</a> to try and improve artisanal <a href="https://www.faircobaltalliance.org/blog/the-fatal-toll-of-artisanal-cobalt-mining-continues-is-responsible-asm-even-possible/">miners’ safety and wellbeing</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/from-cobalt-to-tungsten-how-electric-cars-and-smartphones-are-sparking-a-new-kind-of-gold-rush-100838">From cobalt to tungsten: how electric cars and smartphones are sparking a new kind of gold rush</a>
</strong>
</em>
</p>
<hr>
<p>Although it is well known that artisanal mining is now a vital rural livelihood in developing countries around the world, with World Bank estimates suggesting that there may now be as many as <a href="https://www.internationaltin.org/artisanal-small-scale-mining/">100 million artisanal miners globally</a>, a major concern has focused on its informal nature. Most artisanal mining sites are found in remote locations, remain unplanned and unregulated, and are subject to a host of social and environmental problems.</p>
<p>But at the same time, there has been much fanfare around the idea of organising artisanal miners into cooperatives, as a potential solution to this problem. By organising miners into groups and giving them a stronger collective voice, many argue that this could provide the necessary space for them to challenge their exploitation, including low pay, poor and unsafe working conditions, and human rights abuses. I was eager to find out if the situation at Kamilombe was any different, or if it would just be business as usual.</p>
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
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<p>As we sat on a pile of sacks of cobalt ore in the early morning sun, Ghlislain Mujinga Kaungu, a 28-year cobalt miner and father of five, told me how the rising global demand for cobalt had transformed both the landscape and communities in the region. As we peered into the depths of Ghlislain’s mining pit he explained:</p>
<blockquote>
<p>There are people who come from Kasai, the Chinese who leave China to come here, Canadians who leave their country to come here. All these people come to get the minerals. The ore is very good. It is very good.</p>
</blockquote>
<h2>‘The work we do is hard’</h2>
<p>Five months after my first visit, during the rainy season in December 2021, I returned to the Kamilombe mine to spend more time with the creuseurs, understand more about their difficult predicament, and this time, to produce a short documentary film on their lives.</p>
<p>The creuseurs that I met on site at Kamilombe, and the stories they shared, haunted me. They told me about the severe environmental damage and social harm caused by the rapidly growing extraction of cobalt, and the unequal terms of trade that cut them off completely from the wealth being generated.</p>
<p>Most of the miners I spoke to were well aware that they were being exploited. Many told me they only started mining because they wanted to create a better life for their kids. It is easy to understand why a parent would tolerate hardship, injustice and risk, if it could help their children.</p>
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<p>Listening to their stories, it became immediately apparent that most miners endured such horrific working conditions because there were no other options in an employment-constrained economy. Mama Kalonda Alphonsine, a mother of eight and an ore washer at the Kamilombe mine, explained:</p>
<blockquote>
<p>The work we do is hard because it’s a job you do all day long. And you have to bend all the time. We only do this work because we don’t have the means to survive.</p>
</blockquote>
<p>Likewise, according to Ghlislain: “I have to go down the pit to feed my family. I don’t even have 100 Congolese francs in my house. There is no flour or vegetables.” </p>
<p>Ghislain went on: “I don’t wish my children to be miners. Not even for a single day. Normally, if I get 100 francs from the Chinese, I’ll put it towards their schooling, so that they become respectable people. So I can be proud when people say, ‘this is Ghislain’s son or daughter’.”</p>
<p>Such sentiments were confirmed by Pitchou, a 40-year-old ore transporter and father of four who had dropped out of university to haul bags of cobalt from the mining pit to the washing site on his bicycle. Pitchou said:</p>
<blockquote>
<p>My bike is important because it is what feeds us, me my wife and my children. But the wish I have for my children when they grow up is that they must go to school. Because the education they are going to get will help them in future … My children should never go to the mine, they should focus on school because school is the future …</p>
</blockquote>
<p>Even with our much greater awareness of global supply chains and volumes written about fair trade and sustainability, neocolonial exploitation is as much a part of the fabric of mineral extraction in the DRC as it ever was. But economic exploitation is only part of the story.</p>
<figure class="align-center ">
<img alt="Two men hauling sacks of cobalt on a bike surrounded by three women." src="https://images.theconversation.com/files/569054/original/file-20240112-15-575fwr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/569054/original/file-20240112-15-575fwr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/569054/original/file-20240112-15-575fwr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/569054/original/file-20240112-15-575fwr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/569054/original/file-20240112-15-575fwr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/569054/original/file-20240112-15-575fwr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/569054/original/file-20240112-15-575fwr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Washers intercept an ore hauler to secure his cobalt for washing at Kamilombe.</span>
<span class="attribution"><span class="source">Roy Maconachie</span></span>
</figcaption>
</figure>
<h2>‘We miners die a lot’</h2>
<p>While I was filming with cobalt miners during the rainy season, one of the mining pits collapsed. Six miners were killed and the depth and design of the tunnels meant that the bodies could not be recovered. Ghislain told me:</p>
<blockquote>
<p>We have many cases of accidents during the rainy season. When it rains, a tarpaulin is put over the pit but if it rains heavily, the tarpaulin can tear. Water enters the pit, and anyone inside can drown.</p>
</blockquote>
<p>And to be sure, all the miners I spoke to feared such a disaster could happen to them at any time. Such incidents occur on a regular basis and in January 2023, a similar cave-in at Kamilombe was <a href="https://www.faircobaltalliance.org/blog/the-fatal-toll-of-artisanal-cobalt-mining-continues-is-responsible-asm-even-possible/">reported by David Sturmes</a>, the strategic partnerships director for the Fair Cobalt Alliance. He said: “A lack of mine planning and the resulting inability to manage water flooding into the mine after days of heavy rains caused individual tunnels to be blocked off, leaving no route to escape. The resulting pressure affected the structural integrity of the tunnel walls, causing cave-ins. Sadly, these kinds of incidents are not uncommon at most informal mines.”</p>
<p>For many creuseurs, part of the attraction of artisanal cobalt mining is the sector’s low “barriers to entry”. You don’t need advanced skills, a university degree, or large amounts of capital to invest. Anyone can become an artisanal miner. </p>
<p>However, there is also a downside to this. Compared to large-scale industrial mines, where there are significant capital investments in site preparation and development, artisanal mine sites are usually financed through their erratic cash flow.</p>
<p>More often than not, this leaves cooperatives unable to make much-needed investments in mine infrastructure. Death and injury is common among artisanal miners, due to both tunnel collapses and working without personal protective equipment. In the words of Ghislain:</p>
<blockquote>
<p>Sometimes we are afraid because if you look at the ceiling (of the tunnel), you will see that it is already very fragile. The ceiling is already damaged. So, if we don’t make repairs, at some point when you’re down there, things are going to fall on you. And this can result in either a broken leg or a broken hand, or your skull will be fractured. Collapses are very frequent. We miners die a lot.</p>
</blockquote>
<h2>Toxic dust and birth defects</h2>
<p>Further compounding the hazardous working conditions, cobalt dust is toxic, affecting all those working in mines, but also those <a href="https://www.amazon.co.uk/Cobalt-Red-Blood-Congo-Powers/dp/1250284309">in the wider community</a>. People living near the mines display raised levels of cobalt in their urine and blood, and oxidative damage to DNA in children related to cobalt toxicity <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166862/">has been demonstrated</a>.</p>
<p>That research also found high concentrations of uranium in the urine of exposed children and miners. Correlations have been found between levels of uranium in urine and drinking water.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/569047/original/file-20240112-15-c98vr0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Close up of a sack of cobalt being shipped to China." src="https://images.theconversation.com/files/569047/original/file-20240112-15-c98vr0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/569047/original/file-20240112-15-c98vr0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/569047/original/file-20240112-15-c98vr0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/569047/original/file-20240112-15-c98vr0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/569047/original/file-20240112-15-c98vr0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/569047/original/file-20240112-15-c98vr0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/569047/original/file-20240112-15-c98vr0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Crude cobalt hydroxide is loaded onto trucks destined for South African ports, before being shipped to China for refining and use.</span>
<span class="attribution"><span class="source">Roy Maconachie</span></span>
</figcaption>
</figure>
<p>It is often the case that women wash the raw ore after it has been extracted, and pregnant women handling radioactive cobalt report stillbirths. A Lancet study found that pregnant women living in cobalt-mining communities have the highest levels ever reported of <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(20)30059-0/fulltext">heavy metals in their blood</a>. The same study demonstrated a five-fold increase in risk of birth defects in babies born to fathers working in cobalt mines.</p>
<p>Alphonsine, eloquently described the horrific conditions that washers must endure: </p>
<blockquote>
<p>There are several problems in doing this work. First is the dirty water in which we are forced to work. Typhoid fever is common. We also often suffer from stomach pains and get infections, and as soon as we have a small fever, we get tested and find out it’s malaria. Women should not be washing these types of minerals, because they contain uranium. If uranium enters the body of a pregnant woman, it can cause a miscarriage or the baby to be malformed.</p>
</blockquote>
<p>Another danger to the community are the sites themselves. Disused mining pits are often left abandoned like open sores on the landscape. Instead of being filled in and rehabilitated they fill with water, becoming breeding grounds for malaria-carrying mosquitos and a drowning hazard for local children. </p>
<p>No-one is held accountable. Recent comparisons of time-lapse satellite imagery over the past five years demonstrates the dramatic growth of cobalt mines in and around Kolwezi.</p>
<p>A recent story <a href="https://abcnews.go.com/International/cobalt-mining-transforms-city-democratic-republic-congo-satellite/story?id=96795773">by ABC News noted:</a> “The mines aren’t only growing around the city, they are often creeping into people’s neighbourhoods … satellite images of the west of the city reveal entire streets have disappeared over the last few years.”</p>
<h2>The invisible face of the cobalt rush</h2>
<p>Hunting for the buried blue treasure – a key ingredient in the lithium-ion batteries used in consumer electronics and electric vehicles that are vital to global efforts to combat climate change – artisanal miners like Ghislain have long been the invisible face of the cobalt rush. Until recently, their stories have been largely overlooked or ignored.</p>
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<p>
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<strong>
Read more:
<a href="https://theconversation.com/victims-of-the-green-energy-boom-the-indonesians-facing-eviction-over-a-china-backed-plan-to-turn-their-island-into-a-solar-panel-ecocity-214755">Victims of the green energy boom? The Indonesians facing eviction over a China-backed plan to turn their island into a solar panel 'ecocity'</a>
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<p>However, all this seemed to change in recent years. A number of <a href="https://www.ft.com/cobalt1">high-profile</a> stories have shone a light on how skyrocketing demand for so-called “critical” minerals, such as cobalt, can wreak havoc on people and the environment at the bottom of the supply chain. </p>
<p>In his portrayal of the “dark side” of Congo’s cobalt rush <a href="https://www.newyorker.com/magazine/2021/05/31/the-dark-side-of-congos-cobalt-rush">in The New Yorker</a>, journalist Nicolas Niarchos goes as far as to describe how, upon discovering that his house sat upon a rich seam of cobalt, one resident on the outskirts of Kolwezi tunnelled down 30ft through the floor of his kitchen to haul out ore at night.</p>
<p>The Congolese cobalt rush fuels a <a href="https://www.forbes.com/sites/jenniferwang/2021/05/03/this-chinese-battery-company-has-produced-more-billionaires-than-google-or-facebook/">multi-billion-dollar industry</a> for international mining companies and buying agents – often from China – that have moved into the country. Southern Congo sits upon <a href="https://spheresofinfluence.ca/coblat-mining-drc-green-technology/">3.4 million tons of cobalt</a>, an estimated two thirds of the world’s known supply.</p>
<p>Yet despite the frenzy of activity from foreign agents desperate to secure supplies of cobalt, many miners admitted that they were not entirely sure why there was so much interest in the mineral.</p>
<p>Alphonsine told me that she didn’t know what happened to the cobalt she washed, after it left the site. She said:</p>
<blockquote>
<p>The cobalt will be sold abroad. We heard they sell it to China. How the product will be used in China is not known. We are only told that this product has several uses. But we don’t know what they are.</p>
</blockquote>
<p>In 2021, Chinese companies produced <a href="https://www.statista.com/statistics/1249871/share-of-the-global-lithium-ion-battery-manufacturing-capacity-by-country/#:%7E:text=China%20dominated%20the%20world%27s%20electric,that%20entered%20the%20global%20market.">79%</a> of the world’s electric vehicle lithium-ion batteries and have established a major presence in the DRC, creating new forms of corporate “colonialism”.</p>
<figure class="align-center ">
<img alt="Woman washed what looks like rocks in water." src="https://images.theconversation.com/files/569046/original/file-20240112-25-i1yag7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/569046/original/file-20240112-25-i1yag7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/569046/original/file-20240112-25-i1yag7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/569046/original/file-20240112-25-i1yag7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/569046/original/file-20240112-25-i1yag7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/569046/original/file-20240112-25-i1yag7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/569046/original/file-20240112-25-i1yag7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Mama Kalonda Alphonsine washes cobalt ore. Women are paid the equivalent of US$3.75 for cleaning one full sack.</span>
<span class="attribution"><span class="source">Roy Maconachie</span></span>
</figcaption>
</figure>
<p>Ghislain told me that artisanal miners have very little bargaining power when it comes to negotiating with buying agents or securing a fair price for their cobalt. He explained:</p>
<blockquote>
<p>You will see that to buy the ore, everyone has their price. Instead of buying well so that we too can win, they buy the products maliciously. When you bring the product to a buying house, they will force the price on you. And if you don’t agree, they will ask you to leave.</p>
</blockquote>
<p>As the world transitions to electric vehicles, competition over supplies of cobalt continues to intensify, with global demand set to increase up to <a href="https://www.sciencedirect.com/science/article/pii/S0921344923000575">eight-fold by 2040</a>. This, in turn, has ratcheted up geopolitical tensions and <a href="https://theconversation.com/china-us-tensions-how-global-trade-began-splitting-into-two-blocs-188380">a new rivalry between the US and China</a>, both of which seek to dominate the green energy revolution.</p>
<p>Against this backdrop, the OECD estimates that there are more than <a href="https://mneguidelines.oecd.org/Interconnected-supply-chains-a-comprehensive-look-at-due-diligence-challenges-and-opportunities-sourcing-cobalt-and-copper-from-the-DRC.pdf">200,000 creuseurs</a>, often labouring alongside large-scale industrial operations, who extract <a href="https://www3.weforum.org/docs/WEF_Making_Mining_Safe_2020.pdf">up to 30%</a> of Congo’s cobalt.</p>
<h2>Child labour</h2>
<p>Evidence <a href="https://www.childrights-business.org/resources/study-opportunities-for-businesses-to-promote-child-rights-in-cobalt-artisanal-and-small-scale-mining.html#:%7E:text=The%20study%20examines%20the%20current,labour%20and%20improving%20child%20rights.">from the charity Save the Children</a> suggests that the majority of Congolese artisanal miners earn less than the DRC national minimum wage of $USD5 per day, and there is a significant gender pay gap, with women earning considerably less than men.</p>
<p>Moreover, some estimates indicate that there may be as many as 40,000 children engaged in artisanal cobalt mining in the country. Such claims have provided fertile ground for <a href="https://www.theguardian.com/global-development/2019/dec/16/apple-and-google-named-in-us-lawsuit-over-congolese-child-cobalt-mining-deaths">a high-profile legal case</a> against the world’s largest tech companies, launched in December 2019 by Congolese families, over deaths and serious injuries sustained by child labourers in cobalt mines.</p>
<p>In October 2022, the US Department of Labour added lithium-ion batteries to its list of goods <a href="https://abcnews.go.com/International/cobalt-mining-transforms-city-democratic-republic-congo-satellite/story?id=96795773">produced by child labour</a>.</p>
<p>While it can certainly be argued that powerful multinational companies such as Apple, Google or Tesla should have the resources and technical capability to effectively monitor their supply chains and source their cobalt responsibly, traceability remains difficult. Numerous well-meaning transnational initiatives now exist to improve supply chain transparency, most of which align with <a href="https://www.oecd.org/investment/due-diligence-guidance-for-responsible-business-conduct.htm">OECD due diligence guidance</a>.</p>
<h2>No such thing as ‘clean cobalt’</h2>
<p>At the same time, a significant challenge remains: there are a multitude of intermediaries in the mid and upper-tiers of the cobalt supply chain <a href="https://assets.ctfassets.net/y0dk4vkszqeh/1r5ZlwmS51Zy010gCdUzqs/03b6fd20c2d79c68c4407e439fa2991f/Study_Tracing_Cobalt_in_Fragmented_Supply_Chains.pdf">whose business strategies benefit</a> from opaque practices. Profit margins are much higher when it’s possible to purchase cobalt that is extracted under slave-like conditions.</p>
<p>And the reality is that cobalt unearthed by creuseurs is bought by agents and processed alongside cobalt from large-scale mines, with <a href="https://www.cecc.gov/events/hearings/from-cobalt-to-cars-how-china-exploits-child-and-forced-labor-in-the-congo">over 80%</a> of it then being refined in China. Under such circumstances, the supply chain cannot be fully regulated or monitored: it becomes cross-contaminated, and both sources of cobalt end up in electric vehicles and devices purchased around the world. As things stand, there is no such thing as “clean cobalt”.</p>
<hr>
<p>
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<strong>
Read more:
<a href="https://theconversation.com/eco-friendly-tech-comes-with-its-own-environmental-costs-thats-why-its-vital-to-cut-energy-demand-now-183567">Eco-friendly tech comes with its own environmental costs: that's why it's vital to cut energy demand now</a>
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<p>While many African countries are rich with highly sought-after resources, the wealth generated does not stay in Africa, or benefit its people. And there is, of course, a long history of this that extends back to colonial times. The current cobalt rush in and around Kolwezi appears to be no different.</p>
<p>During the colonial era, European imperial interests were channelled indirectly through small groups of local elites, who helped to govern territories and expedite the exploitation of resources for colonial agents. As African countries gained independence in the 1960s, one legacy of “<a href="https://eprints.lse.ac.uk/27879/1/WP131.pdf">indirect rule</a>” was that it cultivated a ruling class of commercially-minded local elites who were <a href="https://scholar.harvard.edu/files/jrobinson/files/indirect_rule_nber_4_0.pdf">unaccountable to their citizens</a>.</p>
<p>This set the stage for the current second scramble for Africa, where the rampant expropriation of resources characteristic of colonial times has largely remained unaltered, apart from the arrival of new corporate agents of foreign exploitation that are extracting resources on an industrial scale.</p>
<p>The introduction of China and its <a href="https://eng.yidaiyilu.gov.cn/">Belt and Road Initiative</a> as a major new player on the scene, has sparked considerable debate as to whether this offers a new opportunity for Africa, or a new form of colonialism.</p>
<h2>Plausible deniability</h2>
<p>While the negative impacts of the cobalt boom may be increasingly visible and have now become impossible to ignore, industry is not held accountable, partially because it has found new ways to hide its exploitative business practices.</p>
<figure class="align-center ">
<img alt="A large group of 'washers' clean ore are a washing pit." src="https://images.theconversation.com/files/569051/original/file-20240112-21-y8h866.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/569051/original/file-20240112-21-y8h866.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/569051/original/file-20240112-21-y8h866.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/569051/original/file-20240112-21-y8h866.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/569051/original/file-20240112-21-y8h866.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/569051/original/file-20240112-21-y8h866.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/569051/original/file-20240112-21-y8h866.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The washing pit at Kamilombe.</span>
<span class="attribution"><span class="source">Roy Maconachie</span></span>
</figcaption>
</figure>
<p>In the mining sector, intermediaries – buyers, agents, dealers and brokers – exist to shield multinational corporations from being directly implicated in labour exploitation. Complexity in the supply chain helps big corporations to demand profit-boosting efficiencies at arms’ length, giving them plausible deniability for the consequences of their actions.</p>
<p>These companies also have become adept at spinning their purported efforts to improve conditions. Look at their websites and you’ll probably see a massive section devoted to sustainability and community-building. On the surface, this may provide reassurance to a consumer or policymaker. But all those efforts don’t seem to be making a difference to those at the bottom of the chain, like Ghislain or Alphonsine or Pitchou.</p>
<p>We are all potentially complicit. I often tell my students that anyone with a mobile phone in their pocket probably has a little bit of the DRC in there as well. But multinational tech companies, or the mining giants have a lot more power and resources to make real change.</p>
<p>They should be made to pay for their role in creating and perpetuating unequitable systems that harm people and the planet. The people in the DRC’s cobalt belt that I have had the privilege of spending time with, and the many millions like them, deserve much better.</p>
<hr>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption"></span>
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<p><em>For you: more from our <a href="https://theconversation.com/uk/topics/insights-series-71218?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insights series</a>:</em></p>
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<p class="fine-print"><em><span>For this research, Roy Maconachie received funding from the Global Challenge Research Fund (GCRF), the Bath Research in Development (BRID) Fund, and the Bath Impact Fund.</span></em></p>Cobalt is a critical component in the production of batteries, smartphones, jet engines and electric vehicles. Yet miners who risk their lives digging it up receive almost none of the profits.Roy Maconachie, Professor of Natural Resources and Development, University of BathLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2068212024-01-25T10:54:37Z2024-01-25T10:54:37ZDescendants of Holocaust survivors explain why they are replicating Auschwitz tattoos on their own bodies<figure><img src="https://images.theconversation.com/files/570147/original/file-20240118-17-2tn3p3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Orly Weintraub Gilad with her grandfather's Auschwitz number, A-12599, tattooed on her arm.</span> <span class="attribution"><span class="source">John Jeffay for The Conversation</span></span></figcaption></figure><p>Rony Cohen doesn’t remember any particular moment when she first became aware of the number tattooed on her grandmother’s arm. It was just always there. </p>
<p>Cohen says she felt as if she had experienced the Holocaust herself, in a different cycle of her own life. It featured in her dreams. It permeated family life, as did the self-imposed interdiction on talking about the past and the absence of relatives. The legacy of starvation was never far from the surface. Food was used to soothe. There was no waste. Her grandfather finished every crumb from every plate.</p>
<p>The impact the Holocaust has had through the generations runs deep. Quite how we remember the past and its legacy varies hugely. Cohen is one of a small but growing number of the children and grandchildren of Holocaust survivors who have replicated the Auschwitz death camp tattoo on their own body. </p>
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Read more:
<a href="https://theconversation.com/why-some-descendants-of-holocaust-survivors-choose-to-replicate-a-loved-ones-auschwitz-tattoo-podcast-221778">Why some descendants of Holocaust survivors choose to replicate a loved one’s Auschwitz tattoo – podcast</a>
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<p><a href="https://theconversation.com/elie-wiesel-survived-auschwitz-to-give-us-a-vivid-glimpse-of-the-kingdom-of-night-62024">Auschwitz</a>, in Nazi-occupied Poland, was the only camp where numbers were tattooed on those inmates not selected for immediate death. In replacing the person’s name, this number has become the visual symbol of the crimes of the Nazis. </p>
<p>Cohen draws meaning from her tattoo in that it signifies her grandmother’s history and her own identity as a descendant of Holocaust survivors. To her mind, replicating this number was a means of taking her grandmother, as a person, and her legacy forward. As a gesture and an indelible mark she carries with her, she says: </p>
<blockquote>
<p>The number is my grandma. It’s my past, my roots, my story. It’s who I am.</p>
</blockquote>
<h2>A potent gesture</h2>
<p><a href="https://journals.sagepub.com/doi/pdf/10.1177/07255136211042453">My research</a> delves into the stories of those descendants who, like Cohen, have chosen to replicate a parent or a grandparent’s tattoo on their own body. Of the 16 people I have spoken with, 13 are from Israel and three from the US. </p>
<p>As the number of remaining survivors of the Nazi concentration camps grows ever smaller and the Holocaust passes out of living memory, <a href="https://journals.sagepub.com/doi/10.1177/07255136211042453">replicating an Auschwitz tattoo</a> becomes an ever more potent gesture about embodied memorialisation and, crucially, familial ties and love. </p>
<p>The people I have spoken with have relayed complex and varied decision-making processes behind this potent gesture. Some waited until their survivor parent or grandparent had died. Some got the tattoo without seeking approval. Others discussed doing so with their relative, beforehand. </p>
<figure class="align-center ">
<img alt="A woman in a black shirt and jeans holds out a framed photograph." src="https://images.theconversation.com/files/570119/original/file-20240118-27-q3ao2u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/570119/original/file-20240118-27-q3ao2u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=389&fit=crop&dpr=1 600w, https://images.theconversation.com/files/570119/original/file-20240118-27-q3ao2u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=389&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/570119/original/file-20240118-27-q3ao2u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=389&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/570119/original/file-20240118-27-q3ao2u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=489&fit=crop&dpr=1 754w, https://images.theconversation.com/files/570119/original/file-20240118-27-q3ao2u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=489&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/570119/original/file-20240118-27-q3ao2u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=489&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Orly Weintraub Gilad with a photograph of her maternal grandparents.</span>
<span class="attribution"><span class="source">John Jeffay for The Conversation</span></span>
</figcaption>
</figure>
<p>The replica tattoos they have each opted for vary in terms of font, colour and placement. Some have chosen to replicate exactly what the original looked like and where it was placed. Others have chosen to alter the designs in detail and colour, or to place it on a different part of their body. Each decision crafts the meaning of the new tattoo.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/570155/original/file-20240118-26-yv0sb1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A black and white photograph of a young couple." src="https://images.theconversation.com/files/570155/original/file-20240118-26-yv0sb1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/570155/original/file-20240118-26-yv0sb1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=757&fit=crop&dpr=1 600w, https://images.theconversation.com/files/570155/original/file-20240118-26-yv0sb1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=757&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/570155/original/file-20240118-26-yv0sb1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=757&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/570155/original/file-20240118-26-yv0sb1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=951&fit=crop&dpr=1 754w, https://images.theconversation.com/files/570155/original/file-20240118-26-yv0sb1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=951&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/570155/original/file-20240118-26-yv0sb1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=951&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Samuel and Agi Kestenbaum.</span>
<span class="attribution"><span class="source">Orly Weintraub Gilad</span></span>
</figcaption>
</figure>
<p>In the summer of 2022, I met with Orly Weintraub Gilad on Zoom. She had chosen to have her maternal grandfather Samuel Kestenbaum’s number tattooed on her arm, but it was also for her maternal grandmother, Agi Kestenbaum. She had been in Auschwitz too, but was not tattooed because she was not expected to live.</p>
<p>Like Cohen, Weintraub Gilad doesn’t remember a specific time when she first noticed her grandfather’s number, but the stories about the Holocaust were a part of her life from childhood. She says her mother, who died eight years before we spoke, used to talk a lot about the Holocaust. “She knew everything,” Weintraub Gilad says. </p>
<p>All four of her grandparents had survived the Holocaust. Her paternal grandparents died when she was in her late teens and even now, she says, her father doesn’t talk about what they experienced. She says that when she asks her father questions, he doesn’t know the answers.</p>
<figure class="align-center ">
<img alt="A black and white photograph of a couple with two children." src="https://images.theconversation.com/files/570575/original/file-20240122-17-qyagl7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/570575/original/file-20240122-17-qyagl7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=388&fit=crop&dpr=1 600w, https://images.theconversation.com/files/570575/original/file-20240122-17-qyagl7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=388&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/570575/original/file-20240122-17-qyagl7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=388&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/570575/original/file-20240122-17-qyagl7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=488&fit=crop&dpr=1 754w, https://images.theconversation.com/files/570575/original/file-20240122-17-qyagl7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=488&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/570575/original/file-20240122-17-qyagl7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=488&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Weintraub Gilad’s mother, Erica, as a child (right), with her brother Tomy and her parents Samuel and Agi in Romania in the 1960s.</span>
<span class="attribution"><span class="source">Orly Weintraub Gilad</span></span>
</figcaption>
</figure>
<p>Weintraub Gilad remains very close to her grandmother, who is 95 years old. The tattoo gives her the chance to continue what her mother used to do and talk about the Holocaust. “It starts the conversation and that’s the purpose,” she says, “that’s the thing that my grandmother is so happy about. She knows that after she’s gone, that I will talk.”</p>
<p>The tattoo itself features her grandfather’s number in a nest of leafy green vines. From different vines emerge letters, the initials of the names of Weintraub Gilad’s husband and her children. But the resulting composition is as much about her family’s history as it is about their collective future. </p>
<p>The choice of green vines and leaves came from her love of nature. Her grandfather’s number was on his left arm, but Weintraub Gilad placed her own tattoo on her right arm. She says she wanted “to do it the same but different”. One reason for choosing the right arm was because she did not want to see the number “on the side of the heart”. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/XXITp_Y7YAE?wmode=transparent&start=2" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Orly Weintraub Gilad tells the story behind her tattoo. Video by John Jeffay for The Conversation.</span></figcaption>
</figure>
<p>That same summer, I spoke with Yair Ron (Reisz), also on Zoom. He grew up in Israel, on a kibbutz founded by Holocaust survivors. “It was a very small community of people with same idea of communism,” he recalls. “All of them were Holocaust survivors, so all of them have numbers.”</p>
<p>Growing up, no one on the kibbutz had grandparents or spoke about their suffering. Ron’s father, Jakub Reisz – whom everyone knew as Yakshi – said nothing about the Holocaust and, like many children of Holocaust survivors, Ron and his sister knew not to ask. Yakshi would talk about helping people escape from Slovakia to Hungary – but he never said a word about what he had experienced.</p>
<blockquote>
<p>It was impossible to have a conversation about the Holocaust with my father. We were afraid to ask and afraid to hear. Maybe we didn’t want to hear. And he told us that he don’t want to tell, so we couldn’t exchange any information about the Holocaust whatsoever.</p>
</blockquote>
<p>Ron first noticed his father’s number as a child. Just as it was normal not to talk about things – about families, generations, loss – it was also normal to him and his peers that adults had numbers on their bodies. Until he started venturing out into the local town as a teenager, he didn’t really meet people from outside of the kibbutz – adults, that is, who didn’t have numbers. </p>
<blockquote>
<p>It seemed very natural to us that adults had numbers so we didn’t pay very much attention to this. We didn’t know other adults or people without numbers. The kibbutz was far away in the mountain, it was very isolated. </p>
</blockquote>
<figure class="align-center ">
<img alt="A man in a uniform holds up his arm." src="https://images.theconversation.com/files/570699/original/file-20240122-27-mssuh2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/570699/original/file-20240122-27-mssuh2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/570699/original/file-20240122-27-mssuh2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/570699/original/file-20240122-27-mssuh2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/570699/original/file-20240122-27-mssuh2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/570699/original/file-20240122-27-mssuh2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/570699/original/file-20240122-27-mssuh2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Yair Ron bears his father’s number on his arm.</span>
<span class="attribution"><span class="source">John Jeffay for The Conversation</span></span>
</figcaption>
</figure>
<p>It was only after Yakshi’s death that Ron started to piece together his story. Coming across a letter and diary that a friend of his father’s had written, Ron discovered that both men had been deported from Slovakia to Auschwitz. They had then been taken to Nazi-run work camps, from where they were eventually liberated.</p>
<p>After their release, they started their journey back to Slovakia, via Prague. To pass through the British military area without being detained, identification was required. Neither man had any, so they tattooed what looked like Auschwitz numbers on their left arms. Ron shared what he had learned with his family. They were very proud of Yakshi, he says, praising his “creativity and thinking out of the box”. </p>
<p>Ron first thought about getting Yakshi’s number tattooed on his own body when he was around 50 years old, at the turn of the millennium. He discussed it with his father who, like most Holocaust survivors, was strongly opposed to the idea at first. </p>
<figure class="align-right ">
<img alt="A black and white photograph of a man and a young boy." src="https://images.theconversation.com/files/570167/original/file-20240118-21-tpossn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/570167/original/file-20240118-21-tpossn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=817&fit=crop&dpr=1 600w, https://images.theconversation.com/files/570167/original/file-20240118-21-tpossn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=817&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/570167/original/file-20240118-21-tpossn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=817&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/570167/original/file-20240118-21-tpossn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1027&fit=crop&dpr=1 754w, https://images.theconversation.com/files/570167/original/file-20240118-21-tpossn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1027&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/570167/original/file-20240118-21-tpossn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1027&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Ron as a child, in the 1950s, with his father.</span>
<span class="attribution"><span class="source">Yair Ron</span></span>
</figcaption>
</figure>
<p>He says his relationship with his father was not an easy one. There were barriers between them. Ron ascribed these, in part, to Yakshi’s experiences of the Holocaust and the trauma he lived with. But it was more complex than that. </p>
<p>Kibbutzim in the 1950s and 1960s, like the one Ron grew up on, were often organised around collective-socialist principles. Until the 1980s, children were raised separately from their parents and slept in a communal children’s house. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753919/">Research has shown</a> variable attachment responses among those who grew up in this way – although it found little variation in attachment to fathers, compared with those who grew up in family homes.</p>
<p>Ron wonders, however, whether the fact that he and Yakshi did not enjoy a “normal” relationship is in some part due to growing up this way. Although he saw his father as a good man, the distance between them meant they could not speak about, as he puts it, “real feelings and thoughts”.</p>
<p>Having the number on his own body, Ron says, allowed him to reflect on what it is to live “like a numbered person”. As survivors die out, he dwells on the thought that soon there will be no numbered people. This, to his mind, makes the number an important thing to keep – a tool for keeping the memory alive.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/KRJ2YOCxsD8?wmode=transparent&start=2" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Yair Ron explains how and why he got his tattoo. Video by John Jeffay for The Conversation.</span></figcaption>
</figure>
<h2>Tattooing in Auschwitz</h2>
<p>Serial number tattoos with symbols, shapes or letters were first introduced for prisoners in the Auschwitz concentration camp complex in October 1941. More than 400,000 people would be tattooed there. The exceptions were ethnic Germans, Austrians, police prisoners and Polish prisoners deported from Warsaw during the 1944 uprising – plus Jewish prisoners held for a short time while waiting to be moved to other camps. </p>
<p>Prior to tattoos, identification numbers had been sewn on to the prison uniforms. Soviet prisoners of war were the first group to be tattooed after larger numbers started to die and the other prisoners took the deceased’s clothing, making it impossible to keep accurate records. </p>
<p>Initially, the tattoos were placed on the left side of each prisoner’s chest. Those who did the tattooing used a metal stamp with changeable plates fitted with needles that formed numbers, then rubbed blue ink into the bleeding holes. This technique enabled guards and prisoners to tattoo the number on a prisoner’s body in a single action.</p>
<p>By the spring of 1942, all incoming Jewish prisoners selected for forced labour, rather than immediate death, were tattooed. In place of the metal plate, the tattooists now used a single needle to puncture the number into the prisoner’s skin by hand, then rubbed in the ink. </p>
<p>The numbers were tattooed on the prisoners’ left forearms. Shapes and letters were sometimes also used to differentiate between groups of prisoners. Some Jewish prisoners had a triangle tattooed under their number. <a href="https://theconversation.com/the-genocide-of-the-roma-and-how-commemoration-of-this-forgotten-holocaust-is-shifting-92771">Roma and Sinti prisoners</a> had the letter Z appended to their number, the first letter of the (pejorative) German word <em>Zigeuner</em>, used at the time for these communities. </p>
<p>With Hungarian Jews arriving in increasing numbers, new sequences of digits were introduced in May 1944. These began with the number 1 and were prefaced first by the letter A; then, when more were needed, B. </p>
<p>In her 2001 autobiographical book, <a href="https://books.google.co.uk/books/about/Still_Alive.html?id=NX5Fj8rLqkIC&redir_esc=y">Still Alive: A Holocaust Girlhood Remembered</a>, German studies scholar and Holocaust survivor Ruth Klüger describes the experience of getting forcibly tattooed in Auschwitz:</p>
<blockquote>
<p>[After selection], we got our ID numbers tattooed on our left arms. A few female prisoners had been installed outside the building at a table with the necessary equipment and we stood in line, waiting our turn. The women knew their job, they were very fast. At first it looked as if the black ink would easily wash off, and indeed, water took most of it away, but then the fine points of the number remained: A-3537. </p>
</blockquote>
<p>Klüger speaks about “the victims’ skin” saving the Nazis from having to “produce dog tags”. This underlines how dehumanising this Nazi practice of tattooing numbers on inmates was. As the Italian writer and Holocaust survivor Primo Levi <a href="https://journals.sagepub.com/doi/full/10.1177/07255136211042453">puts it</a> in his 1986 book, The Drowned and the Saved: </p>
<blockquote>
<p>Its symbolic meaning was clear to everyone: this is an indelible mark, you will never leave here; this is the mark with which slaves are branded and cattle sent to slaughter, and that is what you have become. You no longer have a name; this is your new name. </p>
</blockquote>
<h2>An embodied public memorial</h2>
<p>The Auschwitz number has marked out those who survived by making them ever recognisable to others. It is this recognition that mattered so much to Rony Cohen in getting her own tattoo: </p>
<blockquote>
<p>I was proud to take my grandmother with me. To take her childhood, her missing her parents – those moments are in this number. Whenever someone sees it, they know this is Auschwitz. I want it to be noticed and understandable. No one should doubt what it is.</p>
</blockquote>
<p>Cohen’s grandmother and great uncle were of the cohort of siblings that have become known as “Mengele twins”. The Nazi physician Josef Mengele had an interest in racial genetics. He first experimented on Roma and Sinti twins in what was known as the “Gypsy camp” in Auschwitz-Birkenau – then on Jewish prisoners who he picked from the Theresienstadt camp-ghetto in Terezín, in the Protectorate of Bohemia and Moravia.</p>
<p>From May 1944, subjects for Mengele’s experiments were also picked from the unloading ramps at Auschwitz. Cohen recalled the story her grandmother had told her, about how she arrived in Auschwitz with her twin brother, aged eight, and her mother and aunts and all the other children of the family: </p>
<blockquote>
<p>They saw the smoke from the crematorium. The family was walking and someone was saying: ‘Twins, twins, twins – where’s twins?’ </p>
</blockquote>
<p>Instead of hiding them, her mother said to her aunts, “Let’s give them the twins”. Her aunts thought she was crazy for suggesting that – but her mother thought she was saving her children. “I’m going to save your life now,” she told her children. “Give mummy a hug and you’re leaving now.” This was the last moment Cohen’s grandmother could remember being with her mother. </p>
<p>Having made it through selection and been forcibly tattooed, twins were sometimes given additional food which helped keep them alive. First-hand accounts <a href="https://collections.ushmm.org/search/catalog/bib4007">describe</a> how Mengele gave his victims chocolate before carrying out the most horrific experiments. He sewed twins’ veins together, injected chemicals into testicles and spines, and inserted large needles into skulls. </p>
<hr>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
<hr>
<p>In the 1994 book, <a href="https://collections.ushmm.org/search/catalog/bib4007">Anatomy of the Auschwitz Death Camp</a>, a chapter by historian Helena Kubica recounts the testimony of one man, Moshe Ofer, who was imprisoned with his twin brother. His testimony was collected by the Jerusalem tribunal that tried Mengele in absentia in 1985. Mengele killed Ofer’s brother with his experiments. </p>
<p>Ofer describes how, after the experiments, the physician would bring gifts. The horror of that had never left him. “Even today,” he says, “I can see him entering through the door and I am paralysed with fear.”</p>
<p>Cohen’s grandmother similarly recalled Mengele bringing food for the twins. It saved them physically, she said, but the psychological damage was immeasurable. As Cohen puts it: </p>
<blockquote>
<p>My grandmother, since the Holocaust, she has a sleeping disorder. In her dreams, her parents come and all the horror comes. She always tells me: ‘I can’t forgive myself that I remember Mengele’s face but I can’t remember my parents’ faces.’ </p>
</blockquote>
<p>Her brother – Cohen’s great uncle – had his tattoo removed after saving enough money. Her grandmother, by contrast, still bears it on her left arm. </p>
<p>As a child, Cohen would ask questions. Sometimes her grandmother would make out that it was nothing. Sometimes she’d say she would tell her when she was older. Cohen describes herself as stubborn – she just kept asking. </p>
<p>When she was 12 or 13, for a school project on roots, she decided to do a video on her family’s history. Cohen interviewed both her maternal grandparents. Her grandfather she describes as “tough”, with “all the characteristics of a typical survivor”. He was keen that Cohen pass on all the information to her mother because, he said, “Your mum never asked.” </p>
<p>Cohen shared everything with her mother and her uncle – and it finally removed the elephant from the room. It made talking about the Holocaust possible. </p>
<p>At 17, like so many Israelis, Cohen went on a high-school visit to Poland, to the camps and the ghettos. Before leaving on this trip, she went to see her grandfather. He told her that going to Auschwitz would change everything: </p>
<blockquote>
<p>When you stand there in those walls and you smell the death smell and you see the gas chamber, you will come back to Israel and you will tell me: ‘I can’t understand.’</p>
</blockquote>
<p>“I can’t understand,” Cohen now says. “My grandfather was so right.” </p>
<h2>How Holocaust memorialisation has changed</h2>
<p>The Auschwitz number tattoo was not always revered. After the second world war, survivors were often stigmatised. Public commemorations celebrated resistance and uprisings. The victims and survivors, by contrast, were <a href="https://www.tandfonline.com/doi/abs/10.1080/02757206.2020.1726907">portrayed as weak</a>. </p>
<p>That early stigmatisation would follow some survivors throughout their lives, even when public perception started to shift. Some, like Cohen’s great uncle, had their number removed. Others covered it up with long sleeves. </p>
<p>From the early 1960s, as French historian Annette Wieviorka shows in <a href="https://www.cornellpress.cornell.edu/book/9780801443312/the-era-of-the-witness/#bookTabs=1">The Era of The Witness</a> (2006), attitudes began to change – partly due to the testimonies heard during the trial of <a href="https://www.yadvashem.org/holocaust/eichmann-trial/about.html">Adolf Eichmann</a> in 1961-62. The author <a href="https://www.newyorker.com/magazine/1963/02/16/eichmann-in-jerusalem-i">Hannah Arendt</a> <a href="https://www.newyorker.com/magazine/a-reporter-at-large/02/23/eichmann-in-jerusalem-ii">reported</a> from the <a href="https://www.newyorker.com/magazine/1963/03/02/iii-eichmann-in-jerusalem">district court</a> in <a href="https://www.newyorker.com/magazine/mjn-=1963/03/09/eichmann-in-jerusalem-iv">Jerusalem</a> for the <a href="https://www.newyorker.com/magazine/1963/03/16/eichmann-in-jerusalem-v">New Yorker</a> magazine, thereby giving survivor voices a global platform. The trauma that emerged from Eichmann’s trial reframed survival in itself as something heroic. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/570170/original/file-20240118-23-vfrt3z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A black and white photograph of a court trial." src="https://images.theconversation.com/files/570170/original/file-20240118-23-vfrt3z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/570170/original/file-20240118-23-vfrt3z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=504&fit=crop&dpr=1 600w, https://images.theconversation.com/files/570170/original/file-20240118-23-vfrt3z.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=504&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/570170/original/file-20240118-23-vfrt3z.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=504&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/570170/original/file-20240118-23-vfrt3z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=634&fit=crop&dpr=1 754w, https://images.theconversation.com/files/570170/original/file-20240118-23-vfrt3z.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=634&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/570170/original/file-20240118-23-vfrt3z.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=634&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Adolf Eichmann is sentenced to death in Jerusalem on December 15 1961.</span>
<span class="attribution"><a class="source" href="https://upload.wikimedia.org/wikipedia/commons/6/61/Adolf_Eichmann_is_sentenced_to_death_at_the_conclusion_of_the_Eichmann_Trial_USHMM_65289.jpg">Wikimedia</a></span>
</figcaption>
</figure>
<p>Then, in 1967, Israel responded to threats from Egypt and other neighbouring states with an offensive that allowed it to expand into and occupy the Sinai Peninsula, the Gaza Strip, the West Bank, East Jerusalem and the Golan Heights. Further afield, the conflict – known as the six-day war – built an affinity between Jewish communities in the US and Israel. Many American Jews began to both embrace their European roots and support Zionism. </p>
<p>Wieviorka’s book highlights the third (and ongoing) phase of Holocaust memorialisation – what she terms the “era of the witness”, which emerged in the 1970s. People started collating survivor testimonies, photographs and documentation. Through visits to Poland, to the camps and ghettos, families began to tell their <a href="https://nyupress.org/9781479839292/the-holocaust-across-generations/">stories</a>.</p>
<p>For some, the visit to Poland triggered the idea of replicating the Auschwitz number on their own body. In the summer of 2022, I spoke with Zeev Forkosh. Now aged 38, he has multiple tattoos – but the idea for his first one came after going to Auschwitz.</p>
<p>The new information Forkosh learned during that trip, about what his grandmother had experienced there, sparked such powerful emotions that he decided to get a Holocaust memorial tattoo. He describes the large Star of David he wears on his back as entwined with “bones, flesh and a lot of clothes, like the Holocaust survivors”. </p>
<p>Next, Forkosh decided to replicate his grandmother’s number on his arm, explaining:</p>
<blockquote>
<p>I will never forget this trip, so it’s on my back now. But after a few years, I wanted to be more specific about my grandmother. I told the tattoo artist that this was for [her]. I’m a third generation of a Holocaust survivor. I think it’s the most beautiful tattoo ever. </p>
</blockquote>
<p>Talking of this number in terms of beauty underscores how reproducing the tattoo gives it new meaning. It is a gesture that, for Forkosh, turns the visual symbol of a genocide into a symbol of love and legacy, of commemoration and pride. </p>
<figure class="align-center ">
<img alt="A close-up of an arm tattoo." src="https://images.theconversation.com/files/570157/original/file-20240118-15-na6vez.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/570157/original/file-20240118-15-na6vez.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=302&fit=crop&dpr=1 600w, https://images.theconversation.com/files/570157/original/file-20240118-15-na6vez.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=302&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/570157/original/file-20240118-15-na6vez.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=302&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/570157/original/file-20240118-15-na6vez.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=379&fit=crop&dpr=1 754w, https://images.theconversation.com/files/570157/original/file-20240118-15-na6vez.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=379&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/570157/original/file-20240118-15-na6vez.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=379&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Yair Ron replicated his father’s number exactly.</span>
<span class="attribution"><span class="source">John Jeffay for The Conversation</span></span>
</figcaption>
</figure>
<p>This marks a radical shift from survivors’ own relationships with the number. They had no choice in the matter: the tattoo was forcibly placed on their bodies. For some whose descendants suggested replicating it, the answer has always been a categorical “no”. Yair Ron discussed the idea with his father: </p>
<blockquote>
<p>I tried to talk to him about the idea that I had to get the tattoo. He did not agree. ‘Why?’ he asked. ‘You don’t need to, it’s not good. Let’s forget everything.’ </p>
</blockquote>
<p>Ron kept trying: “It took a few years for us to talk about it. And then he agreed for me to do it.”</p>
<p>He gave the tattoo artist a photo of his father’s number. He wanted to replicate it as closely as possible. He wanted people to ask about it, to keep the Holocaust in living memory. </p>
<p>In Ron’s mind, this replicated number represents continuity. It ensures there are still people “walking with the number”. He says he wanted to experience what his father had experienced when his name was taken away. </p>
<p>Similarly, Rony Cohen says that deciding to replicate her grandmother’s tattoo was so “she could walk with me for good – it’s a statement for me”. Cohen too wanted it in the same place as the original, so that everyone understood its meaning. She sees her body as becoming a conduit for her grandmother – a means to keep her legacy and life with her at all times. </p>
<p>In contrast to Ron, though, Cohen did not broach the subject with her grandmother. She just went ahead and got the tattoo, then wore long sleeves at family gatherings – much like some survivors had in previous decades. But for her, covering the tattoo wasn’t because of stigma. Rather, she worried about the reactions it might trigger.</p>
<p>Eventually, Cohen decided to show the number to her grandmother. She videoed her response. </p>
<p>At first, her grandmother asks why Cohen has done it. Then she asks if it hurt. “I don’t want you to do something that hurts,” she says. </p>
<p>“No it didn’t,” Cohen replies. </p>
<p>To which her grandmother asks: “Why?” </p>
<p>Cohen is very clear that getting her tattoo was a personal act, a decision relating to her own history, not to a larger historical one. “I’m not a monument,” she says. “I don’t carry the Jewish nation on my back.”</p>
<h2>When the Holocaust passes out of living memory</h2>
<p>Museums and memorials all over the world are dedicated to <a href="https://theconversation.com/why-we-still-need-to-teach-young-people-about-the-holocaust-90481">telling the story</a> of the Holocaust. Since 2006, International Holocaust Remembrance Day has been marked every year on January 27.</p>
<p>But despite the proliferation of Holocaust-related art and culture, despite the books laying out the facts, research shows many people are ignorant of <a href="https://www.pewresearch.org/religion/2020/01/22/what-americans-know-about-the-holocaust/">what happened</a>. In 2021, the <a href="http://www.claimscon.org/uk-study/">global Holocaust Awareness</a> Survey found large gaps in people’s knowledge. </p>
<p>In the UK, 52% of respondents could not specify that six million Jewish people had been murdered – a number which rose to 56% in Austria and 57% in France. Of the adults surveyed in the US and Canada, 45% and 49%, respectively, were unable to name a concentration camp or a ghetto. Among millennials in the US, only 49% could name a concentration camp or ghetto. </p>
<figure class="align-center ">
<img alt="A man in a lilac shirt and tie holds out a photograph." src="https://images.theconversation.com/files/567556/original/file-20240102-15-dlbkqi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567556/original/file-20240102-15-dlbkqi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=386&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567556/original/file-20240102-15-dlbkqi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=386&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567556/original/file-20240102-15-dlbkqi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=386&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567556/original/file-20240102-15-dlbkqi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=485&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567556/original/file-20240102-15-dlbkqi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=485&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567556/original/file-20240102-15-dlbkqi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=485&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">David Rubin with a photograph of his grandmother, Piroska ‘Perl’ Levy, and himself as a kindergartener.</span>
<span class="attribution"><span class="source">Alice Bloch</span></span>
</figcaption>
</figure>
<p>This matters because, as we reach the 79th anniversary of the liberation of Auschwitz on January 27 1945, there are very few survivors left to give a first-hand account of what was done to them. The Holocaust is passing out of living memory.</p>
<p>For those whose family history is tied up with the Holocaust, memorialising it is both public and private. The tattoo replicating the Auschwitz number is a form of memorial practice that speaks, viscerally, to their own family history – but also to the imperative to never forget. </p>
<p>I spoke with David Rubin in the summer of 2022. He bears his grandmother’s number on his arm, the number depicted as if written on a piece of wood alongside a Star of David, a thorny vine of lilac-coloured flowers entwined around it. </p>
<figure class="align-center ">
<img alt="A tattoo of an Auschwitz concentration camp number surrounded by flowers." src="https://images.theconversation.com/files/567256/original/file-20231222-17-tmxex2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567256/original/file-20231222-17-tmxex2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567256/original/file-20231222-17-tmxex2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567256/original/file-20231222-17-tmxex2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567256/original/file-20231222-17-tmxex2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567256/original/file-20231222-17-tmxex2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567256/original/file-20231222-17-tmxex2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Rubin’s tattoo replicates his grandmother’s number, A 6615.</span>
<span class="attribution"><span class="source">Alice Bloch</span></span>
</figcaption>
</figure>
<p>Four of the flowers are open, representing his grandmother, Piroska “Perl” Levy, and her surviving sisters. To the left lie two closed flowers, for her two sisters who were killed. A lone flower completes the floral framing at the bottom, in memory of her brother, also killed.</p>
<p>To Rubin’s mind, his generation is probably the last to speak about this. Getting the tattoo was a means of ensuring that the fourth generation – his children, his grandmother’s great-grandchildren – will know what happened. “I wanted a story, instead of just a number,” he says. The barbed wire has become the thorny vine in flower. “It’s taking the bad thing and [re]creating it as a good thing.” </p>
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<img alt="A young man and an elderly lady." src="https://images.theconversation.com/files/567582/original/file-20240102-17-9herb3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/567582/original/file-20240102-17-9herb3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=947&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567582/original/file-20240102-17-9herb3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=947&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567582/original/file-20240102-17-9herb3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=947&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567582/original/file-20240102-17-9herb3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1190&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567582/original/file-20240102-17-9herb3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1190&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567582/original/file-20240102-17-9herb3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1190&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">David and his grandmother, Piroska ‘Perl’ Levy.</span>
<span class="attribution"><span class="source">David Rubin</span></span>
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<p>Memorial tattoos are a way of expressing a life story. They are an external scar that <a href="https://doi.org/10.1080/07481187.2021.1983889">embodies</a> an internal one. The writer Eva Hoffman <a href="https://www.penguin.co.uk/books/358115/after-such-knowledge-by-eva-hoffman/9780099464723">notes</a> that even where there are silences in how families, including her own, reckon with their traumatic past, the “language of the body” still breaches those silences. It keeps the unspoken past ever present. </p>
<p>While descendants of Holocaust survivors did not experience the trauma directly, the intergenerational trauma is long-lasting. Rony Cohen was not the only grandchild of a survivor who told me they dream or have nightmares about the Holocaust. </p>
<p>In doing these interviews, I have found that replicating the Auschwitz tattoo is an expression of the love felt towards the survivor relative, and a way of keeping the memory of the Holocaust alive. It is an <a href="https://thesociologicalreview.org/podcasts/the-stigma-conversations/tattooing-and-resistance-with-alice-bloch/">act of reclaiming</a> a painful family history. And for some, it is about connections <a href="https://theconversation.com/from-the-manchester-bee-to-the-pompey-dot-the-psychology-of-regional-tattoos-198695">to a collective identity</a>. </p>
<p>In this way, it is about the future too. When there are no more survivors to share their stories, these descendants who bear on their living bodies the numbers once forcibly tattooed on their relatives will stand as a living reminder of where racism and hatred can lead. </p>
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<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p class="fine-print"><em><span>Alice Bloch has received funding from British Academy/Leverhulme Trust Small Research grant in partnership with the Department for Business, Energy and Industrial Strategy to support this research. </span></em></p>As the Holocaust passes out of living memory, such embodied memorialisation ensures people will still talk about what happened.Alice Bloch, Professor of Sociology, University of ManchesterLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2206162024-01-11T12:50:05Z2024-01-11T12:50:05ZInequality is dividing England. Is more devolution the answer?<p>Twenty-five years ago, when new institutions of national government were created in <a href="https://www.parliament.scot/about/history-of-the-scottish-parliament/the-scottish-parliament-reestablished#topOfNav">Scotland</a> and <a href="https://senedd.wales/how-we-work/history-of-devolution/">Wales</a>, they reflected the widely held view that the Welsh and Scots should have more control over their economies, aspects of welfare provision and key public services. Yet at that time, hardly anyone thought devolution might be applied to England – despite it being the largest, wealthiest and most populated part of the UK.</p>
<p>Today, things look rather different. The notion of English devolution has morphed from being of interest only to constitutional experts to being a preoccupation of Britain’s politicians as we approach the next general election – many of whom have lost confidence in the capacity of central government to tackle the country’s most deeply-rooted problems.</p>
<p>A historic <a href="https://www.sunderland.gov.uk/article/29488/4-2bn-North-East-devolution-deal-gets-local-approval">£4.2bn devolution deal</a>, which will bring together seven councils under an elected <a href="https://en.wikipedia.org/wiki/2024_North_East_mayoral_election">mayor of the North East</a> in May 2024, is the latest attempt to address some of the deep geographical inequalities that disfigure and disenfranchise large areas of England.</p>
<p>Meanwhile, much of English local government is experiencing immense financial pressures, with large councils such as <a href="https://www.bbc.co.uk/news/uk-england-birmingham-67053587">Birmingham</a> and <a href="https://www.theguardian.com/society/2023/nov/29/nottingham-city-council-wasnt-reckless-it-was-hollowed-out-by-austerity">Nottingham</a> declaring themselves at risk of bankruptcy while others <a href="https://www.newstatesman.com/spotlight/economic-growth/regional-development/2023/07/council-rescue-package-finance-bankruptcy">teeter on the edge of a financial cliff</a>. In many parts of England, it is <a href="https://www.bennettinstitute.cam.ac.uk/publications/devolving-english-government/">increasingly unclear</a> who local residents should hold accountable for public service provision – in part due to the amount of outsourcing to the private sector that has become routine.</p>
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
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<p>“Take Back Control” was the slogan of the Vote Leave campaign leading up to the Brexit referendum of September 2016. It may not be a coincidence that the country which played the key arithmetical role in determining its outcome – England – was the only one where devolution had not been introduced, and where many non-metropolitan residents felt their views and interests counted for little in the citadels of democratic government. </p>
<p>Since then, more years of political turbulence, economic shocks intensified by the COVID pandemic, and the government’s <a href="https://committees.parliament.uk/committee/17/levelling-up-housing-and-communities-committee/news/195434/levelling-up-policy-will-fail-without-longterm-substantive-funding-for-councils-say-mps/">failure to “level up”</a> as pledged, have combined to erode the allegiance and goodwill of many of its citizens. What this means for the future of a UK union-state model that has rested, to a considerable degree, upon English assent is likely to become one of the key political – and constitutional – issues of our time.</p>
<h2>What is English devolution for?</h2>
<p>In fact, the idea of establishing a new layer of government between Whitehall and England’s complicated network of local councils has engaged the attention of successive governments since the 1960s. But questions about the form, scope and functions of this “middle” layer gradually turned into a party-political football, with governments of different colours inclined to reverse the arrangements put in place by their predecessor. And the wider democratic ambition hinted at by the term “devolution” was largely absent from these reforms.</p>
<p>Whereas in Scotland and Wales, devolution was long ago couched in terms of democratic advance and national self-determination, in England it was largely regarded as a mere extension of central government’s approach to regional policy-making – and even the <a href="https://www.ft.com/content/5fe17864-ae02-11e4-919e-00144feab7de">advent of elected “metro mayors”</a> did little to change this view. But now, politicians from both main political parties have come to believe in a new, sub-national model that can be badged as England’s own version of devolution.</p>
<p>A spate of deals involving the voluntary combining of different councils were announced in 2022, including for <a href="https://www.northyorks.gov.uk/your-council/devolution">North Yorkshire</a>, the East Midlands and the North East, and again in Chancellor Jeremy Hunt’s 2023 <a href="https://www.gov.uk/government/speeches/autumn-statement-2023-speech">autumn statement</a> for Lancashire, Greater Lincolnshire and <a href="https://www.prolificnorth.co.uk/news/autumn-statement-devolution-for-hull-tax-cuts-for-unemployed-500m-for-innovation-centres-and-ai-but-weaker-growth-predicted/#:%7E:text=and%20Jeremy%20Hunt-,Autumn%20statement%3A%20Devolution%20for%20Hull%2C%20NI%20cuts%20for%20all%2C,AI%2C%20but%20weaker%20growth%20predicted&text=Hull%20City%20Council%20and%20East,Chancellor%20Jeremy%20Hunt's%20autumn%20statement.">East Yorkshire</a>. And a report by Labour’s <a href="https://labour.org.uk/wp-content/uploads/2022/12/Commission-on-the-UKs-Future.pdf">Commission on the UK’s Future</a>, chaired by former prime minister Gordon Brown, signalled that the party should <a href="https://www.instituteforgovernment.org.uk/comment/brown-commission-constitutional-reform">extend the current government’s programme</a> of English devolution.</p>
<p>This idea lay at the heart of Boris Johnson’s ambitious programme while he was prime minister for addressing the deep disparities in productivity and social outcomes that exist in England, to which he gave the grand but elusive title “levelling up”. This plan – set out in a <a href="https://assets.publishing.service.gov.uk/media/62e7a429d3bf7f75af0923f3/Executive_Summary.pdf">lengthy white paper</a> in February 2022 – seems, for the most part, to have fallen by the wayside now that Johnson has left the political stage. But it still marked an important staging post in the journey of the once-niche idea of English devolution. Both main political parties have signed up to this principle and have indicated they will create more devolved authorities should they win the next general election.</p>
<p>Advocates sometimes point to an extensive – though hotly contested – body of research on the positive consequences for local economies of taking policy decisions at levels closer to the people they affect. One influential theoretical support for this idea highlights what economists call the “<a href="https://www.semanticscholar.org/paper/Opportunities-for-tacit-knowledge-transfer-within-a-Moloney/f1a8daa5aea06468c03a1a7142c2122661a1a281">tacit knowledge</a>” about a place, which is often vital to understanding the particular policies and initiatives that are likely to yield most benefit there.</p>
<p>What can be said with more confidence is that a lot hinges on the quality of the institutions that are created, and <a href="https://journals.sagepub.com/doi/pdf/10.1177/00323217221136666">how well funded they are</a>.</p>
<p>Others argue that a more decentralised system of political authority is more likely to win the allegiance of, and secure more engagement from, people throughout England – in a context where <a href="https://www.ippr.org/blog/freefall-how-a-year-of-chaos-has-undermined-trust-in-politics">trust in the UK’s political class has plummeted</a>, where <a href="https://www.bennettinstitute.cam.ac.uk/publications/devolving-english-government/">MPs are less popular</a> than local councillors, and where there is widespread disenchantment with the perceived bias of central government towards London and the south-east. </p>
<p>However, to what extent does the record of England’s existing “<a href="https://www.centreforcities.org/publication/everything-need-know-metro-mayors/#whois">metro mayors</a>” support this case?</p>
<h2>‘King of the north’</h2>
<p>When the mayor of Greater Manchester, Andy Burnham, <a href="https://twitter.com/Femi_Sorry/status/1318576386949468164?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1318582661317824515%7Ctwgr%5Ed6e9e68efd3b3c853ef8fce56165ad44c52f62c3%7Ctwcon%5Es3_&ref_url=https%3A%2F%2Fwww.mirror.co.uk%2Fnews%2Fpolitics%2Fking-north-andy-burnham-labelled-22878379">staged an impromptu press conference</a> in the street outside Manchester town hall to protest against the local lockdown that the UK government wanted to introduce in the north-west of England in October 2020, his stance received considerable local support – to the extent that he briefly <a href="https://www.mirror.co.uk/news/politics/king-north-andy-burnham-labelled-22878379">acquired the nickname</a> “king of the north”. Since his election as mayor in May 2017, Burnham has led a number of high-profile initiatives on issues such as <a href="https://www.greatermanchester-ca.gov.uk/news/mayor-hails-pioneering-housing-scheme-that-transformed-homelessness-response-in-greater-manchester-as-number-of-people-on-streets-falls-further/">homelessness</a>, and overseen the integration of health and local social care services.</p>
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<figcaption><span class="caption">Andy Burnham’s impromptu press conference outside Manchester town hall.</span></figcaption>
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<p>Similarly, it is unlikely that a backbench MP would have been able to <a href="https://www.theguardian.com/uk-news/2023/oct/04/tory-mayor-andy-street-considering-quitting-over-rishi-sunak-hs2-u-turn">wrest concessions</a> from a prime minister as did the Conservative mayor of the West Midlands, Andy Street, after he made public his <a href="https://www.telegraph.co.uk/business/2023/09/27/hs2-route-scaled-back-jeopardise-investment-andy-street/">opposition to Rishi Sunak’s decision to cancel the HS2 rail project</a> in September 2023.</p>
<p>While the responsibilities held by England’s metro mayors are, by international standards, pretty limited, they are at times able to deploy what political scientists term the “soft power” that comes from being the acknowledged leader of, and voice for, a locality. They also tend to be more independent of their own party machines than MPs are, going out of their way, when it suits them, to dissent from their parties’ London-based leaderships.</p>
<p>But it would be unwise to get too starry-eyed about a system that relies so heavily on soft power rather than the allocation of formal responsibilities. The absence of an elected legislature tasked with scrutinising and legitimating the work of these leaders – who are typically, and often not very effectively, held to account by local council leaders – is a significant further constraint on their ability to act as democratically legitimate changemakers.</p>
<p>This is very different to the model established in London, which had its <a href="https://www.instituteforgovernment.org.uk/article/explainer/mayor-london-and-london-assembly">own government restored</a> by the first government of Tony Blair in 1999 following a city-wide referendum. The Greater London Authority is made up of elected representatives whose job it is to scrutinise the elected mayor, currently Sadiq Khan, and his administration. </p>
<p>In contrast, metro mayors elsewhere in England – tasked with delivering policies and overseeing funding allocations in areas of priority set by central government – are typically frustrated by the limits imposed on their own agency. Nor do they have the fiscal tools, both in terms of raising revenue and borrowing against financial assets, that are typical of many city and regional governments outside the UK.</p>
<p>The idea of having mini-parliaments across England’s regions, on a par with the legislatures established in Scotland and Wales, was dealt a fatal blow in 2004. During the course of the Blair governments, his long-time deputy prime minister, John Prescott, had pressed for the gradual conversion of the English regional development agencies Labour had created into a form of elected regional administration. But this died a very public death when <a href="https://www.theguardian.com/society/2004/nov/05/regionalgovernment.politics">voters in the north-east overwhelmingly rejected the idea</a> – despite having been selected as the region most likely to support it.</p>
<p>Twenty years on, the suite of new city-regional authorities being created risks deepening the existing cleavage between England’s major cities and those parts of the country without a large urban metropole. Indeed, some of the devolution agreements recently announced had been stalled for years by the unwillingness of particular authorities to participate in these initiatives. The deal encompassing the cities of the north-east, for example, was held up for years by the refusal of Durham County Council to join its larger urban neighbours.</p>
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Read more:
<a href="https://theconversation.com/inspiring-the-devolution-generation-in-greater-manchester-75790">Inspiring the ‘devolution generation’ in Greater Manchester</a>
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<p>The idea that establishing leadership at the level of a large city and its surrounding hinterland can improve the quality of democratic life, and create a more responsive layer of government, remains appealing for many, despite the unsteady emergence of this model in England.</p>
<p>However, amid attempts by UK politicians and administrators to present this as equivalent to the clearer and more robust forms of governance introduced in Scotland, Wales and Northern Ireland, another important question has emerged. Namely, whether the English have come to feel some jealousy and suspicion about these new forms of government established outside England – and less enthusiasm for the union as a whole.</p>
<h2>A national grievance?</h2>
<p>The idea that England and the English need to be recognised as a distinct national entities within a multi-national union has more popular resonance in an era when debates over sovereignty, national identity and self-determination have become integral to political life</p>
<p>For some, this imperative arises from the belief that changes associated with devolution elsewhere have served to put the English majority at a disadvantage. Some express this in financial terms, arguing that England’s taxpayers have been funding the <a href="https://www.instituteforgovernment.org.uk/article/explainer/barnett-formula">more generous per-capita settlements</a> awarded to Northern Ireland and Scotland. Others see it as a reflection of the <a href="https://global.oup.com/academic/product/the-politics-of-english-nationhood-9780198778721?cc=gb&lang=en&">revealed preference of the British political establishment</a> to appease those living in these areas, by awarding their inhabitants additional political rights while neglecting the inhabitants of England’s non-metropolitan areas.</p>
<p>Following the establishment of new parliaments in Belfast, Edinburgh and Cardiff, and the absence of any such model for England, the idea that these reforms have created an imbalance which <a href="https://www.democraticaudit.com/2013/08/15/unfinished-devolution-has-created-constitutional-imbalances-in-the-uk/">puts the largest part of the UK at a disadvantage</a> has become a familiar political sentiment. This was particularly salient when the ability of MPs sitting in Scottish and Welsh seats to vote on contentious legislative proposals that applied only to England became a <a href="https://www.ucl.ac.uk/constitution-unit/research/research-archive/nations-regions-archive/english-question">controversial political issue</a> – as in 2004, when the Blair government introduced <a href="https://www.parliament.uk/business/publications/research/key-issues-for-the-new-parliament/value-for-money-in-public-services/funding-higher-education/#:%7E:text=As%20a%20result%20of%20the,2004%20Act%20was%20highly%20controversial.">controversial legislation</a> requiring students at English universities to pay some of their tuition costs.</p>
<p>The constitutional problem created by this imbalance had been aired in parliament by a number of MPs and members of the House of Lords when devolution was first introduced in the late 1990s. Some argued that one of the unintended effects of these changes might be to engender a feeling of national grievance – perhaps even a reactive nationalism – among the English. But for the most part, this prospect was ignored or scoffed at by politicians from both main political parties.</p>
<p>Soon after the new parliaments were established, however, the question of how reforms elsewhere would affect England – and whether it too needed a mechanism to signal the consent of its MPs to legislation that only affected England – moved into the political mainstream. Some campaigners and MPs suggested that only the <a href="https://www.ucl.ac.uk/constitution-unit/sites/constitution-unit/files/179-options-for-an-english-parliament.pdf">establishment of an equivalent English parliament</a> could address the profound imbalance created by the devolution granted to the other UK countries.</p>
<p>In 2015, the David Cameron-led Conservative government introduced a new set of rules for dealing with those parts of legislation that related to England only. Known by the acronym <a href="http://evel.uk/how-does-evel-work/">EVEL</a> (short for “English vote for English laws”), these reforms proved <a href="https://www.ucl.ac.uk/constitution-unit/sites/constitution-unit/files/EVEL_Report_A4_FINAL.pdf">immensely complicated to operate</a> and elicited little enthusiasm among MPs, while being almost unknown to the wider public. They were quietly abolished by Johnson’s Tory government in 2020.</p>
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<strong>
Read more:
<a href="https://theconversation.com/tory-votes-for-tory-laws-camerons-evel-plan-to-cut-out-the-opposition-44246">Tory votes for Tory Laws? Cameron's EVEL plan to cut out the opposition</a>
</strong>
</em>
</p>
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<p>While the idea of remaking the UK along federal lines, with each part of the state having its own parliament for domestic legislation, enjoys some support and may grow in appeal, Britain’s politicians and the vast majority of its constitutional experts remain decidedly cool towards this idea. They believe that pushing in this direction could lead to the dissolution of the UK given the preponderant size and wealth of England – meaning it would have a disproportionate amount of influence within a federated UK.</p>
<p>Such a reform is unwarranted on this view, because England is already the most powerful and important part of the UK governing system, with an overwhelming majority of MPs sitting in English seats. But once the question of how and where England sits within the UK’s increasingly discordant union was raised, it would never be easy to put it back into obscurity.</p>
<h2>‘When will we get a vote?’</h2>
<p>According to some <a href="https://global.oup.com/academic/product/englishness-9780198870784?cc=gb&lang=en&">survey evidence</a>, the people in England most likely to believe their country is losing out in the UK’s current devolution settlement are those most inclined to feel that central government is too distant from – and neglectful of – their lives. They were also the most likely to vote to get the UK out of the EU in 2016.</p>
<p>This sentiment was already a sensitive political topic by the mid-2000s, when Conservative MPs became concerned about the implications of devolution elsewhere for the English, while their Labour counterparts typically preferred to hymn the virtues of regional devolution, particularly in northern England. But how the English and their political representatives felt about these issues took on new relevance during the Scottish independence referendum of 2014.</p>
<p>Towards the end of this contest, an announcement of further devolution to Scotland was made in the form of a <a href="https://www.itv.com/news/wales/update/2015-01-22/the-vow-to-scotlands-been-kept-claims-cameron/">much-trumpeted “vow”</a> endorsed by the leaders of the Conservative, Labour and Lib Dem parties. Whether this promise of new powers for the Scottish government made any difference to the outcome of this historic poll is highly debatable. But what was notable was the hostile reaction it elicited in different parts of England – including on the part of many Tory MPs towards their prime minister. Such was the level of annoyance it stirred, Cameron was compelled to hold a gathering at his country retreat, Chequers, to assuage the mutinous mood of these backbenchers.</p>
<p><a href="https://www.centreonconstitutionalchange.ac.uk/sites/default/files/migrated/news/Both%20England%20and%20Wales%20oppose%20Scottish%20Independence.pdf">Surveys have suggested</a> that a sizeable minority of the English held strong views about the outcome of the Scottish referendum – with about 20% of respondents happy for the Scots to go, and around the same number worried about the impact of Scotland leaving the UK. But another sentiment was palpable at this time. “When will we get a vote?” was a question I recall being put to me again and again by English audience members at various panel discussions over the summer of 2014. Behind it lay a sense of frustration that, in comparison with the Scots, the English were being left disenfranchised as their allegiance to the governing order was taken for granted.</p>
<p>The contrast between the narrow terms in which the “English question” was framed at Westminster and the growing appeal of powerful ideas about sovereignty, democratic control and national self-determination in this period is striking. And it formed an important prelude to the rebellion of the English majority in the Brexit referendum of 2016 when, finally, they were given a vote on an issue of constitutional importance, with profound economic and societal results.</p>
<p>Despite all that’s since been said about that Brexit vote and its impacts, the question of what happens when a national majority becomes more restive about the multinational arrangements in which it sits demands further consideration in this context. As I argue in my new book, <a href="https://www.hurstpublishers.com/book/fractured-union/">Fractured Union</a>, the future prospects of the UK’s union may even depend on it.</p>
<h2>A lesson from history?</h2>
<p>One – perhaps slightly unexpected – international example worth considering here is Czechoslovakia, which split into the separate states of the Czech Republic and Slovakia on January 1 1993. Despite many differences in context – not least its long history of rule by the Communist party, and the centrifugal dynamics let loose by the party’s disintegration in 1989 – aspects of this story are highly relevant to the current situation facing the Anglo-Scottish Union in particular.</p>
<p>The break-up of Czechoslovakia did not emanate directly from nationalist demands among the populace, but was significantly determined by decisions made at the political level. Just six months prior to the vote, support for the option of splitting Czechoslovakia into two wholly independent states was as low as 16% in both parts of the country. And there is every chance that a referendum on this issue (which came close to happening) would have produced a majority for the continuation of the status quo.</p>
<p>Two decades earlier, in 1968, new legislation established to protect the Slovaks from being dominated by the Czech majority held that constitutional and other important laws had to be passed on the basis of “special majorities”. These provisions were the source of constant grumbling and some resentment on the Czech side, being perceived as anti-democratic checks upon the will of the majority.</p>
<p>Under the political control of the Communist party, these differences were overridden by the party’s interest in the preservation of the wider state. But once Communism ended and a democratic model was introduced, friction between ideas of Slovakian sovereignty and the imperatives of a federal state model accentuated the underlying tensions between these nations and the parliaments where they were represented. In some echo of the Anglo-Scottish situation, many Czechs resented a perceived imbalance at the scale of representation of the Slovaks within the federal government, and <a href="https://journals.akademicka.pl/politeja/article/view/903">questioned the disproportionate transfer of resources</a> to the poorer Slovakian territory.</p>
<p>Despite extended and fraught negotiations over the constitutional framework, the gulf in the constitutional outlooks of politicians from these territories was considerable, with both sets espousing entirely different constitutional perspectives. Agreement was finally reached on a new federal framework in November 1991, but this deal was voted down by the Slovak parliament. Its Czech equivalent thereafter declared that further negotiation with the Slovak side would be pointless.</p>
<p>At the parliamentary elections of June 1992, the main winners in both territories were the political parties least inclined to compromise with the other side. Having given up on negotiations, and with the prospect of a referendum in Slovakia on its future within the state having been abandoned too, the Czech government moved towards the idea of a <a href="https://journals.akademicka.pl/politeja/article/view/913">speedy and complete division</a>.</p>
<h2>Could it happen in the UK?</h2>
<p>Czechoslovakia’s split throws into relief the key role politicians can play in moments of constitutional crisis, as well as the corrosive effect of <a href="https://www.karlobasta.com/symbolic-state">feelings of neglect and unfairness among a national majority</a> that can build up over time. It highlights, too, the challenge of sustaining a union when politicians at central and sub-state levels hold irreconcilable constitutional worldviews, and are fishing for votes in different territorial ponds.</p>
<p>Is it conceivable that some British politicians could, at some point, seek advantage by mobilising an appeal to the English majority against the claims and complaints of the smaller nations in the UK? And might the emergence of public scepticism within parts of the Tory party towards the models of devolved government in Cardiff and Edinburgh be understood as the first signs of such a dynamic?</p>
<p>There have already been moments in the recent political past when the appeal to the defence of neglected English interests has been politically powerful – for instance, during the 2015 general election campaign when the Conservatives deployed images of Labour’s leader, Ed Miliband, sitting in the pocket of the SNP’s leader, Nicola Sturgeon. And this may well recur as a theme in future Westminster elections, particularly if the SNP is able to recover from its current downturn.</p>
<p>However, in the longer run, what will do most to determine how the disaffected inhabitants of “provincial” England feel about devolution – and the lure of greater recognition and protection for English interests – is the quality of governance, service provision and economic opportunity they experience.</p>
<p>In recent years, despite the introduction of metro mayors, there has been little success in closing the regional gaps which “levelling up” was designed to address, and there is a real prospect of yet more local authorities going bankrupt. It would be little wonder, then, if the calls for greater priority to be paid to the concerns of the English heartland grow louder in years to come.</p>
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<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em>For you: more from our <a href="https://theconversation.com/uk/topics/insights-series-71218?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insights series</a>:</em></p>
<ul>
<li><p><em><a href="https://theconversation.com/freedom-of-thought-is-being-threatened-by-states-big-tech-and-even-ourselves-heres-what-we-can-do-to-protect-it-220266?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Freedom of thought is being threatened by states, big tech and even ourselves. Here’s what we can do to protect it
</a></em></p></li>
<li><p><em><a href="https://theconversation.com/mr-bates-vs-the-post-office-depicts-one-of-the-uks-worst-miscarriages-of-justice-heres-why-so-many-victims-didnt-speak-out-220513?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Mr Bates vs The Post Office depicts one of the UK’s worst miscarriages of justice: here’s why so many victims didn’t speak out
</a></em></p></li>
<li><p><em><a href="https://theconversation.com/politics-urgently-needs-more-imagination-competence-alone-will-not-save-us-from-this-polycrisis-193886?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Politics urgently needs more imagination. Competence alone will not save us from this ‘polycrisis’
</a></em></p></li>
</ul>
<p><em>To hear about new Insights articles, join the hundreds of thousands of people who value The Conversation’s evidence-based news. <a href="https://theconversation.com/uk/newsletters/the-daily-newsletter-2?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK"><strong>Subscribe to our newsletter</strong></a>.</em></p><img src="https://counter.theconversation.com/content/220616/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michael Kenny receives funding from the British Academy and (previously) the Economic and Social Research Council. His latest book is Fractured Union: Politics, Sovereignty and the Fight to Save the UK (Hurst, January 2024).
</span></em></p>Years of political turbulence, economic shocks and the failure to ‘level up’ as pledged have turned English devolution into a key political and constitutional issueMichael Kenny, Professor of Public Policy, Department of Politics and International Studies, University of CambridgeLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2202662024-01-08T16:43:08Z2024-01-08T16:43:08ZFreedom of thought is being threatened by states, big tech and even ourselves. Here’s what we can do to protect it<figure><img src="https://images.theconversation.com/files/568035/original/file-20240105-27-gzzeml.jpg?ixlib=rb-1.1.0&rect=46%2C46%2C5184%2C3383&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/danang-vietnam-august-2019-photo-taken-2185304981">Beauty Is In The Eye Inc/Shutterstock</a></span></figcaption></figure><p>The idea of free speech sparked into life 2,500 years ago <a href="https://oll.libertyfund.org/reading-room/2022-08-17-review-free-speech-a-history-from-socrates-to-social-media-by-jacob-mchangama-basic-books-2022">in Ancient Greece</a> – in part because it served a politician’s interests. The ability to speak freely was seen as essential for the new Athenian democracy, which the politician <a href="https://www.routledge.com/Aspects-of-Greek-History-750-323BC-A-Source-Based-Approach/Buckley/p/book/9780415549776">Cleisthenes</a> both introduced and benefited from.</p>
<p>Today, we debate the boundaries of free speech around kitchen tables and watercoolers, in the media and in our courtrooms. The <a href="https://www.equalityhumanrights.com/human-rights/human-rights-act/article-9-freedom-thought-belief-and-religion">right to freedom of thought</a>, however, is more rarely discussed. But thanks to the growing influence of social media, big data and new technology, this “<a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3291586">forgotten freedom</a>” needs our urgent attention.</p>
<p>In democratic societies ruled by ballots not bullets, power is won through persuasion. Efforts at persuasion are ramping up: there will be <a href="https://en.wikipedia.org/wiki/2024_national_electoral_calendar">more than 50 national elections</a> involving half the world’s population in 2024, including in <a href="https://www.forbes.com/sites/siladityaray/2024/01/03/2024-is-the-biggest-election-year-in-history-here-are-the-countries-going-to-the-polls-this-year/">seven of the ten most populous countries</a>. The results will <a href="https://worldview.stratfor.com/article/four-2024-elections-will-shape-second-half-decade">shape our century</a>, making it paramount that we protect people’s ability to think and vote freely. </p>
<p>But corporate and political actors know more about how our minds work than we do. They activate our biases rather than appeal to our reason, push us to share information without thinking, and control our attention to the point of addiction.</p>
<p>Advances in neuroscience may heighten this threat to free thought. Elon Musk and Mark Zuckerburg are among those in a <a href="https://www.vox.com/future-perfect/2023/5/4/23708162/neurotechnology-mind-reading-brain-neuralink-brain-computer-interface">race to read our minds</a> with the help of artificial intelligence (AI). In 2021, the <a href="https://www.ohchr.org/en/documents/thematic-reports/a76380-interim-report-special-rapporteur-freedom-religion-or-belief">UN warned of</a> the risks of neural technologies predicting, identifying and modifying our thoughts. Manhattan projects of the mind threaten to make lab rats of us all.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/567634/original/file-20240103-25-nqv1bk.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Suited man standing next to a brain imaging device." src="https://images.theconversation.com/files/567634/original/file-20240103-25-nqv1bk.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567634/original/file-20240103-25-nqv1bk.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=390&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567634/original/file-20240103-25-nqv1bk.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=390&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567634/original/file-20240103-25-nqv1bk.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=390&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567634/original/file-20240103-25-nqv1bk.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=491&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567634/original/file-20240103-25-nqv1bk.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=491&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567634/original/file-20240103-25-nqv1bk.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=491&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Elon Musk’s brain implant company Neuralink received regulatory approval to conduct the first clinical trial in humans in 2023.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Elon_Musk_and_the_Neuralink_Future.jpg">Steve Jurvetson/Wikimedia</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
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<p>We could respond by calling on our right to freedom of thought. It’s there waiting for us, created in 1948 by the <a href="https://www.un.org/en/about-us/universal-declaration-of-human-rights">Universal Declaration of Human Rights</a> (Article 18) and later <a href="https://www.ohchr.org/en/instruments-mechanisms/instruments/international-covenant-civil-and-political-rights">becoming international law</a>. But anyone reaching for this right may be horrified to find it hollow, bereft of any clear definition and unfit for purpose.</p>
<p>In recent years, the UN has sought to <a href="https://www.tandfonline.com/doi/full/10.1080/13642987.2023.2227100">give this right more substance</a>. One of its special rapporteurs, Ahmed Shaheed, has made a <a href="https://www.ohchr.org/en/documents/thematic-reports/a76380-interim-report-special-rapporteur-freedom-religion-or-belief">series of recommendations</a> (which I will outline) that should, eventually, lead to a better defined, more muscular right to free thought. This process has promise – it could help shield our thoughts from prying eyes and protect our minds from manipulation.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/to-what-extent-are-you-truly-free-71188">To what extent are you truly free?</a>
</strong>
</em>
</p>
<hr>
<p>But it also has the potential for harm. In international law, freedom of thought is an absolute right. This means it could run roughshod over other important concerns. Activists could, for example, use this right to silence their political opponents by claiming their opponents’ speech is manipulating thoughts.</p>
<p>This right could also go wrong by failing to protect all forms of thought. We must ask where “thinking” ends and “speaking” begins in today’s world: should performing an online search, writing a personal diary, or asking a question in a WhatsApp group be regarded as forms of thought, or outright speech?</p>
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<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
<hr>
<p>History suggests the right to free thought will only become globally relevant if political factions <a href="https://www.hup.harvard.edu/books/9780674064348">or states</a> use it to serve their purposes. And this looks increasingly likely as accusations of <a href="https://www.theguardian.com/uk-news/2020/jan/04/cambridge-analytica-data-leak-global-election-manipulation">mental manipulation</a> and <a href="https://www.bbc.co.uk/news/uk-politics-48065622">“thoughtcrime” creation</a> fly between the political right and left, and the US looks for new weapons in its <a href="https://www.hoover.org/research/cold-war-ii-niall-ferguson-emerging-conflict-china">developing cold war with China</a>.</p>
<p>For both technological and (geo)political reasons, the right to freedom of thought’s time may have come. Whatever it is decided to mean, it will bind us all. As I argue in my new book <a href="https://oneworld-publications.com/work/freethinking/">Freethinking</a>, this makes it crucial that we can all have input into its design. </p>
<h2>Free thought past</h2>
<p>The term “freethinker” came into common use during the Enlightenment in late 17th-century Europe, describing people who questioned religious authorities. Today, freethinking typically refers to being <a href="https://www.taylorfrancis.com/chapters/mono/10.4324/9780203429488-94/value-free-thought-1944-kenneth-blackwell-harry-ruja-bernd-frohmann-john-slater-sheila-turcon">guided by evidence and reason, not authority</a> – although this hasn’t stopped people who play fast and loose with evidence appropriating the term too.</p>
<p>Up against the freethinkers are those who seek to control thought to achieve and cement power. George Orwell’s classic vision of this threat, Nineteen Eighty-Four, actually came out 20 years after <a href="https://www.dukeupress.edu/thought-crime">Japan’s Peace Preservation Law</a> had already termed many people on the political left as “thought criminals”.</p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/T8BA7adK6XA?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Nineteen Eighty-Four official trailer (1984)</span></figcaption>
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<p>In Orwell’s novel, the ruling party aims to “extinguish once and for all the possibility of independent thought”. Beginning in childhood, people are taught to deny the evidence of their eyes and ears. No one is to be left alone to think – yet nor are they able to think with others. People are encouraged to stop themselves on the threshold of dangerous thoughts, as the terrifying Thought Police find and punish those who commit “thoughtcrime”.</p>
<p>The ruling party also uses extensive surveillance, parallels to which can be seen today. Consider the effects of Edward Snowden’s 2013 revelations that the US was heavily surveilling the internet. This led to <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2412564">a 10% drop</a> in internet searches that could have got Americans in trouble with their government, such as “domestic security”, “nuclear” and “organized crime”. Americans’ suspicion that they were being watched harmed their freedom of thought.</p>
<p>New technologies drive new laws. Just as photography spurred <a href="https://heinonline.org/HOL/Page?handle=hein.journals/mslr2008&div=7&g_sent=1&casa_token=kSy5i8DmOnMAAAAA:SOLEoYd1oW26YL0UiKKPWV9aKVd7KfdzUfLUOgUyAMRLC2FF8L3RVWY33iU9bZ8gNTkQX8tW6w&collection=journals">a right to privacy</a> in 1890, today <a href="https://link.springer.com/book/10.1007/978-3-030-84494-3">scholars</a> want to develop the right to freedom of thought in response to <a href="https://www.jstor.org/stable/24756752">neurotechnology</a> and the <a href="https://www.doughtystreet.co.uk/sites/default/files/media/document/Rethinking%20Freedom%20of%20Thought%20for%20the%2021st.pdf">digital world</a>. This means confronting the gulf between the extensive lauding of this right and the <a href="https://www.tandfonline.com/doi/full/10.1080/13642987.2023.2227100">bewildering neglect</a> of what it practically involves. Enter the UN.</p>
<h2>Free thought present</h2>
<p>In October 2021, special rapporteur Shaheed <a href="https://www.ohchr.org/en/documents/thematic-reports/a76380-interim-report-special-rapporteur-freedom-religion-or-belief">presented a report</a> on the right to freedom of thought. To underpin this right, he proposed four pillars which I summarise as follows, including some questions I think we should consider about them:</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/567687/original/file-20240103-510735-l12yif.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Universal Declaration of Human Rights document" src="https://images.theconversation.com/files/567687/original/file-20240103-510735-l12yif.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/567687/original/file-20240103-510735-l12yif.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=809&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567687/original/file-20240103-510735-l12yif.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=809&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567687/original/file-20240103-510735-l12yif.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=809&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567687/original/file-20240103-510735-l12yif.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1017&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567687/original/file-20240103-510735-l12yif.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1017&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567687/original/file-20240103-510735-l12yif.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1017&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption"></span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:The_universal_declaration_of_human_rights_10_December_1948.jpg">UN via Wikimedia</a></span>
</figcaption>
</figure>
<p><strong>1. Mental privacy.</strong> People cannot be forced to reveal their thoughts. This means we must scrutinise technological developments that open new windows into our minds. But should our minds always be private?</p>
<p><strong>2. Mental immunity.</strong> People cannot be punished for their thoughts. This idea has existed since ancient Rome, though today we need to decide what exactly should count as a “thought”.</p>
<p><strong>3. Mental integrity.</strong> People and organisations cannot alter others’ thoughts without permission. We know subliminal advertising is wrong because it bypasses our conscious mind – but beyond this, we enter a grey zone. When does persuasion become impermissible manipulation?</p>
<p><strong>4. Mental fertility.</strong> This enshrines a government’s duty to create an enabling environment for free thought. But will governments really do this if free thought challenges their power? And even if they want to, how can they design a society that promotes free thought?</p>
<p>To build on these pillars, we need to answer basic questions about what thought is and what makes it free. Before we can protect thought, we must first define it.</p>
<h2>Free thought future</h2>
<p>Traditionally, the law views thoughts as happening inside our brains. Yet philosophers (and, increasingly, psychologists and technologists) have <a href="https://www.jstor.org/stable/3328150">long claimed that</a> thought “ain’t just in the head”, proposing that our minds extend into the world. </p>
<p>A notebook can be the functioning memory of someone with dementia. Writing in a diary, as Winston Smith did illegally in Nineteen Eighty-Four, can also represent thinking. Writing doesn’t only express thought; sometimes “<a href="https://doi.org/10.1017/CBO9780511583360">the thinking is the writing</a>”. Similarly, some internet searches can be a form of thinking as we use them to question, reason and reflect.</p>
<p>If the right to freedom of thought is deemed to cover our “extended minds”, this will have important consequences. Authorities <a href="https://www.newstatesman.com/science-tech/2016/08/how-your-google-searches-can-be-used-against-you-court">often access the internet search histories</a> of people accused of crimes, using this as evidence. In homicide trials, searches such as “how to get rid of someone annoying” or “chloroform” have been <a href="https://www.newstatesman.com/science-tech/2016/08/how-your-google-searches-can-be-used-against-you-court">cited in court</a>. But if such searches are deemed to constitute thinking, then accessing someone’s search history could become a violation of their mental privacy.</p>
<p>Speaking aloud can also be regarded as a form of thinking – we sometimes speak to find out what we think. As novelist <a href="https://www.tandfonline.com/doi/full/10.1080/1600910X.2019.1630846">E.M. Forster asked</a>: “How do I know what I think until I see what I say?”</p>
<p>But we also speak aloud in order to think with other people – and we may <a href="https://doi.org/10.1016/j.geb.2009.09.003">think better with others</a> than we do alone. Thought can be at its most powerful when it is social, rather than the solitary act depicted by <a href="https://en.wikipedia.org/wiki/The_Thinker">Auguste Rodin</a>. So, for thought to be truly free, we require public as well as private thinking spaces.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/567693/original/file-20240103-29-s0we6w.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Rodin's statue The Thinker in a leafy garden." src="https://images.theconversation.com/files/567693/original/file-20240103-29-s0we6w.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567693/original/file-20240103-29-s0we6w.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567693/original/file-20240103-29-s0we6w.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567693/original/file-20240103-29-s0we6w.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567693/original/file-20240103-29-s0we6w.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567693/original/file-20240103-29-s0we6w.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567693/original/file-20240103-29-s0we6w.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Thinking is not always best done alone, despite Rodin’s famous depiction.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Rodin%27s_The_Thinker_-_panoramio.jpg">Roman Suzuki/Wikimedia</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
</figcaption>
</figure>
<p>To facilitate this, we may need a new legal concept of “<a href="https://oneworld-publications.com/work/freethinking/">thoughtspeech</a>”. This would represent the thinking aloud we do with others in the name of “good faith truth-seeking”. Thoughtspeech could be protected as absolutely as the thoughts inside our head: while one could (and should) still disagree with others, attempts to silence or punish thoughtspeech would be a human rights violation.</p>
<p>However, an obvious concern is that this concept could be misused to justify hate speech that <a href="https://commission.europa.eu/strategy-and-policy/policies/justice-and-fundamental-rights/combatting-discrimination/racism-and-xenophobia/combating-hate-speech-and-hate-crime_en#:%7E:text=Hate%20motivated%20crime%20and%20speech,or%20national%20or%20ethnic%20origin.">Europe</a>, but <a href="https://www.ala.org/advocacy/intfreedom/hate">not the US</a>, has deemed illegal. The protestation that “I’m just asking questions” can easily be employed <a href="https://doi.org/10.1080/00207659.2021.1939946">as a cover to demonise people</a>. At the same time, a creeping prohibition of asking difficult or challenging questions is also potentially dangerous, not least to society’s minorities who seek to challenge the status quo. Where necessary, courts would have to decide whether the claimed thoughtspeech was genuine truth-seeking in good faith, or had darker motives.</p>
<p>To see these thorny questions in practice, consider how, in Ireland, both <a href="https://www.kildarestreet.com/debate/?id=2023-04-26a.380">the left</a> and right have argued that the proposed <a href="https://data.oireachtas.ie/ie/oireachtas/bill/2022/105/eng/ver_b/b105b22d.pdf">criminal justice (incitement to violence or hatred and hate offences) bill</a> 2022 will create “thought crimes”. Section 10(3) of this bill states that if you possess hateful material that you haven’t shown anyone, and it is reasonable to assume this material is not just intended for personal use, then you are presumed to be breaking the law. The police could then seek a warrant to enter your premises and access this information.</p>
<p>One <a href="https://www.independent.ie/podcasts/the-big-tech-show/the-big-tech-show-irelands-new-hate-speech-law-will-create-thought-crimes/a978548546.html">politician claimed</a> this bill would not create thought crimes because it involved “production of material”, and that “nobody is ever going to be prosecuted for what they’re thinking inside their heads”. This illustrates the restricted view of thought that some politicians hold – and suggests that legislators could leave much of our thinking naked and vulnerable.</p>
<p>Once we have settled on what thought is, we must work out what makes it free. The <a href="https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=celex%3A32022R2065">EU’s Digital Services Act</a> forbids online platforms from deceiving or manipulating users, or impairing their ability to make “free and informed decisions”. But what counts as manipulation or impairing free decision-making?</p>
<p>Psychology suggests that free thinking requires us to control our attention, be able to reason and reflect, and to not need superhuman courage to think aloud with others. This makes platforms and products problematic that either capture our attention to the <a href="https://www.mdpi.com/1660-4601/16/14/2612">point of addiction</a>, or employ “<a href="https://doi.org/10.1093/jla/laaa006">dark patterns</a>” that undermine reflection and reasoning.</p>
<p>For instance, in the “false demand” dark pattern, a shopping website may falsely tell you that “Abby in London” has just bought a pillow. This could undermine your reasoning by triggering a panicky sense of scarcity in you, or setting a false norm of others buying the pillow, making you more likely to purchase.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/567710/original/file-20240103-19-2ta8k1.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Three UK local election ballot papers" src="https://images.theconversation.com/files/567710/original/file-20240103-19-2ta8k1.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/567710/original/file-20240103-19-2ta8k1.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=372&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567710/original/file-20240103-19-2ta8k1.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=372&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567710/original/file-20240103-19-2ta8k1.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=372&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567710/original/file-20240103-19-2ta8k1.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=468&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567710/original/file-20240103-19-2ta8k1.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=468&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567710/original/file-20240103-19-2ta8k1.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=468&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">UK local election ballot papers with candidates listed in alphabetical order.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Ballot_papers_for_the_2021_United_Kingdom_local_elections.jpg">domdomegg/Wikimedia</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
</figcaption>
</figure>
<p>The designers of systems need not even intentionally play on our mental biases for their products to be problematic. For instance, listing candidates in alphabetical order on a voting ballot paper may seem neutral, but the candidate named first gains a small <a href="https://doi.org/10.1016/j.electstud.2016.06.019">but measurable advantage</a>. This is partly because we have a <a href="https://doi.org/10.1016/j.electstud.2016.09.002">mental bias to prefer</a> the first item on a list. </p>
<p>Some US states don’t use <a href="https://www.sciencedirect.com/science/article/abs/pii/S0261379414000584">alphabetical ordering on ballots</a> for this reason. Instead they randomly rotate the order of candidates’ names on ballots across districts. Yet, elsewhere, <a href="https://www.electoralcommission.org.uk/guidance-acting-returning-officers-administering-a-uk-parliamentary-election-great-britain/voter-materials/production-ballot-papers/ballot-paper-design/candidate-details">including in the UK</a>, this alphabetical practice continues. Alphabetical ordering arguably violates voters’ right to freedom of thought.</p>
<p>I believe the right to freedom of thought should protect thinking wherever it occurs – in our heads, our diaries, on the internet, or when we’re engaged in good faith truth-seeking when thinking aloud with others. And crucially, to keep thoughts free, our environment must be designed and regulated to let us control our attention, think logically and reflectively, and not fear punishment for our thoughts. Unfortunately, new technologies threaten this ideal.</p>
<h2>The power to punish thought</h2>
<p>New technologies have the potential to undermine three of the UN’s pillars of free thought – mental privacy, immunity, and integrity. It is well known, for example, that social media can use knowledge of how our minds work to hijack our attention, discourage reflection, and facilitate the punishment of wrongthink, thereby <a href="https://link.springer.com/article/10.1007/s13347-022-00567-7">harming our autonomy</a>. Less well known is how social media revives an old social pattern that threatens free thought.</p>
<p>Our hunter-gatherer ancestors lived in egalitarian communities with no dominant individuals. This was due to a “<a href="https://doi.org/10.1086/204166">reverse dominance hierarchy</a>” which meant that, if someone tried to rise above others, the group would work together to humble, exclude or even kill this would-be “tall poppy”.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/567734/original/file-20240103-23-v2f60j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Cave painting of hunter gatherers" src="https://images.theconversation.com/files/567734/original/file-20240103-23-v2f60j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567734/original/file-20240103-23-v2f60j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567734/original/file-20240103-23-v2f60j.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567734/original/file-20240103-23-v2f60j.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567734/original/file-20240103-23-v2f60j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567734/original/file-20240103-23-v2f60j.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567734/original/file-20240103-23-v2f60j.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Our hunter-gatherer ancestors lived in egalitarian communities without dominant individuals.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/ancient-prehistoric-cave-painting-known-white-2005544015">R.M. Nunes/Shutterstock</a></span>
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<p>My book <a href="https://oneworld-publications.com/work/spite/">Spite</a> (2020) explains how anthropologists believe this was possible due to humans’ ability to moralise, wield weapons and use language. Language in particular, especially gossip, helped coordinate actions against tall poppies. When agriculture was invented, larger groups, private property and recognised authority figures came on to the scene, enabling a <a href="https://www.hachettebookgroup.com/titles/christopher-boehm/moral-origins/9780465020485/">more hierarchical form of life</a>.</p>
<p>Social media has bought back the reverse dominance hierarchy. People online can unite to moralise and gossip, sometimes with the effect of bringing down individuals. And while this can helpfully check people who abuse their power, it can also harm freethinkers who disturb the status quo and undermine what they see as society’s “<a href="https://en.wikipedia.org/wiki/Noble_lie">noble</a>” (or ignoble) lies.</p>
<p>And not only can new technologies facilitate the punishment of thought, they also have the potential to powerfully manipulate our thoughts. AI will soon know exactly what to say to us to maximise the chances of us performing a desired behaviour. As OpenAI’s CEO <a href="https://youtu.be/e1cf58VWzt8?feature=shared&t=526">Sam Altman has warned</a> in relation to the 2024 elections:</p>
<blockquote>
<p>What if an AI reads everything you have ever written online – every tweet, every article, every everything – then right at the exact moment, sends you one message, customised just for you, that really changes how you think about the world?</p>
</blockquote>
<p>The power disparity between us and AI means that courts could deem AI to have improper undue influence over our minds.</p>
<p>New technologies can also uncover our hidden thoughts. This goes beyond what Big Brother was capable of. As Orwell wrote in Nineteen Eighty-Four, even the ruling party “had never mastered the secret of finding out what another human being was thinking”. </p>
<p>Today, brain-reading technology that detects thoughts via brain scans or neural interfaces threatens to uncover this secret. Meta (Facebook’s owner) <a href="https://ai.meta.com/blog/brain-ai-image-decoding-meg-magnetoencephalography/">recently showed</a> it could determine what people were seeing by examining their brainwaves using magnetoencephalography (MEG) technology. Behaviour-reading techniques that use our actions, such as <a href="https://psycnet.apa.org/record/2003-00779-011">musical preferences</a> or what we <a href="https://doi.org/10.1073/pnas.1218772110">“like” on Facebook</a>, can also be used to infer our internal states. </p>
<p>Now, imagine if a government had someone in custody suspected of having planted a nuclear bomb in a city. There would be a strong temptation to use mind-reading technology to identify the location of the bomb from that individual’s brain – but this would violate the suspect’s right to free thought. Some people, perhaps many, would argue that this right <em>should</em> be violated in such circumstances. </p>
<p>Perhaps the future could include places where free thought is legally limited. While this is a challenging idea, it would be ironic if we failed to think critically about free thought itself. Legal scholar Jan Christoph Bublitz has speculated on the idea of “<a href="https://www.jstor.org/stable/24756752">zones of restricted freedom of thought</a>” in places vulnerable to terrorism, such as airports. In these zones, our thoughts could be permissibly accessed by the state to prevent calamities. </p>
<p>Likewise, the philosopher <a href="https://www.simonandschuster.com/books/The-Moral-Landscape/Sam-Harris/9781439171226">Sam Harris has suggested</a> that once mind reading technology can detect lies, it could be used to create “zones of obligatory candour”. These would be locations, such as courtrooms, where lies would be automatically detected from your brainwaves.</p>
<p>Yet, concerns about mind-reading technologies are frequently blighted by <a href="https://doi.org/10.1080/13642987.2023.2227100">hyperbole, alarmism and exaggeration</a>. One does not simply fall into an MRI scanner; one must consent. Once inside, <a href="https://www.biorxiv.org/content/10.1101/2022.09.29.509744v1">we must cooperate</a> with researchers for brain-reading to work. The extent to which our mental content can be accurately identified is often over-hyped, as it requires extremely specific conditions.</p>
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Read more:
<a href="https://theconversation.com/does-ai-have-a-right-to-free-speech-only-if-it-supports-our-right-to-free-thought-212555">Does AI have a right to free speech? Only if it supports our right to free thought</a>
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<p>It’s also important to recognise that the same technologies that threaten free thought can also benefit thought. Brain-computer interfaces, where we interact with computers simply by thinking, could <a href="https://www.technologyreview.com/2023/09/29/1080472/elon-musk-bandwidth-brains/">boost our mental bandwidth</a>. AI systems such as ChatGPT can stimulate new ideas. So, over-regulating these technologies could be seen as harming free thought.</p>
<p>Clearly, we need to protect free thought in response to new technologies. But in my view, overreacting with unnecessary laws won’t lead to freer minds – it will simply enable other people’s anxieties to rule our lives.</p>
<h2>Protecting employees’ and users’ thoughts</h2>
<p>Traditionally, governments were seen as the main threat to our freedoms. Today, corporations, particularly those involved in controlling flows of information such as media and technology companies, vie for this crown. </p>
<p>Such companies influence what information we do and don’t see. They can also overwhelm us with too much content, creating “<a href="https://www.degruyter.com/document/doi/10.7312/poze19712-002/html">reverse censorship</a>” that harms our ability to think. Corporations also threaten free thought through their ability to fire employees for thoughtcrime, potentially in response to a public outcry. </p>
<p>The British philosopher Bertrand Russell warned <a href="https://en.wikipedia.org/wiki/Free_Thought_and_Official_Propaganda">a century ago</a> that “thought is not free if the profession of certain opinions makes it impossible to earn a living”. Russell said this problem would grow unless the public insisted that employers controlled nothing in their employees’ lives except their work. Today, employers can influence their employees’ <a href="https://www.jstor.org/stable/26842250">morality</a>, <a href="https://doi.org/10.4135/9781526488664">opinions</a>, and even <a href="https://slate.com/news-and-politics/2012/10/employers-increasingly-telling-employees-workers-how-to-vote.html">voting decisions</a>. As a starting point, we need laws that protect employees from being fired for their thinking.</p>
<p>To take another example, while the anti-discriminatory aims of implicit bias training are laudable, corporations could require employees to reveal their thoughts when doing it. The designers of a common element of this training, the implicit association test, <a href="https://psycnet.apa.org/record/1998-02892-004">admit it is</a> “a method that gives the clearest window now available into a region of the mind that is inaccessible to question-asking methods”. Forcing someone into this training could therefore be a breach of mental privacy.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/social-networking-sites-may-be-controlling-your-mind-heres-how-to-take-charge-88516">Social networking sites may be controlling your mind – here's how to take charge</a>
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<p>Turning from employees to users, perhaps big tech companies should be required to design their products to support, promote and protect their users’ free thoughts. For example, social media platforms could set their default options to those that minimise the risk of addiction.</p>
<p>Woodrow Wilson once noted that chewing tobacco “gave a man time to think between sentences”. Big tech could provide digital gum in the form of options that <a href="https://profilebooks.com/work/how-to-think/">give users time for thought</a>, like timeouts before responding to posts or making purchases. X (formerly Twitter) already <a href="https://www.theguardian.com/technology/2020/jun/11/twitter-aims-to-limit-people-sharing-articles-they-have-not-read">asks users</a> if they want to share articles they have not yet read.</p>
<p>Similarly, search engines could offer options to show information that challenges users’ existing views rather than confirming their opinions. Websites <a href="https://ground.news/">such as Ground News</a> already highlight which stories are primarily featuring on left or right media, helping people see what is happening outside their own thought bubbles.</p>
<p>Big tech companies such as <a href="https://blog.google/outreach-initiatives/public-policy/our-ongoing-commitment-to-human-rights/">Google</a> and <a href="https://humanrights.fb.com/annual-human-rights-report/">Meta</a> assess their human rights impacts, including through <a href="https://about.fb.com/wp-content/uploads/2022/09/Human-Rights-Due-Diligence-of-Metas-Impacts-in-Israel-and-Palestine-in-May-2021.pdf">independent assessments</a>. But freedom of thought is often overlooked. And while the UN has issued its Guiding Principles on Business and Human Rights, these have been described as “<a href="https://www.hrw.org/sites/default/files/related_material/business.pdf">woefully inadequate</a>” by Human Rights Watch as they lack any enforcement mechanism.</p>
<h2>It’s not just ‘them’, it’s us</h2>
<p>It is not just governments and corporations that threaten free thought – we the people do too. Free thinking has often been risky. “Tell the truth and run,” an old Yugoslavian proverb counsels. </p>
<p>Throughout history, though, some societies have tried to protect free thought and truth-telling. The ancient Athenians had the concept of a “parrhesiast”, someone who spoke truth despite the risks. An example of this came when the aged statesman Solon challenged <a href="https://us.macmillan.com/books/9781250009104/thecourageoftruth">politician Pisistratus’s</a> quest for power in Athens. After arriving at the Greek Assembly dressed in armour to highlight Pisistratus’s aim to use force, Solon declared:</p>
<blockquote>
<p>I am wiser than those who have failed to understand the designs of Pisistratus, and I am more courageous than those who have understood but remain silent out of fear.</p>
</blockquote>
<p>To benefit from the parrhesiast, Athenians had to be willing to bear what philosopher Michel Foucault calls “<a href="https://us.macmillan.com/books/9781250009104/thecourageoftruth">the injuries of truth</a>”. In this parrhesiastic contract, the truth-teller risked speaking out and the listeners promised not to punish them. There again, Solon was not thanked for his contribution, being labelled mad by his colleagues.</p>
<p>Creating a safe space for truth requires a “<a href="https://oneworld-publications.com/work/freethinking/">deep enlightenment</a>” that goes beyond simply educating people to think critically. Designing a society that protects and promotes free thought among its population at all levels could even include city planning.</p>
<p>A Brazilian colleague once told me how the design of the country’s modern capital, Brasília, with its lack of street corners, was meant to prevent people assembling and thinking together – because such thinking could one day threaten the ruling powers. Indeed, the Portuguese for street corners can translate as “points of solidarity”. The <a href="https://politicalscience.yale.edu/publications/seeing-state-how-certain-schemes-improve-human-condition-have-failed">design of Brasília</a> is an offence against free thought.</p>
<p>Rather, we need to design physical and virtual spaces that protect, promote and support “<a href="https://mitpress.mit.edu/9780262581080/the-structural-transformation-of-the-public-sphere/">people’s public use of their reason</a>”. This function was partially performed by coffee houses during the Enlightenment. New spaces should allow a diverse range of voices to be brought together in debate – in order to <a href="https://doi.org/10.1017/S0140525X10000968">help us best find truth</a>. Yet all of this hinges on simultaneously building <a href="https://www.simonandschuster.com/books/Trust/Francis-Fukuyama/9780684825250">a culture of trust</a> that makes people feel safe to think.</p>
<h2>The oxygen of freethinking</h2>
<p>The principle of free thought is in trouble. Today, public thinking is difficult unless you are rich, reckless or anonymous. Online public spaces, such as much social media, typically prioritise engagement and profit over truth-seeking, and can exclude challenging views. A corporate-controlled mainstream news media routinely excludes or distorts important perspectives <a href="https://www.cornellpress.cornell.edu/book/9780801488870/framed/">such as labour issues</a>. Some academics feel compelled to publish ideas anonymously in outlets such as the <a href="https://journalofcontroversialideas.org/">Journal of Controversial Ideas</a>. These are all warning lights of flashing failure on the dashboard of democracy.</p>
<p>The first freethinkers challenged religious authorities and were associated with egalitarianism and the political left. Yet they had their own “<a href="https://plato.stanford.edu/entries/enlightenment/">faith of the Enlightenment</a>” – the belief that developing one’s own reason could create a better life. Today, as well as sharing this faith in reason, many of us have faith that <a href="https://www.penguin.co.uk/books/13399/the-end-of-history-and-the-last-man-by-fukuyama-francis/9780241991039">liberal democracy creates the best form of life</a>.</p>
<p>However, some modern freethinkers are pushing back against these faiths. Such individuals tend to be pro-hierarchy and on the political right. The <a href="https://www.jordanbpeterson.com/wp-content/uploads/2023/03/A-Conservative-Manifesto.pdf">conservative</a> psychologist Jordan Peterson <a href="https://www.youtube.com/watch?v=WEP5ubPMGDU">argues</a> that we’re at the start of a “counter enlightenment”, while legal scholar Adrian Vermeule maligns the “<a href="https://www.firstthings.com/article/2017/01/liturgy-of-liberalism">evidence-based freethinkers of the quiet car</a>” who won’t speak out about liberalism’s problems. Alternatively, so-called “<a href="https://doi.org/10.1111/japp.12331">Dark Enlightenment</a>” thinkers such as <a href="https://www.unqualified-reservations.org/">Curtis Yarvin</a> and <a href="https://www.imperiumpress.org/shop/the-dark-enlightenment/">Nick Land</a> question the benefits of democracy. </p>
<p>Whatever you think of these views, an important question is: will the descendants of the egalitarian left, who used freethinking to challenge societal norms, support the hierarchical right’s freedom to do the same? Or do they regard the political right as <a href="https://www.marcuse.org/herbert/publications/1960s/1965-repressive-tolerance-fulltext.html">in need of silencing</a> rather than debating?</p>
<p>Of course, freethinking on the left is silenced too – including those who oppose the “religion” of capitalism. Consider what happened when a declared socialist, Jeremy Corbyn, ran for prime minister in the 2017 UK parliamentary elections. An academic report on his <a href="https://www.lse.ac.uk/media-and-communications/research/research-projects/representations-of-jeremy-corbyn">coverage by the mainstream media</a> concluded by asking whether it was:</p>
<blockquote>
<p>acceptable that the majority of British newspapers uses its mediated power to attack and delegitimise the leader of the largest opposition party against a rightwing government to such an extent and with such vigour?</p>
</blockquote>
<p>Whatever one’s views on democracy, liberalism, capitalism, or any other important topic, freethinking on these issues can prove profoundly valuable. If someone’s ideas have value, we may adopt them to live better lives. If we adjudge them mistaken, we will still emerge with a better understanding of precisely why our own ideas are valuable, having remade them as <a href="https://www.gutenberg.org/files/34901/34901-h/34901-h.htm">living truths rather than dead dogmas</a>.</p>
<p>Free thought is not merely about gaining more perspectives. It is about duelling perspectives. The left and right could find common ground not in a <a href="https://www.thefire.org/research-learn/campus-disinvitation-database">commitment to mutual cancellation</a>, but in a renewed dedication to debate. We must embrace the value of thinking. </p>
<p>Unfortunately, we often find thought a painful effort. Evolution has shaped us to make decisions using minimal energy, pressuring us to become <a href="https://doi.org/10.1080/13546783.2018.1459314">cognitive misers</a> who are “<a href="https://doi.org/10.1080/13546783.2018.1459314">as stupid as we can get away with</a>”, as psychologist Keith Stanovich argues. Many of us are not merely disinclined to think but actively prefer electrocution to being left alone with our thoughts, <a href="https://www.science.org/doi/full/10.1126/science.1250830">according to one 2014 study</a>.</p>
<p>The rise of generative AI threatens to make this situation worse. One vision of the future imagines <a href="https://www.penguinrandomhouse.com/books/291221/the-singularity-is-near-by-ray-kurzweil/">a singularity</a> where we merge with machines by connecting our brains directly to AI. But what if we approach a bifurcation point rather than a singularity? Humans could become a mere source of animalistic appetites and desires, while machines do the thinking for us.</p>
<p>If we abandon free thought, homo sapiens will have been a brief candle between ape and AI. Humanity’s flame cannot continue to burn in an authoritarian vacuum – it requires the oxygen of freethinking. A right to free thought can give us this air, but we still have to breathe in.</p>
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<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p class="fine-print"><em><span>Simon McCarthy-Jones receives funding from the European Union’s Horizon 2020 program via a Marie Skłodowska-Curie Actions Innovative Training Network.</span></em></p>Corporate and political actors know more about how our minds work than we do. The right to free thought can no longer be our ‘forgotten freedom’Simon McCarthy-Jones, Associate Professor in Clinical Psychology and Neuropsychology, Trinity College DublinLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2205132024-01-04T16:29:28Z2024-01-04T16:29:28ZMr Bates vs The Post Office depicts one of the UK’s worst miscarriages of justice: here’s why so many victims didn’t speak out<p>The new <a href="https://www.itv.com/watch/news/mr-bates-vs-the-post-office-real-life-scandal-turned-into-tv-drama/sfs8khr">ITV drama</a> about the <a href="https://theconversation.com/the-post-office-scandal-is-possibly-the-largest-miscarriage-of-justice-in-uk-history-and-its-not-over-yet-211217">Post Office Horizon IT scandal</a> is an incredibly important vehicle for getting the story of what is increasingly recognised as one of the greatest miscarriages of justice in British history into public consciousness.</p>
<p>However, viewers might find themselves with one looming unanswered question as they watch: how could this persist, at such a scale, for so long? How could hundreds of people face wrongful termination of their employment contracts, loss of their businesses, bankruptcy and often criminal prosecution at the hands of the same organisation for over a decade, with no one seeming to pay any attention?</p>
<p>The four-part series focuses on a handful of sub-postmasters who defiantly spoke out against the injustices they faced, and who were key players in bringing this scandal to light. Chief among them is Alan Bates, a sub-postmaster from north Wales who established the <a href="https://www.jfsa.org.uk/">Justice for Sub-postmasters Alliance</a> and has worked tirelessly on behalf of victims of the Horizon scandal. The efforts of Bates and others have been invaluable – but they are a tiny subset of the overall victims.</p>
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<p>Today, we know the Post Office wrongly <a href="https://publications.parliament.uk/pa/cm5802/cmselect/cmbeis/1129/report.html">prosecuted 736 sub-postmasters</a> for theft, false accounting and related charges because of technical faults in the Horizon IT system, and these accusations persisted for 16 years – from 1999 to 2015, which equates to an average of roughly one person charged each week.</p>
<p>By and large, most sub-postmaster victims did not speak out about the injustice they faced. Some took years to come forward, and many still prefer to remain anonymous. As depicted in the drama, the first journalist to help break the story, who was from Computer Weekly, was only able to identify and vet seven victims for <a href="https://www.computerweekly.com/news/2240089230/Bankruptcy-prosecution-and-disrupted-livelihoods-Postmasters-tell-their-story">her story</a> – and it was published ten years after the Post Office began falsely accusing sub-postmasters of various crimes. So where were the other victims?</p>
<p>Based on a detailed analysis of hundreds of transcripts from the <a href="https://www.postofficehorizoninquiry.org.uk/">public inquiry</a> and interviews with sub-postmasters across the UK, our <a href="https://www.thebritishacademy.ac.uk/funding/ba-leverhulme-small-research-grants/past-awards/british-academy-leverhulme-small-research-grants-2022-2023/">ongoing research</a> has enabled us to identify the four main barriers that the victims of this scandal faced when it came to speaking out.</p>
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<img alt="" src="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
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<p>Understanding these barriers can help us understand, more broadly, why miscarriages of justice often take a long time to surface, especially when they happen at the hands of an employer – and even more so in contexts like the Horizon scandal, where people were quick to believe the technology and blame the user.</p>
<h2>Sub-postmasters told they were the ‘only ones’</h2>
<p>Viewers of the ITV drama will see that accused sub-postmasters were repeatedly told they were the “only one” having problems with the Horizon system, even when cases like theirs were going on all over the country. We found similar accounts time and again within the <a href="https://www.postofficehorizoninquiry.org.uk/hearings">public inquiry</a> witness statements, with one witness, Katherine McAlerney, representing the experiences of many when <a href="https://www.postofficehorizoninquiry.org.uk/evidence/witn03250100-katherine-mcalerney-witness-statement">she said</a>: “I was told during my
interview that I was the only one who had a problem like this with the system.”</p>
<p>Another sub-postmaster, Margery Lorraine Williams, <a href="https://www.postofficehorizoninquiry.org.uk/evidence/witn01740100-margery-lorraine-williams-first-witness-statement">recalled</a>:</p>
<blockquote>
<p>I confirmed that I had not done anything wrong and asked again about issues with the Horizon system. I was led to believe at this meeting that I was the only sub-postmaster who was having problems with shortfalls. It made me feel stupid that I was the only person who had these issues.</p>
</blockquote>
<p>However, the ITV drama quickly moves past this period, and we see the sub-postmasters coming together and finding out about each other’s similar situations. While this is a key turning point in bringing this injustice to light, in reality most of the sub-postmasters suffered for years believing what they had been told – that they were the only one – before becoming aware of any other victims.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-post-office-scandal-is-possibly-the-largest-miscarriage-of-justice-in-uk-history-and-its-not-over-yet-211217">The Post Office scandal is possibly the largest miscarriage of justice in UK history – and it's not over yet</a>
</strong>
</em>
</p>
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<p>In her <a href="https://www.postofficehorizoninquiry.org.uk/evidence/witn03250100-katherine-mcalerney-witness-statement">witness statement</a>, McAlerney said: “I believed firmly that I was the only one until about four years later, when I saw an article about the Horizon system and I thought: ‘Oh my god, that is what happened to me.’” </p>
<p>Another key person whose story we see in the TV drama, <a href="https://youtu.be/_OPvd8ovGSo?si=YL6rpzoSfJ09ktuk&t=5785">Hughie Noel Thomas</a>, was sentenced to nine months in prison in November 2006, based on faulty information from Horizon. A few scenes after we are introduced to Thomas in the drama, he is shown meeting with another key sub-postmaster, Jo Hamilton. In fact, this meeting occurred nearly three years after his sentencing.</p>
<p>Thomas has <a href="https://www.troubador.co.uk/bookshop/biography/the-stamp-of-innocence">written a memoir</a> in which he reflects on his feeling of isolation over those three years, and how it discouraged him from speaking out. He wrote:</p>
<blockquote>
<p>With no mention anywhere else that any other sub-postmaster had been implicated in the same way as I had been, it all seemed completely hopeless. I was all on my own, in a post-prison hell. And it was a terribly lonely place to be, believe you me.</p>
</blockquote>
<p>When we interviewed Thomas near his home in Anglesey, north Wales, about this “in-between” period, he said: “After I went to prison, I was in cuckoo land for three years. I was basically silent about everything until I found the others.” In his <a href="https://www.troubador.co.uk/bookshop/biography/the-stamp-of-innocence">memoir</a>, he refers to finding out about other victims as “manna from heaven”.</p>
<p>Another victim we interviewed, Janet Skinner – who pleaded guilty to false accounting and was sent to jail for nine months – told us that she felt similarly isolated, and was also reluctant to speak out publicly about the injustice. Instead, she “tried to bury it” because she too was led to believe she was “the only person who was having any kind of issues with the system”.</p>
<p>Being told they were the only one not only discouraged victims from speaking out, it also planted a seed of self-doubt in many of their minds. As Hamilton, a sub-postmaster from a village in Hampshire, <a href="https://www.youtube.com/watch?v=PmjGS7LdVf8">told the public inquiry</a>:</p>
<blockquote>
<p>I began to feel like I was going mad and that it was entirely my fault … When he said I was the only one, that’s how I did feel … I thought: Oh God, I must be – you know, I just thought it was me.</p>
</blockquote>
<p>This cycle of isolation and self-doubt helps explain why most did not attempt to find other possible victims or try to speak out publicly about the injustice – which contributed to the scandal persisting for so long.</p>
<h2>‘Spat on, shouted at and shunned’</h2>
<p>There are countless examples of victims of the Horizon IT Scandal being stigmatised in and by their local community. While the drama focuses on the heartwarming story of Hamilton, who received an inordinate amount of support from her local community, most sub-postmasters were not so lucky. In fact, they had quite the opposite experience.</p>
<p>Our analyses of the public inquiry statements reveal the local stigmatisation and shame that many felt. There are vivid accounts of sub-postmasters being <a href="https://www.telegraph.co.uk/news/uknews/royal-mail/10179024/Labelled-as-criminals.html">spat on</a>, <a href="https://www.postofficehorizoninquiry.org.uk/evidence/witn02450100-philip-cowan-witness-statement">shouted at</a> and <a href="https://www.theguardian.com/commentisfree/2022/feb/15/post-office-scandal-workers-computer-system">shunned</a>. As sub-postmaster Nicola Arch, who had worked for the Post Office since 1993, <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/973319/horizon-focus-group-feb-25_Redacted.pdf">told the inquiry</a>:</p>
<blockquote>
<p>In the village, I couldn’t walk through it without people [thinking]: ‘This is the lady who stole from the pensioners.’ It was all in the local papers. I couldn’t go in the supermarket – the whole place would go silent. Village life was so … almost incestuous. Everyone knew everybody. It was a living nightmare to the point where I refused to leave the house … I stayed indoors and never even went out to the shop for 19 months.</p>
</blockquote>
<p>Skinner, one of more than 230 sub-postmasters who were wrongly jailed, <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/973319/horizon-focus-group-feb-25_Redacted.pdf">told the inquiry</a>: “People automatically assume that you are a thief … You have a stigma. It’s people talking about you and pointing the finger at you. ‘Oh, that’s that woman who nicked all the money from the Post Office. Do you remember?’ I’ve heard that so many times.”</p>
<p>In his <a href="https://www.troubador.co.uk/bookshop/biography/the-stamp-of-innocence">memoir</a>, Thomas described how it felt to lose his standing in his community. “I felt this immense sense of shame … Shame for myself, shame for my family, and shame for my community to have been drawn into such a scandal.”</p>
<p>We have also collected and analysed local news reports on the early accusations. Common themes include describing the allegations as “stealing from pensioners” or “having their hand in the till”, and the sub-postmasters frequently being labelled as criminals and thieves and exhibiting a “fall from grace” – even when they were not prosecuted. </p>
<p>This sense of shame is just the tip of the iceberg in terms of the negative mental health effects that sub-postmasters experienced from being wrongfully accused. A <a href="https://bpspsychub.onlinelibrary.wiley.com/doi/pdf/10.1111/lcrp.12247">2023 study</a> found no difference in the severity of mental health symptoms between the sub-postmasters convicted of criminal offences and those who were investigated, prosecuted or pursued in a civil court. Those who experienced a wrongful accusation had similar negative mental health outcomes as those who were wrongfully convicted.</p>
<p>Our research leads us to believe these feelings of shame and experiences of stigmatisation discouraged people from speaking out about the injustice.</p>
<h2>Victims were unable to defend themselves</h2>
<p>But what if someone did want to speak out and fight back? Those who did faced an impossible task. </p>
<p>Imagine that, tomorrow morning, you walk into work and are called into your line-manager’s office. They accuse you of something and tell you to gather your personal items as you are being sacked. You try to reassure them you’ve done nothing wrong, and you know that if you can access some files on your computer, you can clear it all up. But when you go to your desk, you see that your computer is gone, along with your access to all your IT systems, emails, documents and archived electronic files.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/XY5cpJrYEME?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
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<p>This is the nightmare reality that sub-postmasters who were accused of theft and false accounting often faced. The Horizon point-of-sale IT system provided them with a very limited paper trail to cross-check their transactions – and when they were investigated, everything was seized from them (even their paperwork) with no notice. As one victim, Keith Macaldowie, <a href="https://www.youtube.com/watch?v=SHxb9-IlSPA">recalled</a> during the inquiry:</p>
<blockquote>
<p>They closed the office when they suspended me, so I couldn’t gain access. They took all of the keys off me for the post office – the safe and the till – and I was locked out of Horizon.</p>
</blockquote>
<p>Those who tried to fight the false accusations had a hard time convincing others that Horizon was at fault. As Lee Castleton, a former sub-postmaster from Bridlington who is profiled in the ITV drama, told us in an interview:</p>
<blockquote>
<p>I went to court and lost epically. I couldn’t have done any more. I’d been presented with a problem, a problem that I couldn’t climb over [and] couldn’t get my head around. I couldn’t make other people understand what I was trying to show them.</p>
</blockquote>
<p>Castleton was bankrupted by his legal ordeal. Because sub-postmasters did not have the information to prove their innocence, many ended up taking plea bargains. One who prefers to remain anonymous told us he took a plea bargain because he “couldn’t prove that I didn’t do it”. After pleading guilty, he said he wasn’t sure even his parents believed he was innocent until his conviction was overturned. Like so many others, he waited decades for his <a href="https://evidencebasedjustice.exeter.ac.uk/current-research-data/post-office-project/#acquittalstodate">conviction to be overturned</a>. Many more are still waiting.</p>
<p>In May 2021, <a href="https://www.bbc.co.uk/news/business-57113342">a BBC news report</a> revealed that former sub-postmaster Parmod Kalia hid his conviction from his closest family members for 20 years. He only revealed to them what happened when his conviction was overturned.</p>
<p>Overall, we found the lack of access to information that could prove the sub-postmasters’ innocence discouraged them from trying to speak out. This finding is particularly pertinent for workplace disputes, especially in the digital age when someone’s communications are usually all electronic and are technically owned by their employer. It is a frightening reality that if you are suspected of something at work, you can immediately lose access to any information that will prove your innocence.</p>
<h2>‘The Queen’s business’</h2>
<p>At the time these false accusations were taking place, the Post Office was seen by many as “<a href="https://www.judiciary.uk/judgments/hamilton-others-v-post-office-limited/">the nation’s most trusted brand</a>”. The high reputation it had in society further encouraged sub-postmasters to think no one would believe them if they tried to fight the injustices they faced. As one of the victims, Nicola Arch, told us:</p>
<blockquote>
<p>Working for the Post Office, it was the Queen’s business. It was very respected, very highly regarded. The Queen acknowledges the Post Office — her face is on the stamps. In that era, everyone believed that it was a very prestigious company to work for, very respected … Everyone thought the Post Office could never be wrong.</p>
</blockquote>
<p>Skinner recalled a similar experience when we interviewed her. “I think because of the reputation of the Post Office, people believed them over you – even though you were telling the truth … It was a case of: ‘Well, she must have taken the money, or else why would she have gone to prison?’ So [my response] was more buried than fighting against anything.”</p>
<p>It wasn’t only the general public who had faith in the Post Office. Among both its management and audit team at the time – which we know much more about now through the public inquiry – there was a hierarchical culture in which criticism was not welcomed. </p>
<p>Despite individual appeals by sub-postmasters, Post Office managers did not challenge the leadership or organisation, and apparently believed their systems, including Horizon, were infallible. Over and over again, the Post Office made public statements about Horizon being “robust”. </p>
<p>In a 2021 Court of Appeal decision that cleared the names of dozens of former sub-postmasters, <a href="https://www.bbc.co.uk/news/business-56859357">Lord Justice Holroyde said</a> the Post Office knew there were serious issues with the system, yet “consistently asserted that Horizon was robust and reliable” and “effectively steamrolled over any sub-postmaster who sought to challenge its accuracy”.</p>
<p>In interactions with sub-postmasters, the Post Office auditors emphasised that the computer could not be wrong, as shown in the following account from Arch’s <a href="https://www.postofficehorizoninquiry.org.uk/evidence/witn01220100-nichola-arch-witness-statement">witness statement</a> to the inquiry:</p>
<blockquote>
<p>[The auditor said:] ‘You popped it in your purse.’ I said: ‘No, I didn’t.’ I told him the daily totals were right and I had evidence to show that, but I couldn’t access it. And he replied that he was not interested in what I said as the computer was the most hi-tech equipment you could wish for, and no one else had had any problems with it.</p>
</blockquote>
<h2>The myth of ‘infallible systems’</h2>
<p>The lack of willingness on the part of the Post Office to even entertain the idea that its IT systems might have a problem discouraged sub-postmasters from trying to resolve the issue with the Post Office directly. It also fuelled their self-doubt about whether this “perfect” system really could have any bugs in it.</p>
<p>This last factor is particularly pertinent for disputes around technology, in which people can easily fall prey to what researchers call <a href="https://academic.oup.com/jpart/article/33/1/153/6524536">“automation bias”</a>, a psychological bias in which people readily discount information that does not conform to what technology advises or has determined.</p>
<p>When injustices comes to light, often years after harm has occurred, we often hear people ask: ‘If this was going on, why didn’t they tell someone? Why are they only saying this now?’</p>
<p>In examining this case, we have found there are numerous legitimate reasons why victims don’t speak up – especially when they are intentionally isolated, experience self-doubt, feel ashamed about what has happened, and are not given access to the vital information they need to prove their innocence against a powerful perpetrator.</p>
<p>It all seems so obvious in hindsight. Sub-postmasters were highly vetted and highly skilled people. Post Office employees have <a href="https://www.youtube.com/watch?app=desktop&v=-O24T0TmoVc">given evidence</a> confirming that sub-postmasters were subject to “good character checks”. Statistically, such a high percentage of them being criminals was very unlikely. This alone should have raised concerns about these accusations, both inside and outside the Post Office.</p>
<p>But Post Office management falsely believed their technological systems were infallible, and dug their heels in at any opportunity to recognise this injustice for what it was. </p>
<p>At the end of the day, this is not a scandal about technological failing. It is a scandal about the gross failure of management to stand up for the human beings who had dedicated so many years of their lives working for ‘the Queen’s business’.</p>
<hr>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em>For you: more from our <a href="https://theconversation.com/uk/topics/insights-series-71218?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insights series</a>:</em></p>
<ul>
<li><p><em><a href="https://theconversation.com/covid-heroes-left-behind-the-invisible-women-struggling-to-make-ends-meet-198210?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">COVID heroes left behind: the ‘invisible’ women struggling to make ends meet
</a></em></p></li>
<li><p><em><a href="https://theconversation.com/the-hidden-danger-of-asbestos-in-uk-schools-i-dont-think-they-realise-how-much-risk-it-poses-to-students-203582?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">The hidden danger of asbestos in UK schools: ‘I don’t think they realise how much risk it poses to students’
</a></em></p></li>
<li><p><em><a href="https://theconversation.com/how-to-solve-our-mental-health-crisis-214776?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">How to solve our mental health crisis
</a></em></p></li>
<li><p><em><a href="https://theconversation.com/im-always-delivering-food-while-hungry-how-undocumented-migrants-find-work-as-substitute-couriers-in-the-uk-201695?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">‘I’m always delivering food while hungry’: how undocumented migrants find work as substitute couriers in the UK
</a></em></p></li>
</ul>
<p><em>To hear about new Insights articles, join the hundreds of thousands of people who value The Conversation’s evidence-based news. <a href="https://theconversation.com/uk/newsletters/the-daily-newsletter-2?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK"><strong>Subscribe to our newsletter</strong></a>.</em></p><img src="https://counter.theconversation.com/content/220513/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Grace Augustine receives funding from the British Academy / Leverhulme Trust for her research on the Post Office Horizon IT Scandal project. </span></em></p><p class="fine-print"><em><span>Jan Lodge receives funding from the British Academy / Leverhulme Trust for his research on the Post Office Horizon IT Scandal project.</span></em></p><p class="fine-print"><em><span>Mislav Radic receives funding from the British Academy / Leverhulme Trust for his research on the Post Office Horizon IT Scandal project.</span></em></p>Our research has identified four main barriers that stopped hundreds of sub-postmasters speaking out for so long.Grace Augustine, Associate Professor in Business & Society, University of BathJan Lodge, Assistant Professor, Department of Business-Society Management, Rotterdam School of ManagementMislav Radic, Assistant Professor, Department of Social and Political Sciences, Bocconi UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2200852023-12-29T09:30:46Z2023-12-29T09:30:46ZInsights 2023: from unheard voices and AI to the origin story of a very popular rabbit<figure><img src="https://images.theconversation.com/files/567124/original/file-20231221-19-d9yco4.jpeg?ixlib=rb-1.1.0&rect=5%2C21%2C919%2C510&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">An illustration by Beatrix Potter from The Tale of the Flopsy Bunnies.</span> <span class="attribution"><a class="source" href="https://www.britishmuseum.org/collection/image/218381001">The Trustees of the British Museum</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span></figcaption></figure><p>This year, the <a href="https://theconversation.com/uk/insights">Insights series</a> has covered a wide range of important topics but the themes of ‘unheard voices’, artificial intelligence (AI) and mental health have led the way.</p>
<p>In long-form articles and <a href="https://theconversation.com/domicide-a-view-from-homs-in-syria-on-what-the-deliberate-destruction-of-homes-does-to-those-displaced-by-conflict-podcast-216374">podcasts</a>, our authors have put the spotlight on groundbreaking new research, at times giving voice to those who rarely get a chance to tell their stories.</p>
<h2>Unheard voices</h2>
<p>We started the year with the “invisible” COVID heroes <a href="https://theconversation.com/covid-heroes-left-behind-the-invisible-women-struggling-to-make-ends-meet-198210">struggling to make ends meet</a> and examined the <a href="https://theconversation.com/uncovering-the-secret-religious-and-spiritual-lives-of-sex-workers-195126">religious lives of sex workers</a>, before taking a deep-dive into the issues faced by <a href="https://theconversation.com/its-like-youre-a-criminal-but-i-am-not-a-criminal-first-hand-accounts-of-the-trauma-of-being-stuck-in-the-uk-asylum-system-202276">asylum seekers</a> in the UK and <a href="https://theconversation.com/a-toxic-policy-with-little-returns-lessons-for-the-uk-rwanda-deal-from-australia-and-the-us-201790">abroad</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/covid-heroes-left-behind-the-invisible-women-struggling-to-make-ends-meet-198210">COVID heroes left behind: the 'invisible' women struggling to make ends meet</a>
</strong>
</em>
</p>
<hr>
<p>We heard from <a href="https://theconversation.com/im-always-delivering-food-while-hungry-how-undocumented-migrants-find-work-as-substitute-couriers-in-the-uk-201695">undocumented migrants</a> who were finding work as substitute food couriers, and from <a href="https://theconversation.com/they-just-ignored-my-tears-they-ignored-my-unhappiness-former-irish-nuns-reveal-accounts-of-brainwashing-and-abuse-197569">former Irish nuns</a> who opened up about the brainwashing and abuse they were forced to endure.</p>
<p>In June, on the 75th anniversary of Windrush, Maria del Pilar Kaladeen began her long read: “My father never spoke to us about Guyana, the country of his birth, when we were growing up because he believed that his history had no value to his children.” Kaladeen’s <a href="https://theconversation.com/invisible-windrush-how-the-stories-of-indian-indentured-labourers-from-the-caribbean-were-forgotten-206330">deeply personal article</a> looked at how the stories of Indian indentured labourers from the Caribbean were largely forgotten in the overall Windrush narrative.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/invisible-windrush-how-the-stories-of-indian-indentured-labourers-from-the-caribbean-were-forgotten-206330">Invisible Windrush: how the stories of Indian indentured labourers from the Caribbean were forgotten</a>
</strong>
</em>
</p>
<hr>
<p>She says they were a minority within a minority and subsequent generations were left with little information about their pasts – about who they were. </p>
<p>In September, the Oxford academic Ammar Assouz <a href="https://theconversation.com/my-home-city-was-destroyed-by-war-but-i-will-not-lose-hope-how-modern-warfare-turns-neighbourhoods-into-battlefields-211627">wrote about</a> how he was forced to flee his home in Homs, Syria, 12 years ago as the war there began tearing apart streets and neighbourhoods.</p>
<p>His research examines how modern wars, whether in Iraq, Ukraine, Syria or Yemen, are increasingly putting civilians on the frontline, turning cities into battlefields and displacing millions across the world.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/my-home-city-was-destroyed-by-war-but-i-will-not-lose-hope-how-modern-warfare-turns-neighbourhoods-into-battlefields-211627">'My home city was destroyed by war but I will not lose hope' – how modern warfare turns neighbourhoods into battlefields</a>
</strong>
</em>
</p>
<hr>
<p>And in October we reported from Indonesia where a small fishing community is facing eviction under plans to transform Rempang Island into a solar panel “ecocity”.
Around 7,500 islanders are fighting to keep their homes as the government plans to uproot them to make way for a multi-billion dollar Chinese-backed manufacturing hub. </p>
<p>Nikita Sud <a href="https://theconversation.com/victims-of-the-green-energy-boom-the-indonesians-facing-eviction-over-a-china-backed-plan-to-turn-their-island-into-a-solar-panel-ecocity-214755">visited the island</a> and reported on the violent backlash from state forces as protestors took to the streets. She believes Rempang is just the latest “sacrificial zone” in the international quest for green energy which is reliant on developing countries.</p>
<h2>AI and data</h2>
<p>We’ve also been keeping a close eye on developments in AI and machine learning and the real-life consequences of this fast developing technology.</p>
<p><a href="https://theconversation.com/ai-will-soon-become-impossible-for-humans-to-comprehend-the-story-of-neural-networks-tells-us-why-199456">David Beer’s story</a> investigated the history of neural networks and revealed how the early analogue versions of ChatGPT were huge contraptions which performed baffling memory tasks which their creators could not understand. </p>
<figure class="align-center ">
<img alt="Yellow Distributed connection atom with black background." src="https://images.theconversation.com/files/567127/original/file-20231221-15-1s2eex.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567127/original/file-20231221-15-1s2eex.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=350&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567127/original/file-20231221-15-1s2eex.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=350&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567127/original/file-20231221-15-1s2eex.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=350&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567127/original/file-20231221-15-1s2eex.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=440&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567127/original/file-20231221-15-1s2eex.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=440&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567127/original/file-20231221-15-1s2eex.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=440&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Will we ever understand how artificial neural networks operate?</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/blockchain-network-machine-learning-deep-neural-1724030938">Shutterstock/Valentyn640</a></span>
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<p>And it turns out that modern machine minds are just as mysterious. The unknown, it seems, has been pursued as a fundamental part of these systems from their earliest stages. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/ai-will-soon-become-impossible-for-humans-to-comprehend-the-story-of-neural-networks-tells-us-why-199456">AI will soon become impossible for humans to comprehend – the story of neural networks tells us why</a>
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</p>
<hr>
<p>Meanwhile, Melissa Hamilton and Pamela Ugwudike, revealed how <a href="https://theconversation.com/a-black-box-ai-system-has-been-influencing-criminal-justice-decisions-for-over-two-decades-its-time-to-open-it-up-200594">AI’s digital tentacles</a> are firmly wrapped around elements of the UK’s criminal justice system. This influence dates back further, and runs much deeper, than most people realise.</p>
<p>For more than two decades, a “black box” AI system has been influencing decisions made by our courts and prisons, and by parole and probation officers. Yet scientists outside the UK government have never been permitted full access to the data behind this system, to independently analyse its workings and assess its accuracy.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/a-black-box-ai-system-has-been-influencing-criminal-justice-decisions-for-over-two-decades-its-time-to-open-it-up-200594">A 'black box' AI system has been influencing criminal justice decisions for over two decades – it's time to open it up</a>
</strong>
</em>
</p>
<hr>
<h2>Mental health</h2>
<p>Insights also launched a new series in 2023. Tackling the Mental Health Crisis aimed to better understand the complex challenges – and the potential solutions – around this huge issue.</p>
<p>Our authors have so far investigated how and why <a href="https://theconversation.com/how-music-heals-us-even-when-its-sad-by-a-neuroscientist-leading-a-new-study-of-musical-therapy-214924">music is such an effective therapy</a> for mental illness, and how OCD is so much <a href="https://theconversation.com/ocd-is-so-much-more-than-handwashing-or-tidying-as-a-historian-with-the-disorder-heres-what-ive-learned-219281">more than handwashing</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-to-solve-our-mental-health-crisis-214776">How to solve our mental health crisis</a>
</strong>
</em>
</p>
<hr>
<p>To kick off the series, health historian Matthew Smith <a href="https://theconversation.com/how-to-solve-our-mental-health-crisis-214776">wrote about how</a> we already know how to solve the mental health crisis – we just don’t care enough about society as a whole to do it.</p>
<h2>Peter Rabbit</h2>
<p>But it was an article commissioned by arts and culture editor Naomi Joseph about a familiar bunny that provided our most-read piece of the year.</p>
<p>Most of us know Peter, the little rabbit in the blue coat. Beatrix Potter’s tales of his exploits have populated many childhoods.</p>
<p>These stories are held to be decidedly British, believed to have sprung from the mind of Potter who was inspired by the rolling green countryside of north-west England and her pet rabbit Peter. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/beatrix-potters-famous-tales-are-rooted-in-stories-told-by-enslaved-africans-but-she-was-very-quiet-about-their-origins-202274">Beatrix Potter's famous tales are rooted in stories told by enslaved Africans – but she was very quiet about their origins</a>
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</em>
</p>
<hr>
<p>However, while researching the African-inspired folk tales of Brer Rabbit, the post-colonial literature academic <a href="https://theconversation.com/beatrix-potters-famous-tales-are-rooted-in-stories-told-by-enslaved-africans-but-she-was-very-quiet-about-their-origins-202274">Emily Zobel Marshall saw</a> some surprising connections.</p>
<p>Closely reading Potter’s letters, biographies and books, Marshall argues that Potter’s tales owe a great debt to Brer and the enslaved Africans who retold these stories on plantations in the US – a debt she never acknowledged publicly.</p><img src="https://counter.theconversation.com/content/220085/count.gif" alt="The Conversation" width="1" height="1" />
Diverse long reads with a global reach.Paul Keaveny, Investigations Editor, Insights, The ConversationNaomi Joseph, Arts + Culture EditorMike Herd, Investigations Editor, InsightsLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2196882023-12-19T06:13:08Z2023-12-19T06:13:08ZGrenfell should have been a wake-up call – but the UK still doesn’t take fire safety seriously because of who is most at risk<p>In March 2023, a fire in Tower Hamlets, east London, claimed the life of Mizanur Rahman, a 41-year-old father-of-two from Bangladesh. <a href="https://www.london-fire.gov.uk/incidents/2023/march/flat-fire-shadwell/">Five fire engines and 35 firefighters</a> attended the call to the two-bedroom flat in Maddocks House, on the Tarling West housing estate, in the early hours of the morning.</p>
<p>Rahman, who had only recently arrived in the UK, was rescued and taken to the Royal London Hospital suffering from smoke inhalation, where he died from his injuries. On the night of the fire, estate residents claimed that <a href="https://tarlingwestestate.wordpress.com/2023/04/13/tarling-west-estate-residents-association-report-1-04-2023-on-recovery-ofresidents-of-18-maddocks-house-possessions-after-the-fire-on-friday-17-march-2023/">18 men</a> had been sleeping in the flat’s three rooms including a converted lounge – despite the premises only being licensed to accommodate a maximum of three people.</p>
<p>While the fire itself was caused by a <a href="https://www.bbc.co.uk/news/uk-england-london-66774376">faulty lithium e-bike battery</a>, an inspection by the London Fire Brigade prior to the fire had <a href="https://www.bigissue.com/news/housing/shadwell-flat-fire-maddocks-house-uk-housing-crisis/">raised serious safety concerns</a>, finding that the flat “was not in a good condition with multiple people living in it”.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/GDiGJ-fuRM8?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Report on the Maddocks House fire (March 2023). Film by Rainbow Collective.</span></figcaption>
</figure>
<p>Seven months after the fire, Tower Hamlets Council took the flat’s landlords to court for breaches of the 2004 Housing Act. They have subsequently <a href="https://www.theguardian.com/uk-news/2023/nov/28/landlords-of-crowded-london-flat-that-caught-fire-plead-guilty-to-criminal-charges">pleaded guilty</a> to nine charges <a href="https://www.towerhamlets.gov.uk/News_events/2023/November/Tower-Hamlets-landlords-plead-guilty-to-overcrowding-charges.aspx">including</a> multiple failures to comply with licence conditions, carry out inspections and have a valid gas safety certificate, as well as allowing the premises to be overcrowded. The landlords await sentencing.</p>
<p>However, following the inquest into Rahman’s death, the assistant coroner did not comment on overcrowding in the property in his <a href="https://www.judiciary.uk/prevention-of-future-death-reports/mizanur-rahman-prevention-of-future-deaths-report/">prevention of future deaths report</a>. He did, though, recommend that the government introduces standards regulating the sale of lithium batteries for e-bikes.</p>
<p>Ahead of the court case, <a href="https://grenfellunited.org.uk/about-us">Grenfell United</a>, a group of survivors and bereaved families founded days after the Grenfell Tower fire on June 14 2017, <a href="https://x.com/GrenfellUnited/status/1719025477854155043?s=20">pledged its support</a> to all those affected by the Maddocks House fire, stating:</p>
<blockquote>
<p>Seven months since the Tarling West estate fire in which an innocent man lost his life … We stand with the family, residents, friends and all those campaigning for justice.</p>
</blockquote>
<p>The Grenfell disaster – the UK’s worst post-war residential fire – claimed the lives of 72 people in <a href="https://www.mylondon.news/lifestyle/londons-richest-poorest-boroughs-average-23380005">London’s richest borough</a>, Kensington & Chelsea. The <a href="https://www.grenfelltowerinquiry.org.uk/">inquiry into the disaster</a> is expected to make a host of recommendations about the need to strengthen residential fire safety when it is finally published, after <a href="https://www.theguardian.com/uk-news/2023/nov/25/grenfell-tower-inquiry-final-report-delayed-again">yet more delays</a>, in 2024. But this is too late for Mizanur Rahman.</p>
<p>Indeed, more than six years after the Grenfell fire, community groups and homelessness charities have taken matters into their own hands to support renters and tenants who continue to be endangered by unsafe housing conditions in London and throughout the UK. But despite their best efforts, the risks facing residents of multiple-occupancy housing appear largely undiminished. Worryingly, policymakers – especially those who have responsibility for English housing and safety legislation – have seemingly forgotten the lessons from the UK’s <a href="https://uolpress.co.uk/book/before-grenfell/">past experiences of mass-fatality fire</a>.</p>
<h2>Another Grenfell-style fire?</h2>
<p>The Maddocks House fire added to widespread concerns that, despite Grenfell having been <a href="https://www.theguardian.com/uk-news/2022/nov/10/every-death-was-avoidable-grenfell-tower-inquiry-closes-after-400-days">an eminently avoidable disaster</a>, another major fire involving a large loss of life could happen in a bedsit, converted flat or other <a href="https://www.legislation.gov.uk/ukpga/2004/34/part/7/crossheading/meaning-of-house-in-multiple-occupation#:%7E:text=254Meaning%20of%20%E2%80%9Chouse%20in%20multiple%20occupation%E2%80%9D&text=(f)rents%20are%20payable%20or,occupation%20of%20the%20living%20accommodation.">house in multiple occupation</a>. In part, this is the result of safety being neglected by <a href="https://hansard.parliament.uk/Lords/2016-06-10/debates/40C06C83-5A10-4F0B-8855-C10BF76E4182/Renters%E2%80%99RightsBill(HL)?highlight=%22the%20term%20%E2%80%98rogue%20landlord%E2%80%99%20is%20widely%20understood%20in%20the%20lettings%20industry%20to%20describe%20a%20landlord%20who%20knowingly%20flouts%20their%20obligations%20by%20renting%20out%20unsafe%20and%20substandard%20accommodation%20to%20tenants%2C%20many%20of%20whom%20may%20be%20vulnerable%22#contribution-50867390-8CF2-4915-B369-5DA6BCFF2699">rogue landlords</a> who <a href="https://hansard.parliament.uk/Lords/2016-06-10/debates/40C06C83-5A10-4F0B-8855-C10BF76E4182/Renters%E2%80%99RightsBill(HL)?highlight=%22the%20term%20%E2%80%98rogue%20landlord%E2%80%99%20is%20widely%20understood%20in%20the%20lettings%20industry%20to%20describe%20a%20landlord%20who%20knowingly%20flouts%20their%20obligations%20by%20renting%20out%20unsafe%20and%20substandard%20accommodation%20to%20tenants%2C%20many%20of%20whom%20may%20be%20vulnerable%22#contribution-50867390-8CF2-4915-B369-5DA6BCFF2699">“knowingly flout their obligations</a> by renting out unsafe and substandard accommodation to tenants, many of whom may be vulnerable”.</p>
<p>Another <a href="https://www.fsmatters.com/London-HMO-landlord-receives-substantial-fine">recently completed case</a> saw a landlord and property management company <a href="https://www.rbkc.gov.uk/newsroom/council-prosecutes-landlord-poor-housing-conditions-hyde-park-gate-houseshare">fined £480,000 plus costs</a> for leasing an unlicensed 22-bedroom property with multiple fire safety and damp-related risks in the same borough, Kensington & Chelsea, in which <a href="https://www.theguardian.com/inequality/ng-interactive/2017/nov/18/life-shadow-grenfell-tower-next-door">Grenfell Tower is located</a>. Throughout the UK, local authorities <a href="https://www.taylorfrancis.com/chapters/edit/10.1201/9781003246534-10/regulating-houses-multiple-occupation-hmos-louise-harford-kevin-thompson">face multiple challenges</a> – including lack of resources, limits to their legal powers, and cultural barriers – when reactively trying to regulate the standard of privately rented accommodation in houses in multiple occupation (known as HMOs).</p>
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<img alt="" src="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
<hr>
<p><a href="https://blog.shelter.org.uk/2023/06/government-is-risking-another-fatal-fire-by-deregulating-hmo-accommodation/">Housing</a> and <a href="https://www.fbu.org.uk/news/2019/05/21/government-complacency-risks-another-grenfell">fire safety</a> campaigners have repeatedly warned of complacency over enforcing safety in the UK’s private rented sector, among others. In recent years, the government’s own safety experts have <a href="https://www.theguardian.com/society/2023/nov/16/experts-warned-government-of-tower-block-collapse-risk-last-year-leak-reveals">expressed concern</a> about ministers’ failures to tackle “potentially catastrophic life safety implications” in buildings ranging from tower blocks and HMOs to schools and hospitals.</p>
<p>Since 2022, the <a href="https://commonslibrary.parliament.uk/research-briefings/cbp-9428/">cost of living crisis</a> has left <a href="https://www.gov.uk/government/statistics/statutory-homelessness-in-england-january-to-march-2023/statutory-homelessness-in-england-january-to-march-2023">record numbers</a> of disadvantaged people living in overcrowded, unfit and unsafe accommodation – including families with young children, frail older people, those with long-term health conditions, university students and migrants. They have little hope of accessing affordable and safe housing. And people living in the private rented sector are <a href="https://www.gov.uk/government/statistics/english-housing-survey-2020-to-2021-feeling-safe-from-fire/english-housing-survey-2020-to-2021-feeling-safe-from-fire">twice as likely to feel unsafe in their home</a> as owner-occupiers, because of their fear that a fire might break out.</p>
<h2>A generation of rogue landlords</h2>
<p>While the campaign for improved standards of safety in HMOs originated in the 1960s, it intensified during the early 1980s following <a href="https://hansard.parliament.uk/Lords/2023-06-07/debates/41061D9F-F385-4CF5-9B77-8EB8852381A3/IllegalMigrationBill?highlight=hmo%20fire#contribution-74FECC2F-0658-405B-905B-E19EBCDAA212">several mass-fatality fires</a> – as I chart in my new book, <a href="https://uolpress.co.uk/book/before-grenfell/">Before Grenfell: Fire, Safety and Deregulation in Twentieth-Century Britain</a>.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/565792/original/file-20231214-15-a47go8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Smoke coming out of the window of a large London apartment" src="https://images.theconversation.com/files/565792/original/file-20231214-15-a47go8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/565792/original/file-20231214-15-a47go8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=942&fit=crop&dpr=1 600w, https://images.theconversation.com/files/565792/original/file-20231214-15-a47go8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=942&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/565792/original/file-20231214-15-a47go8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=942&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/565792/original/file-20231214-15-a47go8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1184&fit=crop&dpr=1 754w, https://images.theconversation.com/files/565792/original/file-20231214-15-a47go8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1184&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/565792/original/file-20231214-15-a47go8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1184&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Clanricarde Gardens fire (1981).</span>
<span class="attribution"><a class="source" href="https://www.nationalarchives.gov.uk/">The National Archives</a></span>
</figcaption>
</figure>
<p>Shortly before Christmas 1981, <a href="https://read.uolpress.co.uk/read/before-grenfell/section/68c02bc3-7033-4d94-a928-9a2896e9c3b5">fire gutted a residential property</a> in Notting Hill Gate, west London, killing eight residents and injuring many more. The property comprised 56 bedsits across three converted terraced houses on Clanricarde Gardens, a once-fashionable cul-de-sac which, with its low-quality bed-and-breakfast-style accommodation, by then aimed at the cheaper end of London’s rental market. Although estimates vary, almost 100 people are thought to have been sleeping in the property on the night of the fire, which started around four o’clock in the morning. Local newspapers quoted a resident being woken by “a tremendous shouting and screaming”:</p>
<blockquote>
<p>At first I thought it was a Christmas party – but then I knew from the sound that this was no party. </p>
</blockquote>
<p><a href="https://read.uolpress.co.uk/read/before-grenfell/section/68c02bc3-7033-4d94-a928-9a2896e9c3b5">Fire investigators</a> would later find numerous defects in the property, including combustible partition walls, unprotected staircases, a maze of corridors without fire-stopping doors, and a dangerously high electrical loading.</p>
<p>Six of the eight people who died were adult migrants who had come to Britain from Latin America and eastern Europe to study and work; the other two were elderly British men. Many of the residents were employed in the low-paid hospitality sector.</p>
<p>The survivors, having lost their possessions, were clothed and put up in hotels – then interviewed by officials from the Royal Borough of Kensington & Chelsea (RBKC) to determine their eligibility for rehousing. Due to a shortage of available housing, many were rejected. Some had no option but to <a href="https://read.uolpress.co.uk/read/before-grenfell/section/68c02bc3-7033-4d94-a928-9a2896e9c3b5#footnote-061-backlink">move into the property next door</a> to the burnt-out shell of their former home.</p>
<p>The Clanricarde Gardens fire inquest exposed a generation of rogue London landlords who had placed profits before safety in their <a href="https://hansard.parliament.uk/Commons/1982-03-18/debates/888c059e-7af2-4781-8516-8341eb21e941/Hostels(London)?highlight=fire%20clanricarde#contribution-11c52e90-a78c-40d9-83f9-37f12681b496">unregulated “Victorian hostels”</a>. Major shortcomings were also revealed in the level of oversight from RBKC, which was identified as having some of the <a href="https://read.uolpress.co.uk/read/before-grenfell/section/68c02bc3-7033-4d94-a928-9a2896e9c3b5#footnote-060">worst housing conditions</a> in the capital, with unregistered HMOs comprising between a quarter and a third of its housing stock. <a href="https://read.uolpress.co.uk/read/before-grenfell/section/68c02bc3-7033-4d94-a928-9a2896e9c3b5#footnote-059">Early warnings</a> about the dangerous condition of the Notting Hill property had not been acted upon by officers at the time of the fire, and the council was subsequently <a href="https://www.theguardian.com/inequality/2017/jul/24/underfunded-and-overstretched-the-lawyers-seeking-justice-for-grenfell-tower-fire">found guilty of maladministration</a>.</p>
<p>The jury at the inquest returned a verdict of death by misadventure, but found no evidence of negligence by the landlord. <a href="https://read.uolpress.co.uk/read/before-grenfell/section/68c02bc3-7033-4d94-a928-9a2896e9c3b5">The coroner</a> angered campaigners and survivors by declining to add recommendations for the government to improve safety. He claimed that the need to reconcile cheap accommodation for homeless people with “expensive” fire precautions was “insoluble”.</p>
<p>In the aftermath, the Campaign for Bedsit Rights (CBR) – led by tenacious housing activist <a href="https://www.theguardian.com/society/2020/oct/27/nick-beacock-obituary">Nick Beacock</a> – published a <a href="https://archive.org/details/firesafetyguidec0000unse">guide to fire safety</a> for tenants, issued a semi-regular newsletter, and collaborated with sympathetic members of parliament who advocated for statutory licensing and regulation of these “<a href="https://hansard.parliament.uk/Commons/1983-02-25/debates/a0b92dae-fe08-41fe-8191-3c86a5853e9e/Housing(HousesInMultipleOccupation)Bill?highlight=housing%20houses%20multiple%20occupation#contribution-0bc09dc4-c3a9-4f49-b88e-be8171cd818a">Dickensian</a>” lodgings. The urgency of the situation was marked by the scale of homelessness across the capital at that time, with rough sleeping <a href="https://api.parliament.uk/historic-hansard/commons/1985/dec/20/homelessness-london">on the rise</a> due to cuts in housing benefit.</p>
<p>Yet, in February 1983, a <a href="https://hansard.parliament.uk/Commons/1983-02-25/debates/a0b92dae-fe08-41fe-8191-3c86a5853e9e/Housing(HousesInMultipleOccupation)Bill">private members’ bill</a> to introduce licensing was defeated by the government despite enjoying strong cross-party support. Ministers defended the decision on the grounds of public spending restrictions and, <a href="https://read.uolpress.co.uk/read/before-grenfell/section/68c02bc3-7033-4d94-a928-9a2896e9c3b5#footnote-052">in a quote attributed to housing minister George Young</a>, a reluctance to “add unnecessarily” to landlords’ costs in a way that might “discourage them from making accommodation available”. Throughout the 1980s, landlords’ interests were largely prioritised ahead of tenants’, in a decade that saw the <a href="https://www.tandfonline.com/doi/abs/10.1080/02673039608720868">deregulation of the private rental market</a>.</p>
<p>Four decades on, even after the public outcry following the Grenfell disaster, cases continue to highlight that, around the UK, local authorities vary widely in their interpretation and enforcement of their obligations over licensing rental properties. In many cases, they simply <a href="https://www.theguardian.com/uk-news/2023/nov/19/landlords-double-income-ignoring-hmo-licence-overcrowding">lack the resources</a> to track landlords.</p>
<p>In July 2023, the <a href="https://www.legislation.gov.uk/ukpga/2023/36/enacted">Social Housing (Regulation) Act</a> was given royal assent, introducing a more proactive system whereby complaints about the standard of <a href="https://england.shelter.org.uk/support_us/campaigns/what_is_social_housing">social housing</a> can be investigated by the regulator. It has taken <a href="https://blog.shelter.org.uk/2023/07/royal-assent-transformation-social-housing/">almost six years</a> of campaigning by Grenfell United, Shelter and other organisations to get to this stage. However, the act does not cover the private rented sector, and much work is still needed to protect these residents.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/gGcPtRcpeBU?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">A film by Grenfell United.</span></figcaption>
</figure>
<h2>Years of inaction</h2>
<p>Over the decades since the 1983 defeat of the licensing bill, it is hard not to conclude that several deadly fires might have been prevented had the UK government introduced mandatory licensing, backed up by strong powers of enforcement.</p>
<p><a href="https://read.uolpress.co.uk/read/before-grenfell/section/68c02bc3-7033-4d94-a928-9a2896e9c3b5#footnote-059">One notable incident</a>, in November 1984, involved the death of a 27-year-old Bangladeshi woman, Mrs Abdul Karim, and her two young children, aged three and five, in a five-storey HMO in Westminster, central London. Despite being a priority for rehousing, the family had lived in a single room at the top of an unenclosed staircase for the previous nine months. In all, more than 50 people lived in the property, including 18 families who had been accommodated there by Camden Borough Council.</p>
<p>Firefighters found as many as seven people sleeping in a single room, and rescued a baby sleeping in a cot in a bathroom. “It was a miracle more people were not killed,” a survivor told a local newspaper. A local homelessness charity representative described the fire as highlighting “all the things we have been saying about the conditions homeless families are forced to live in”. Eventually, following a <a href="https://read.uolpress.co.uk/read/before-grenfell/section/68c02bc3-7033-4d94-a928-9a2896e9c3b5#footnote-059">two-week occupation</a> of Camden town hall by furious families, councillors rehoused the survivors in improved accommodation within the borough.</p>
<p>This fire exposed <a href="https://www.tandfonline.com/doi/full/10.1080/02673030903561842">historic racial inequalities</a> within London’s housing market, with many non-white families left to the whims of exploitative landlords. While the national media showed little interest, author Salmon Rushdie wrote an excoriating piece for the Guardian which was cited in a <a href="https://api.parliament.uk/historic-hansard/commons/1984/dec/14/homeless-persons-accommodation">House of Commons debate</a>:</p>
<blockquote>
<p>When it started, no alarm rang. It had been switched off. The fire extinguishers were empty. The fire exits were blocked. It was night time but the stairs were in darkness because there were no bulbs in the lighting sockets. And in the single, cramped top-floor room where the cooker was next to the bed, Mrs Abdul Karim, a Bangladeshi woman, and her five-year-old son and three-year-old daughter died of suffocation.</p>
</blockquote>
<p>Rushdie pointed the finger of blame squarely at the racist landlords and councillors who persistently ignored the complaints of black and Asian families. He wrote: “Those of us who do not live in slum housing get used with remarkable ease to the fact that others do” – not least because black and Asian families “are far more likely than white ones to be placed in such ‘temporary’ places”.</p>
<p>After a Camden councillor was quoted by journalists as complaining that the town hall occupation had been “manipulated” by Bengali families" to jump the housing queue", Rushdie sarcastically added that “presumably not enough people have been burned to death yet” to improve the situation.</p>
<p>Following compelling evidence of systematic neglect of the property by its landlord, the inquest jury returned an open verdict on the deaths. Campaigners again called for powers to license hostels: Mel Cairns, an experienced environmental health officer, told a local paper: “People who look after dogs and cats need licences, and the same should apply to landlords who have human beings in their charge.”</p>
<p>The coroner concurred, demanding of ministers that “action be taken to prevent the occurrence of similar fatalities”. <a href="https://www.theguardian.com/society/2014/dec/10/chris-holmes">Chris Holmes</a>, director of the Campaign for the Homeless and Rootless (and a future government adviser on reducing street homelessness), <a href="https://api.parliament.uk/historic-hansard/commons/1984/dec/14/homeless-persons-accommodation">concluded</a>:</p>
<blockquote>
<p>The fire at Gloucester Place tragically shows the need for there to be a legal duty on local authorities to inspect this kind of property. If an HMO Act had existed, that family need not have died.</p>
</blockquote>
<p>Yet, despite compiling its own evidence on the extent of the risk, successive consultations by Conservative governments during the 1980s and 1990s rejected mandatory licensing on grounds of proportionality and cost. <a href="https://archive.org/details/firesafetyguidec0000unse/page/2/mode/2up">Four in every five HMOs</a> were identified as having inadequate means of escape in a fire, while the risk of death or injury due to fire was ten times greater for people living in an HMO than in a single-occupancy family house, according to Home Office figures from the early 1990s.</p>
<p>In 1994, a fire in a Scarborough hostel in which a 33-year-old woman and her two-year-old child died finally led the prime minister, John Major, to <a href="https://api.parliament.uk/historic-hansard/commons/1994/may/05/engagements">pledge</a> his government to investigate “the feasibility of introducing a licensing system to control such establishments”. However, the following year, the Department of the Environment <a href="https://read.uolpress.co.uk/read/before-grenfell/section/68c02bc3-7033-4d94-a928-9a2896e9c3b5#footnote-018">concluded</a> that licensing “would lead to excessive cost and bureaucracy by forcing every local authority to follow a standard licensing approach”.</p>
<p>After further government obfuscation and more avoidable deaths, licensing of HMOs was finally introduced in the early 2000s. Although the ruling Labour party had <a href="http://www.labour-party.org.uk/manifestos/1997/1997-labour-manifesto.shtml">promised to introduce licensing</a> in the lead-up to both the 1997 and 2001 general elections, it took further campaigning to secure the legislation through the <a href="https://www.legislation.gov.uk/ukpga/2004/34/contents">2004 Housing Act</a>. The legislation also introduced other measures to improve fire safety, including the <a href="https://www.gov.uk/government/collections/housing-health-and-safety-rating-system-hhsrs-guidance">housing health & safety rating system</a>, which required local authorities to take legal action against landlords letting homes with serious hazards.</p>
<p>In 2006, statutory regulations were introduced to guarantee minimum standards within both the <a href="https://www.legislation.gov.uk/uksi/2006/373/contents/made">licensing</a> and <a href="https://www.legislation.gov.uk/uksi/2006/372/contents/made">management</a> of multiple occupancy-style rental accommodation. Though far from the end point in the fight for safe housing for all, it signalled a major victory for campaigners such as Beacock. In recent years, however, owing to the growing housing crisis in London and other large UK cities, the problem of rogue landlords who are prepared to “game” the licensing regime has re-emerged.</p>
<p>Across the UK’s private rented sector, we see examples of landlords operating even after being refused a licence. Some fail to sign tenancy agreements, evict tenants without legal grounds, and allow unauthorised people to live in licensed properties. Such has been the scale of the problem that in 2019, the government issued <a href="https://assets.publishing.service.gov.uk/media/5cffa8bce5274a3cfa8a4fea/Rogue_Landlord_Enforcement_-_Guidance_for_LAs.pdf">advisory guidance</a> to local authorities to “clamp down on these rogue landlords and force them to improve the condition of their properties, or leave the sector completely”.</p>
<h2>‘A price tag on our lives’</h2>
<p>London has a <a href="https://www.jstor.org/stable/3133531">history</a> of housing managed by a small number of unscrupulous private landlords prepared to use illegal and immoral practices to profit from the poor. Perhaps most famously, <a href="https://academic.oup.com/tcbh/article-abstract/12/1/69/1735310">Peter Rachman</a> operated in Notting Hill during the 1950s and ’60s, exploiting and intimidating his tenants so much that the phrase “Rachmanism” entered popular vocabulary. In 2019, his “<a href="https://hansard.parliament.uk/Lords/2019-01-31/debates/AE8030C8-FF1A-4BBF-A9EF-179616F5E6C9/SocialHousing?highlight=%22peter%20rachman%22#contribution-8D6AC161-3887-4907-8A1B-8EB5B5C3094D">inhumane activities</a>” were still being highlighted in a Lord’s debate on social housing.</p>
<p>But nor are local authority landlords exempt from criticism, as the Grenfell disaster exposed. At the time of the fire, the tower block was owned by the Royal Borough of Kensington & Chelsea, with management services provided by its tenant management organisation (TMO). Many of its residents were tenants of the local authority or a local housing association, while a small number owned the leasehold to their flats or were private renters.</p>
<p>During testimony to the <a href="https://www.grenfelltowerinquiry.org.uk/">Grenfell Tower inquiry</a>, witnesses criticised both the borough and its TMO for ignoring safety concerns raised during the tower block’s refurbishment in 2015-16. <a href="https://assets.grenfelltowerinquiry.org.uk/documents/transcript/Transcript%209%20November%202022.pdf">Residents</a> reported being made to “feel like second-class citizens – a nuisance, troublemakers, who should take what they were given and be grateful”. As one survivor, <a href="https://assets.grenfelltowerinquiry.org.uk/documents/transcript/Transcript%2020%20April%202021.pdf">Emma O’Connor</a>, said in her testimony:</p>
<blockquote>
<p>I don’t think it’s fair … that all these corporate companies were allowed to be given the choice to choose what the price tag on our lives should be.</p>
</blockquote>
<p>Some local authorities are beginning to tackle the problem through criminal proceedings. In <a href="https://news.camden.gov.uk/first-prosecution-by-camdens-new-rogue-landlord-taskforce/#:%7E:text=Monsoon%20Properties%20Limited%20and%20the,in%20multiple%20occupation%20(HMO)%20and">Camden</a>, a property management company was fined more than £49,000 in 2023 for fire safety breaches at an HMO and added to the Mayor of London’s “<a href="https://www.london.gov.uk/rogue-landlord-checker/3594/nojs?destination=rogue-landlord-checker">rogue landlord database</a>”. In 2020, Coventry City Council obtained a <a href="https://www.local.gov.uk/case-studies/successful-banning-order-against-rogue-landlord">banning order</a> against a landlord who had a “flagrant disregard for housing legislation”, including fire safety measures.</p>
<p>Research commissioned by the UK government into local authority enforcement of housing standards revealed that <a href="https://www.gov.uk/government/publications/local-authority-enforcement-in-the-private-rented-sector-headline-report/local-authority-enforcement-in-the-private-rented-sector-headline-report">non-compliance with the law is rife</a> across the private rented sector. Under half of local authorities in England reported that over 90% of notices served for the most serious <a href="https://www.legislation.gov.uk/ukpga/2004/34/part/1#:%7E:text=%E2%80%9Chazard%E2%80%9D%20means%20any%20risk%20of,an%20absence%20of%20maintenance%20or">category-1 hazards</a> had been complied with in 2019-20, while nearly a quarter (23%) reported that fewer than 50% of hazard notices had been complied with.</p>
<p>Much work remains to be done around enforcement by local authorities, to ensure that all landlords meet minimum safety requirements. In the meantime, some appear unconcerned about the risks – and potential consequences – of playing with fire.</p>
<h2>Another avoidable death</h2>
<p>In March 2023, Rahman’s death in the Maddocks House fire exposed once more the problems facing many people who live in a permanent state of precarity, often at the mercy of an exploitative housing market. The flat was licensed for occupancy by three people across two families, yet <a href="https://tarlingwestestate.wordpress.com/2023/04/13/tarling-west-estate-residents-association-report-1-04-2023-on-recovery-ofresidents-of-18-maddocks-house-possessions-after-the-fire-on-friday-17-march-2023/">18 men</a> reportedly occupied the flat on the night of the blaze.</p>
<p>The landlords had converted three rooms into dormitory-like sleeping spaces to pack in as many tenants as possible, <a href="https://www.theguardian.com/uk-news/2023/nov/28/landlords-of-crowded-london-flat-that-caught-fire-plead-guilty-to-criminal-charges">allegedly earning</a> over £100,000 a year in rent. <a href="https://www.bbc.co.uk/news/uk-england-london-64914885">One survivor</a> described how some of the residents, mostly Bangladeshi citizens, were “sleeping in the kitchen, some sharing beds, some sleeping on the floor” – a significant breach of the licence. There was a single shared toilet and bathroom, and the kitchen was out of bounds for cooking. For this, each tenant paid rent of up to £100 a week.</p>
<p>The <a href="https://tarlingwestestate.wordpress.com/2023/04/13/tarling-west-estate-residents-association-report-1-04-2023-on-recovery-ofresidents-of-18-maddocks-house-possessions-after-the-fire-on-friday-17-march-2023/">survivors</a>, who lost everything including their phones and passports, were housed in emergency accommodation by Tower Hamlets council, which owns the freehold to the property. The council <a href="https://democracy.towerhamlets.gov.uk/mgAi.aspx?ID=141846">passed an urgent motion</a> declaring the fire “an abuse of the most socially and economically vulnerable residents and workers by a greedy, vulturous and predatory class of landlord”.</p>
<p>The landlords, Sofina Begum and her husband Aminur Rahman (no relation to the victim), recently <a href="https://www.towerhamlets.gov.uk/News_events/2023/November/Tower-Hamlets-landlords-plead-guilty-to-overcrowding-charges.aspx">pleaded guilty</a> to a total of nine criminal charges at Thames magistrates court in east London, and are due to be sentenced in January 2024.</p>
<p>Anthony Iles, chair of the tenants and residents association, <a href="https://www.theguardian.com/uk-news/2023/nov/28/landlords-of-crowded-london-flat-that-caught-fire-plead-guilty-to-criminal-charges">commented</a> that the case provided “some small trickle of justice” and “serves as a warning to other landlords in the borough”. Conditions in Maddocks House were <a href="https://www.theguardian.com/society/2023/apr/23/men-who-escaped-fire-in-crowded-london-flat-face-homelessness">described</a> by one resident as “worse than slums in Bangladesh”.</p>
<p>Yet the men living there, many of whom worked as delivery drivers, restaurant and warehouse workers (some while also studying at university), had been afraid to complain to the council about the conditions because of their fear of being made homeless.</p>
<p>Tower Hamlets council has <a href="https://www.insidehousing.co.uk/news/resident-groups-rally-to-support-survivors-of-flat-fire-in-east-london-left-facing-homelessness-81294">rehoused those residents</a> “who are entitled to recourse to public funds”. It recently <a href="https://www.towerhamlets.gov.uk/News_events/2023/October/Tower-Hamlets-Council-to-manage-housing-directly-from-November-2023.aspx">resumed responsibility</a> for managing its housing stock, and <a href="https://www.towerhamlets.gov.uk/News_events/2023/November/Tower-Hamlets-landlords-plead-guilty-to-overcrowding-charges.aspx">approved plans</a> to renew an additional licensing scheme for HMOs under its jurisdiction.</p>
<p>However, some of the Maddocks House residents have international student visas, which means they are <a href="https://whitechapellondon.co.uk/shadwell-flat-fire-survivors-council-support-ended/">not entitled</a> to homelessness assistance or housing benefit. They have been forced back into the informal housing sector, the ongoing victims of an affordable housing crisis in which the average private rent in Tower Hamlets has <a href="https://www.theguardian.com/society/2023/apr/23/men-who-escaped-fire-in-crowded-london-flat-face-homelessness">risen</a> 33% since 2021 to £2,560 a month – far in excess of the earnings of these Maddocks House survivors.</p>
<p>Given the shortage of affordable housing in London and other UK cities, HMO-style accommodation remains the most, perhaps the only, practicable option for many people and families. In 2019, <a href="https://commonslibrary.parliament.uk/research-briefings/sn00708/">nearly 500,000 properties</a> were officially registered as HMOs in England – although recent reports indicate the <a href="https://propertyindustryeye.com/englands-hmo-stock-continues-on-downward-trend/">market is now retracting</a>, due to the introduction of <a href="https://www.legislation.gov.uk/uksi/2018/221/made">tighter licensing rules in 2018</a> that extended provisions to cover two-storey HMOs.</p>
<p>But HMOs vary widely in terms of their size, occupancy, building type and amenities, which makes them immensely challenging for local authorities to regulate. These same local authorities suffered <a href="https://www.instituteforgovernment.org.uk/explainer/local-government-funding-england">major reductions</a> to their funding from central government in the ten years prior to the COVID pandemic, and council leaders <a href="https://www.theguardian.com/politics/2023/nov/26/jeremy-hunt-budget-cuts-chancellor-threat-flagship-councils-england-bankrupt">are warning</a> they are likely to face “a new wave of austerity” during the next parliament, whoever is in power.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/4M7Aoj6gtrI?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">The Tower Next Door: Living in the Shadow of Grenfell – a documentary by the Guardian.</span></figcaption>
</figure>
<h2>Fire <em>does</em> discriminate</h2>
<p>Contrary to the popular mantra that fire doesn’t discriminate, the poor and disadvantaged in UK and other societies are <a href="https://www.theguardian.com/inequality/2017/jul/11/grenfell-tower-tragedy-worldwide-truth-fire-is-an-inequality-issue">disproportionately affected by fire</a> because they are forced to live in unsafe or overcrowded housing.</p>
<p>Over a span of more than 40 years, the fires at Clanricarde Gardens, Gloucester Place, Grenfell Tower and Maddocks House – and many others besides – show us that residents who raise safety concerns with their landlords are too often ignored or dismissed as troublemakers.</p>
<p>The survivors, bereaved and local communities affected by fires have repeatedly called on the government to act more decisively and comprehensively in the interests of residents rather than landlords. In the wake of the Grenfell disaster, they have again spoken out bravely, holding senior ministers to account for their <a href="https://www.theguardian.com/uk-news/2017/jun/29/grenfell-tower-inquiry-judge-to-meet-residents-and-survivors">pledge</a> that “no stone will be left unturned” in the quest to learn lessons from Grenfell. While their representative bodies continue to fight for justice and safer housing, their legal counsel at the Grenfell inquiry <a href="https://assets.grenfelltowerinquiry.org.uk/documents/transcript/Transcript%207%20November%202022.pdf">warned</a> that, if we allow the lessons from Grenfell to be forgotten, we risk facing “another inquiry, following another disaster … where all the same points are being made”.</p>
<p>The UK government claims its response to Grenfell, via the <a href="https://www.gov.uk/guidance/the-building-safety-act">Building Safety Act</a> (2022), has been to introduce “groundbreaking reforms to give residents and homeowners more rights, powers and protections – so homes across the country are safer”. But this does not extend to large numbers of disadvantaged people and homeless families with children, all struggling to cope in the cost of living crisis.</p>
<p>Some landlords are adept at identifying loopholes in the legislation that enable them to evade their obligations towards tenants. Central government has been slow to close these or equip local authorities with the powers to force greater levels of compliance. There is little in the government’s “landmark” legislation (and related <a href="https://www.gov.uk/government/news/42-million-to-support-delivery-of-building-safety-reforms">safety funding plans</a>) that indicates any more willingness than its predecessors to tackle the problem of rogue landlords within the private rented sector.</p>
<p>As long ago as the 1980s, pioneering campaign organisations like the Campaign for Bedsit Rights (which <a href="https://www.lgcplus.com/archive/shelter-takes-over-campaign-for-bedsit-rights-10-12-1997/">became part of Shelter in 1997</a>) recognised that fire safety is a social equality issue. Forty years and many fires later, it is long overdue that everyone in a position of power recognises this principle – and acts upon it to reduce fire inequality. It is too late for Mizanur Rahman, who died inside Maddocks House, and for the 72 people who lost their lives in Grenfell Tower in 2017. How many more lives must be lost?</p>
<hr>
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<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p class="fine-print"><em><span>Shane Ewen received funding from an Arts and Humanities Research Council Standard Open Grant: Forged by Fire: Burns Injury and Identity in Britain, c.1800-2000. He would like to thank Anthony Iles (Tarling West TRA), Deborah Garvie (Shelter), Paul Hampton (Fire Brigades Union) and Rachel Rich (Leeds Beckett University) for their assistance with this article.</span></em></p>Fire is a social equality issue. Amid fresh concerns over rogue landlords and dangerous overcrowding, why have calls for change gone unheeded for so long?Shane Ewen, Professor of History, Leeds Beckett UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2192812023-12-07T17:28:07Z2023-12-07T17:28:07ZOCD is so much more than handwashing or tidying. As a historian with the disorder, here’s what I’ve learned<figure><img src="https://images.theconversation.com/files/563995/original/file-20231206-25-yjbxqt.jpg?ixlib=rb-1.1.0&rect=15%2C22%2C5077%2C3328&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/woman-touching-her-temples-hands-suffering-2196452389">Elena Abrazhevich/Shutterstock</a></span></figcaption></figure><p><em>Readers are advised that this article contains explicit discussion of suicide and suicidal and obsessional thoughts. If you are in need of support, contact details are included at the end of the article.</em> </p>
<hr>
<p>At the age of 12, “out of nowhere”, Matt says he started having repetitive thoughts concerning whether he wanted to end his life. Every time he saw a knife, he would ask himself: “Am I going to stab myself?” Or, when he was near a ledge: “Am I going to jump?”</p>
<p>Matt had heard a lot about teenage depression, and thought this must be what was going on. But it was confusing, he says: “I didn’t feel suicidal, I really enjoyed my life. I just had an intense fear of doing something to hurt myself.”</p>
<p>Shortly afterwards, pre-empted by hearing about a notorious banned film, Matt began questioning whether he, like the central character, might be a serial killer. These thoughts “kept coming and coming” and he would lie in bed running over scenarios, trying to work out whether he was “going crazy”:</p>
<blockquote>
<p>I really needed help. I didn’t know who to talk to. But it wasn’t on my radar to think about this as OCD.</p>
</blockquote>
<p>Obsessive-compulsive disorder (OCD) is a significant mental health diagnosis in the 21st century. The World Health Organization (WHO) lists it as <a href="https://www.bmj.com/content/348/bmj.g2183.long">one of the ten most disabling illnesses</a> in terms of loss of earning and reduced quality of life, and OCD is frequently cited as the fourth most common mental disorder globally after depression, substance abuse and <a href="https://www.nhs.uk/mental-health/conditions/social-anxiety/#:%7E:text=Social%20anxiety%20disorder%2C%20also%20called,better%20as%20they%20get%20older.">social phobia</a> (anxiety about social interactions).</p>
<p>Yet everything Matt knew about OCD, he tells me, came from daytime talkshows where “people were washing their hands 1,000 times a day – it was all about external and really extreme behaviours”. And that didn’t feel like what he was going through.</p>
<hr>
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<hr>
<p>A similar experience is recounted in the 2011 book <a href="https://overcoming.co.uk/582/Taking-Control-Of-OCD---VealeWillson">Taking Control of OCD</a> by John (not his real name) who, after a colleague had taken their own life, became “inundated with thoughts” about what he might do to himself. Every time he crossed the road, John thought: “What would happen if I stopped moving and was run over by a bus?” He also had thoughts of murdering those he loved. John recalled:</p>
<blockquote>
<p>Try as I might, I just couldn’t chase the thoughts out of my head … When I tried to explain what was going on to my girlfriend, I couldn’t find a way of articulating what was happening to me … At the time, I thought OCD was all about triple-checking you had locked the front door and that your drawers were tidy.</p>
</blockquote>
<p>Despite the prevalence of OCD in contemporary society, the experiences of Matt and John reflect two important features of this disorder. First, that the stereotype of OCD is one of washing and checking behaviours – the <a href="https://www.nhs.uk/mental-health/conditions/obsessive-compulsive-disorder-ocd/overview/">compulsions</a> aspect, defined clinically as “repetitive behaviours that a person feels driven to perform”. And that obsessions – defined as “<a href="https://www.nhs.uk/mental-health/conditions/obsessive-compulsive-disorder-ocd/overview/">unwanted, unpleasant thoughts</a>” often of a harmful, sexual or blasphemous nature – are viewed as obscure, confusing and unrecognisable as OCD.</p>
<p>People who experience obsessional thoughts are therefore frequently unable to identify their symptoms as OCD – and <a href="https://pubmed.ncbi.nlm.nih.gov/26132683/">neither</a>, very often, are the experts they see in clinical settings. Due to mischaracterisations of the disorder, OCD sufferers with non-typical, less visible presentations usually <a href="https://www.sciencedirect.com/science/article/pii/S2666915321001578?via%3Dihub">go undiagnosed for ten or more years</a>.</p>
<p>When John visited his GP, he was diagnosed with depression. He recalled that the GP concentrated more on the visible effects of his distress - a lack of appetite and disrupted sleeping patterns. The thoughts remained invisible. As he put it:</p>
<blockquote>
<p>I don’t know how you’re supposed to tell someone you don’t know that you have thoughts about killing people you love.</p>
</blockquote>
<p>Even for those with “textbook” OCD such as my friend Abby, “the compulsion is just the tip of the iceberg”. Abby was able to self-diagnose at the age of 12, when she experienced handwashing and locking door compulsions. She says people still think of her as “Abby [who] likes to wash her hands a lot”.</p>
<p>Now, she tells me, “I realise that I have no interest in washing my hands – I’m a pretty messy person, and I don’t mind other people being messy.” Rather than a love of cleaning, her acts were related to the altogether scarier obsessional thought: “What if I am going to hurt other people?”</p>
<p>Clinical guidelines, such as those provided in the UK by the <a href="https://www.nice.org.uk/guidance/cg31/resources/obsessivecompulsive-disorder-and-body-dysmorphic-disorder-treatment-pdf-975381519301">National Institute for Health and Care Excellence</a>, define OCD as being characterised by both compulsions <em>and</em> obsessions. So, why do the difficulties encountered by Matt, John and Abby – of recognising the internal thoughts that dominate their lives – appear to be <a href="https://letsqueerthingsup.com/2018/05/12/i-didnt-know-i-had-ocd-heres-why-the-stereotypes-are-so-harmful/">so common</a>?</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/564001/original/file-20231206-27-hklxdx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Wordcloud for obsessive-compulsive disorder (OCD)" src="https://images.theconversation.com/files/564001/original/file-20231206-27-hklxdx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/564001/original/file-20231206-27-hklxdx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=383&fit=crop&dpr=1 600w, https://images.theconversation.com/files/564001/original/file-20231206-27-hklxdx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=383&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/564001/original/file-20231206-27-hklxdx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=383&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/564001/original/file-20231206-27-hklxdx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=481&fit=crop&dpr=1 754w, https://images.theconversation.com/files/564001/original/file-20231206-27-hklxdx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=481&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/564001/original/file-20231206-27-hklxdx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=481&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">OCD is a multifaceted disorder, yet understanding tends to focus on the visual, compulsive aspect.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/obsessive-compulsive-disorder-ocd-word-cloud-1786299122">Colored Lights/Shutterstock</a></span>
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<h2>My experience of OCD</h2>
<p>From the age of 16, I have also suffered with thoughts that I later came to associate with OCD, but which began as invisible and tormenting. An article I wrote in 2014, entitled <a href="https://www.ocduk.org/the-unseen-obsession/">The Unseen Obsession</a>, described my experience of having left university midway through my studies due to a single thought that gathered “such power that I even ended up attacking my body in an attempt to eliminate its force”. I wrote:</p>
<blockquote>
<p>I have suffered with obsessional thoughts for the last four years, and can safely say that [OCD] is far from being about clean hands.</p>
</blockquote>
<p>My obsessions have taken many forms since my teenage years. They began with me wondering whether things really existed, whether my parents were really who they said they were, and whether I wanted to harm – and was a risk to – my family, friends, even my dog.</p>
<p>Many of us know what it is like to ruminate about a person, a conflict, or something else we feel anxious about. But for those with obsessional thoughts (diagnosed or otherwise), this is quite different to simply “overthinking”. As I attempted to explain in my article:</p>
<blockquote>
<p>Conversations falter as the thought leaps through your mind. Other topics seem less important, and time to yourself provides space to assess, analyse, and look for evidence of the thought being ‘true’ … [Obsessing] is like fighting: you push and shove your thoughts away and they come back with twice as much force. You spend time trying to avoid them and they pop up everywhere, taunting and mocking your failed attempt at running away.</p>
</blockquote>
<p>It took me six months of weekly therapy sessions before I felt able to voice my obsessional thought to my therapist – someone I had known for a number of years. My unwillingness to be open about it was not only tied up with feelings of shame about its taboo content, but also my inability to see such thinking as part of a recognised disorder.</p>
<p>The question of what constitutes OCD, why we understand – and misunderstand – it as we do, as well as my own experience of living with it, led me to study <a href="https://www.cambridge.org/core/journals/british-journal-for-the-history-of-science/article/visible-compulsions-ocd-and-the-politics-of-science-in-british-clinical-psychology-19481975/D431B7D6003860F9E6ABE50476BA46A4">how OCD became recognised and categorised as a mental health disorder</a>.</p>
<p>In particular, my research shows that there are important insights to be gained from the research decisions made by a group of influential clinical psychologists in south London in the early 1970s – shedding light on why so many people, myself included, still struggle to recognise and make sense of our obsessional thoughts.</p>
<h2>The origin of the concepts</h2>
<p>Categories of mental illness are not stable across time. As medical, scientific, and public knowledge about an illness changes, so does how it is experienced and diagnosed.</p>
<p>Prior to the 1970s, “obsessions” and “compulsions” did not exist in a unified category – rather, they appeared in an array of psychiatric classifications. At the start of the 20th century, for example, British doctor James Shaw <a href="https://www.cambridge.org/core/services/aop-cambridge-core/content/view/8D219344EF697D92E69BF9ED60F8508B/S000712500016204Xa.pdf/verbal-obsessions.pdf">defined</a> verbal obsessions as “a mode of cerebral activity in which a thought – mostly obscene or blasphemous – forces itself into consciousness”.</p>
<p>Such cerebral activity could, according to Shaw, arise in hysteria, <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/neurasthenia">neurasthenia</a>, or as a precursor to delusions. One of his patients – a woman who experienced “irresistible, obscene, blasphemous and unutterable thoughts” – was diagnosed with obsessional melancholia, a “form of insanity”.</p>
<p>The symptom arose from what Shaw defined as “nervous weakness”, an explanation that reflected the <a href="https://academic.oup.com/book/25373/chapter-abstract/192459930?redirectedFrom=fulltext">broader 19th-century view</a> that obsessional thoughts were indicative of a fragile nervous system – either inherited, or weakened through overwork, alcohol or promiscuous behaviour (described as “<a href="https://pubmed.ncbi.nlm.nih.gov/3514404/">degeneration theory</a>”). Notably, Shaw did not mention any form of repetitive behaviour in relation to these verbal obsessions.</p>
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<a href="https://images.theconversation.com/files/563989/original/file-20231206-15-nk8woa.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Bearded man holding a cigar" src="https://images.theconversation.com/files/563989/original/file-20231206-15-nk8woa.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/563989/original/file-20231206-15-nk8woa.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=844&fit=crop&dpr=1 600w, https://images.theconversation.com/files/563989/original/file-20231206-15-nk8woa.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=844&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/563989/original/file-20231206-15-nk8woa.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=844&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/563989/original/file-20231206-15-nk8woa.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1061&fit=crop&dpr=1 754w, https://images.theconversation.com/files/563989/original/file-20231206-15-nk8woa.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1061&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/563989/original/file-20231206-15-nk8woa.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1061&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Sigmund Freud, founder of psychoanalysis.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Sigmund_Freud_LIFE.jpg">Max Halberstadt via Wikimedia Commons</a></span>
</figcaption>
</figure>
<p>At a similar time to Shaw’s writings, Sigmund Freud, the Austrian founder of psychoanalysis, developed his psychoanalytic category of “<a href="https://journals.sagepub.com/doi/10.1177/0957154X9800903504">Zwangsneurose</a> – translated in Britain as "obsessional neurosis” and in the US as “compulsion neurosis”. In Freud’s <a href="https://www.mhweb.org/freud/ratman1.pdf">writings</a>, the “Zwang” referred to persistent ideas that emerged from a repressed conflict between unresolved childhood impulses (those of love and hate) and the critical self (ego).</p>
<p>Freud’s <a href="https://ia802907.us.archive.org/17/items/SigmundFreud/Sigmund%20Freud%20%5B1909%5D%20Notes%20Upon%20A%20Case%20Of%20Obsessional%20Neurosis%20%28The%20Rat%20Man%20Case%20History%29%28James%20Strachey%20Translation%201955%29.pdf">most famous case study</a>, published in 1909, featured the “Rat Man”, a former Austrian army officer who possessed a variety of elaborate symptoms. In the first instance, he had become obsessed that he would fall victim to a horrific rat-based punishment that had been recounted to him by a colleague. The patient also expressed that if he had certain desires such as a wish to see a woman naked, his already-deceased father “will be bound to die”.</p>
<p>The Rat Man was described by Freud as engaging in a “system of ceremonial defences” and “elaborate manoeuvres full of contradictions” that have been read by some as the behavioural aspects of what would become OCD. However, there are crucial differences between the “defences” of Freud’s client and the compulsions of OCD, including that the former largely involved thinking rather than acting, and were by no means consistent or stereotyped.</p>
<hr>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption"></span>
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
<hr>
<p>The psychoanalytic category of “obsessional neurosis” was adopted and modified in Britain during the first world war, and became a staple – but inconsistently defined – diagnosis in British psychiatric textbooks of the inter-war period. Up to the 1950s, the terms “obsession” and “compulsion” were being used interchangeably in psychiatric writing. The complexity surrounding their meaning is demonstrated in the <a href="https://www.google.co.uk/books/edition/Inquiries_in_Psychiatry_Clinical_and_Soc/JsZrAAAAMAAJ?hl=en">writings of Aubrey Lewis</a>, a leading figure in post-war British psychiatry, who referred to “obsessional illnesses” as being made up of “compulsive thoughts” and “compulsive inner speech”.</p>
<p>Like Freud, Lewis mentioned the “complex rituals” of the obsessional – such as the patient “who is perpetually putting himself in the greatest trouble to ensure that he never steps on a worm inadvertently”. But he cautioned against “the dangers of associating any kind of repetitious activity with obsessionality”, writing that “it certainly cannot be judged on behaviourist grounds”.</p>
<h2>Defining OCD by visible behaviour</h2>
<p>OCD began to emerge in the form we recognise it today from the early 1970s – and was established as a formal psychiatric disorder through its inclusion in the third and fourth editions of the American Psychiatric Association’s <a href="https://aditpsiquiatriaypsicologia.es/images/CLASIFICACION%20DE%20ENFERMEDADES/DSM-III.pdf">Diagnostic and Statistical Manual</a> (commonly known as DSM-III and DSM-IV) in 1980 and 1994.</p>
<p>The centrality of visible and measurable behaviours in the categorisation of OCD – particularly washing and checking – can be traced back to a series of experiments conducted by clinical psychologists in the early 1970s at the Institute of Psychiatry and the Maudsley Hospital in south London.</p>
<p>Under the direction of South African psychologist Stanley Rachman, the complex array of symptoms contained in the categories of obsessional illness and obsessional neurosis were divided into two: “visible” compulsive rituals, and “invisible” obsessional ruminations. While Rachman and his colleagues conducted a large research programme on compulsive behaviours, obsessions were relegated to the backburner.</p>
<p>For example, in <a href="https://www.sciencedirect.com/science/article/pii/000579677190009X">their investigation</a> of ten psychiatric inpatients diagnosed with obsessional neurosis, “compulsions had to be present for entry into the trial and patients complaining of ruminations were excluded” – a statement reiterated throughout subsequent experiments.</p>
<p>Indeed, this study did not merely require patients to exhibit some form of visible compulsion. The ten patients included were exclusively those with “visible handwashing” behaviour, which was viewed as the “easiest” symptom to experiment on. Likewise, the second round of studies only included patients who engaged in visible “checking” behaviour, such as whether a door was unlocked.</p>
<p>In a <a href="https://www.sciencedirect.com/science/article/pii/0005796771900088">1971 paper</a>, Rachman offered his rationale for taking this approach, explaining how “obsessional ruminators raise special problems for the clinical psychologist because of their subjective, private nature”. This, he argued, was in contrast with “the other main feature of obsessional neurosis, compulsive behaviour, which can be approached with greater ease. It is visible, has a predictable quality, and many reproducible analogies in animal research”.</p>
<p>Rachman viewed compulsions as “visible” and “predictable” in large part due to the way clinical psychology had developed as a new profession in Britain, at the Maudsley Hospital in particular, in the decades following the second world war. To differentiate their practice from the existing mental health professions of psychiatry (medically trained doctors specialising in mental health) and psychoanalysis (talking therapy derived from Freud), these early clinical psychologists presented themselves as “<a href="https://www.bps.org.uk/psychologist/eysenck-and-development-cbt">applied scientists</a>” who brought scientific methods from the laboratory to a clinical setting. Their conception of science was rooted in empiricism – with an emphasis on visibility, measurability and experimentation.</p>
<p>As part of this commitment to empirical science, these clinical psychologists adopted a <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Fh0054288">model of anxiety</a> derived from 20th-century behaviourism. This focus on observable behaviour was <a href="https://www.cambridge.org/core/journals/journal-of-mental-science/article/abs/learning-theory-and-behaviour-therapy/38CA4A9BC0CA773F6BEE93EDDC71584F">viewed as</a> having much greater scientific value than psychoanalysis, which dealt with the “<a href="https://www.taylorfrancis.com/books/mono/10.4324/9780203766767/causes-cures-neurosis-psychology-revivals-eysenck-rachman">unverifiable</a>” and “unscientific” realm of thoughts and thinking.</p>
<p>So, when obsessional ruminations gained a renewed focus in the mid-1970s, it was through this lens of visible compulsive behaviours. Rachman and his colleagues started talking about “mental compulsions” (such as saying a good thought after a bad thought) as “equivalent to handwashing”- rather than focusing on the importance and content of these thoughts in their own right.</p>
<p>In the early 1980s, clinical psychology came under pressure from cognitive psychologists (those concerned with thinking and language) for its reductive focus on behaviour. But despite this move to <a href="https://www.sciencedirect.com/science/article/abs/pii/0005796785901056">include cognitive approaches</a>, the centrality of visible behavioural compulsions has continued to characterise perceptions of OCD in cultural and clinical domains. </p>
<p>This is perhaps most evident in media portrayals of the disorder – a critique taken up by cultural scholars such as <a href="https://www.tandfonline.com/doi/abs/10.1080/01639625.2013.872526">Dana Fennell</a>, who look at representations of OCD in TV and film.</p>
<p>The archetypal portrayal of OCD has <a href="https://www.ocduk.org/david-beckham-documentary-our-statement/">not been helped</a> by the recent publicity given to David Beckham and his <a href="https://www.mirror.co.uk/news/health/david-beckham-ocd-update-football-31102545">extensive tidying</a>. When I ask Abby what she thought about the <a href="https://www.theguardian.com/football/2023/apr/28/david-beckham-ocd-obsessive-compulsive-disorder-netflix-documentary">attention</a> that Beckham’s OCD was receiving in the media, she replies: “It’s so boring. It’s the same presentation that always gets thought of as OCD.”</p>
<h2>Limitations to the ‘gold standard’ treatment</h2>
<p>This archetypal portrayal of OCD also relates to how it is treated. The <a href="https://www.dovepress.com/getfile.php?fileID=54942">“gold standard” treatment</a> in the UK today is the behavioural technique of <a href="https://www.ocduk.org/overcoming-ocd/accessing-ocd-treatment/exposure-response-prevention/">exposure and ritual prevention</a> (ERP), either on its own or combined with cognitive therapy. ERP gained acceptance from the experiments of Rachman and colleagues in the early 1970s, when they were exclusively working with patients with observable behaviours.</p>
<p>One of their <a href="https://www.sciencedirect.com/science/article/abs/pii/S0005796772800032">key studies</a> involved patients from the Maudsley Hospital who repeatedly washed their hands. They were told to touch smears of dog excrement and put hamsters in their bags and in their hair, while being prevented from washing for increased lengths of time.</p>
<p>Such experiments were again governed by observability and measurability. The “success” of ERP treatment – and its perceived superiority over psychiatric and psychoanalytic methods – was demonstrated by a reduction in the patients’ visible handwashing behaviour.</p>
<p>Today, if you are diagnosed with OCD by a psychiatrist and given OCD-specialist treatment via the NHS, you will most likely be told to undergo the same kind of ERP procedure that hospital inpatients were experimentally given in the 1970s: touching a set of items that you fear (exposure) while being prevented from engaging in your usual compulsive behaviour.</p>
<p>An identical method is also used when it comes to obsessional thoughts. Patients are asked to identify their worrying obsession, then either expose themselves to provoking situations or repeat the thought in their mind without engaging in “mental compulsions” – such as counting, replacing a bad thought with a good thought, or trying to “solve” the content of the obsessional thought.</p>
<p>It’s certainly true that this form of behavioural therapy can be <a href="https://www.dovepress.com/getfile.php?fileID=54942">hugely helpful</a> in the treatment of OCD symptoms. Abby, after undergoing ERP for 14 years, said she had “developed a lot of practices around not giving into my [washing and checking] compulsions”.</p>
<p>I also found the approach beneficial in reducing the threatening quality of my obsessional thoughts. Repeating “I want to hurt my family” or “I don’t really exist” to myself over and over again, without actually trying to solve these issues, reduced the time I spent ruminating.</p>
<p>However, while being a huge advocate of ERP, Abby also observed that “sometimes when I get rid of a compulsion, it doesn’t mean I just get rid of the obsession.” While the “outward compulsions” disappear, “it doesn’t mean my mind stops cycling and mental questioning”.</p>
<p>Some contemporary clinicians have referred to ERP, designed around visible symptom reduction, as a “<a href="https://www.justinkhughes.com/wp-content/uploads/2021/03/ocd_texas_talk_with_molly_and_justin_2019__22common_pitfalls_of_erp_for_ocd_22.pdf">whack-a-mole technique</a>” – you get rid one symptom (obsession or compulsion) and another pops up.</p>
<p>ERP is frequently accompanied with cognitive therapy techniques, such as <a href="https://www.apa.org/pubs/books/supplemental/Treatment-for-Postdisaster-Distress/Handout-27.pdf">cognitive restructuring</a> (identifying beliefs and providing evidence for and against them), or being told that obsessions are “just thoughts”, that they are meaningless, and that you do not want to enact them.</p>
<p>Despite the success of cognitive-behaviour therapy (CBT) and ERP in scientific trials, a <a href="https://www.sciencedirect.com/science/article/pii/S0010440X21000018?via%3Dihub">major review of evidence</a> in 2021 questioned whether the effects of the approach in treating OCD had been overstated – reflecting the high proportion of OCD cases that are designated as “<a href="https://www.ncbi.nlm.nih.gov/books/NBK551808/">treatment resistant</a>”. </p>
<p>I also believe there are some crucial limitations to contemporary treatments for OCD. Exposure (ERP) techniques stem from a period in which thoughts were not being considered at all by clinical psychologists, while CBT designates the content of obsessional thoughts as unimportant. Matt, like me, has found that CBT “can only take you so far”, explaining:</p>
<blockquote>
<p>Part of this was that [CBT therapists] are so committed to the idea that thoughts don’t have meaning … [They] treat your symptom and once those are gone, you should get on with your life. I didn’t find that there was a way of thinking about [my] ruminations in the context of my whole life.</p>
</blockquote>
<h2>Experiences of alternative treatments</h2>
<p>So much of my understanding about OCD has changed since I first wrote about it for <a href="https://www.rethink.org/aboutus/">Rethink Mental Illness</a> almost a decade ago. Thinking about the historical development and categorisation of OCD has, it turns out, given me a greater sense of ease regarding this widely misunderstood condition. I feel less bound by our current conceptual frameworks, and more able to reflect on what I think is helpful in terms of how to successfully manage my obsessional thoughts.</p>
<p>For example, despite being warned away from psychoanalysis from a young age (my mum is a clinical psychologist, and psychologists are often fervently anti-psychoanalytic!), I have found psychoanalysis incredibly helpful in becoming comfortable with my thoughts. </p>
<p>This is because CBT typically focuses on present symptoms without looking into their meaning or how they relate to your personal history, and this comes into tension with my desire, as a historian, to think about the past. In contrast, psychoanalysis locates obsessional thoughts in history – pointing to childhood as a crucial point of psychic development. I have been able to understand my obsessions as the result of a deep childhood fear concerning the death of my loved ones, from which I developed a rigid desire for control.</p>
<p>As a young teenager trying to determine what was going on with him, Matt went to the public library and took out a <a href="https://ia903102.us.archive.org/15/items/petergay1989freudreader/Adam%20Phillips%20%5B2006%5D%20Penguin%20Freud%20Reader.pdf">Freud reader</a>. He describes this as “the worst possible thing for a 14-year-old to read”, as it made him believe “that I did really have all these [murderous suicidal] impulses and all my fears are true”.</p>
<p>Despite this experience, while training to become a social worker, he “got into psychoanalysis as an alternate way to think about therapy and think about my own experience”. For him, psychoanalysis revealed the opposite to the image of “OCD as handwashing”.</p>
<p>Instead, he says, it focused on the aspects of “obsessionality that are internal”, showing him that the “mind is so powerful that it can produce a lot of imaginary fears”. It also allowed him to see “OCD symptoms as wrapped up with my whole life”.</p>
<p>Particularly profound in psychoanalytic thought is the acceptance of the complexity and unknowability at the heart of human experience. As Jaqueline Rose, professor of humanities at Birkbeck, University of London, <a href="https://fitzcarraldoeditions.com/books/the-plague">wrote:</a>: </p>
<blockquote>
<p>Psychoanalysis begins with a mind in flight, a mind that cannot take the measure of its own pain. It begins, that is, with the recognition that the world – or what Freud sometimes refers to as ‘civilisation’ – makes demands on human subjects that are too much to bear.</p>
</blockquote>
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<a href="https://images.theconversation.com/files/563998/original/file-20231206-17-435y0w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Illustration of a woman with eyes closed holding her temples." src="https://images.theconversation.com/files/563998/original/file-20231206-17-435y0w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/563998/original/file-20231206-17-435y0w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/563998/original/file-20231206-17-435y0w.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/563998/original/file-20231206-17-435y0w.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/563998/original/file-20231206-17-435y0w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/563998/original/file-20231206-17-435y0w.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/563998/original/file-20231206-17-435y0w.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/woman-touching-her-temples-hands-suffering-2156846349">Elena Abrazhevich/Shutterstock</a></span>
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<p>This idea of “a mind in flight” has helped me think about my obsessions – whether my parents are really who they say they are; am I going to hurt those I love? – as part of a battle for certainty and control that is both unattainable and understandable, considering the world we live in.</p>
<p>The aim of psychoanalytic treatment is not to eradicate symptoms but to bring to light the difficult knots that humans have to deal with. Matt refers to psychoanalysis as acknowledging “a sort of messiness of the mind … I’ve found the psychoanalytic view of accepting your own messiness extremely helpful”. Rose similarly describes psychoanalysis as “the opposite of housework in how it deals with the mess we make”.</p>
<p>In the UK, psychoanalysis has been rejected within NHS service provision. And I believe this is, at least in part, a result of historical critiques levelled at it by clinical psychologists as they developed behaviour therapies to treat OCD in the late 20th century.</p>
<h2>‘A lot of emotion and sadness’</h2>
<p>While compulsive behaviour such as handwashing and checking is widely perceived as “representative” of OCD, the tormenting experience of having obsessional thoughts is still rarely acknowledged and discussed. The <a href="https://www.theguardian.com/commentisfree/2019/feb/21/ocd-sex-disorder-pure-rose-cartwright">shame and confusion</a> attached to such thoughts, coupled with the feeling of being misunderstood, make this an important issue to address, particularly when <a href="https://www.madeofmillions.com/articles/pure-o-an-exploration-into-a-lesser-known-form-of-ocd">misdiagnosis of OCD</a> is so high.</p>
<p>My <a href="https://www.cambridge.org/core/journals/british-journal-for-the-history-of-science/article/visible-compulsions-ocd-and-the-politics-of-science-in-british-clinical-psychology-19481975/D431B7D6003860F9E6ABE50476BA46A4">PhD on the history of OCD</a> has also showed me the ways in which psychological research shapes how we conceive of diagnostic categories – and consequently, ourselves. While psychology’s commitment to objectivity, empiricism and visibility has provided tools that are tremendously useful in the clinic, my research sheds lights on how the often-exclusive focus on visible symptoms has at times trumped the appreciation of the complex experience of having obsessional thoughts.</p>
<p>I first met Matt in 2019 at the first <a href="https://ocdinsociety.wixsite.com/home/2019">OCD in Society</a> conference, held at Queen Mary University of London, where he was giving a presentation on the “multiple meanings of OCD”. We discussed our own experiences of the disorder, and what we thought that history, psychoanalysis and anthropology could contribute to understandings of OCD.</p>
<p>Matt was 34, and he told me this was the first time he “had ever voiced the internal stuff out loud, and heard other people talk about it”. Recalling how this made him feel, he continued:</p>
<blockquote>
<p>I felt a lot of emotion and sadness. The isolation had been such a big part of my life that I had stopped noticing it. Then being out of the isolation was such a relief, it made me realise how bad it had been.</p>
</blockquote>
<hr>
<p><em>If you are experiencing suicidal thoughts and need support, you can call your GP, <a href="https://www.nhs.uk/nhs-services/urgent-and-emergency-care-services/when-to-use-111/">NHS 111</a>, or free helplines including <a href="https://www.samaritans.org/">Samaritans</a> (116 123), <a href="https://www.thecalmzone.net/">Calm</a> (0800 585858) or <a href="https://papyrus-uk.org/">Papyrus</a> (0800 068 4141).</em></p>
<p><em>In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found <a href="http://www.suicide.org/international-suicide-hotlines.html">here</a>.</em></p>
<hr>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em>For you: more from our <a href="https://theconversation.com/uk/topics/insights-series-71218?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insights series</a>:</em></p>
<ul>
<li><p><em><a href="https://theconversation.com/how-to-solve-our-mental-health-crisis-214776?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">How to solve our mental health crisis</a></em></p></li>
<li><p><em><a href="https://theconversation.com/how-music-heals-us-even-when-its-sad-by-a-neuroscientist-leading-a-new-study-of-musical-therapy-214924?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">How music heals us, even when it’s sad – by a neuroscientist leading a new study of musical therapy
</a></em></p></li>
<li><p><em><a href="https://theconversation.com/unlocking-new-clues-to-how-dementia-and-alzheimers-work-in-the-brain-uncharted-brain-podcast-series-194773?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Unlocking new clues to how dementia and Alzheimer’s work in the brain – Uncharted Brain podcast series
</a></em></p></li>
</ul>
<p><em>To hear about new Insights articles, join the hundreds of thousands of people who value The Conversation’s evidence-based news. <a href="https://theconversation.com/uk/newsletters/the-daily-newsletter-2?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK"><strong>Subscribe to our newsletter</strong></a>.</em></p><img src="https://counter.theconversation.com/content/219281/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Eva Surawy Stepney receives funding from the Arts and Humanities Research Council (AHRC) via the White Rose College of the Arts and Humanities (WRoCAH). </span></em></p>Research decisions made by clinical psychologists in the 1970s can help explain why so many people, myself included, struggle to make sense of our obsessional thoughts.Eva Surawy Stepney, PhD Candidate in History, University of SheffieldLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2186292023-11-30T10:21:06Z2023-11-30T10:21:06ZPalantir: privacy fears over handing NHS data to US defence provider show how lack of trust is holding back much-needed reform<figure><img src="https://images.theconversation.com/files/562145/original/file-20231128-29-yf36gf.jpg?ixlib=rb-1.1.0&rect=613%2C49%2C6769%2C4978&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/clerk-leafing-through-stored-folders-looking-2254682601">Shutterstock/Marian Weyo</a></span></figcaption></figure><p>Controversial US tech company Palantir <a href="https://www.england.nhs.uk/2023/11/new-nhs-software-to-improve-care-for-millions-of-patients/">has been awarded a £330 million contract</a> to create a new system for sharing data – including patients’ medical details – within the NHS in England. </p>
<p>The move has been <a href="https://www.england.nhs.uk/2023/11/new-nhs-software-to-improve-care-for-millions-of-patients">welcomed by NHS leaders</a> as a way to enable healthcare workers to access live healthcare data at the “touch of a button”. But doctors’ organisations and human rights charities have <a href="https://www.theguardian.com/society/2023/nov/21/patient-privacy-fears-us-spy-tech-firm-palantir-wins-nhs-contract">expressed concerns</a> <a href="https://www.nytimes.com/2023/11/21/business/palantir-nhs-uk-health-contract-thiel.html">about the contract</a> and Palantir, including whether patient data would be suitably protected.</p>
<p>The NHS is in desperate need of a better way to share information between the many care organisations that comprise it. The inability of its many existing data systems to talk to each other can lead to delays in care, poor understanding of local health service needs and hide inequalities in <a href="https://www.health.org.uk/publications/long-reads/how-better-use-of-data-can-help-address-key-challenges-facing-the-nhs">who gets care</a>.</p>
<p>However, our research shows the UK public are currently ambivalent about their medical data being handled by private companies. So actions that further increase mistrust risk holding back these vital reforms.</p>
<p>Data on the health of UK citizens is held in many databases across GP practices, hospitals, health authorities, care homes, pharmacies and many other organisations. This means a doctor seeing a patient from a different area of the UK would typically not be able to rapidly access their hospital records.</p>
<p>But we know things can be different. Close to real-time <a href="https://www.thelancet.com/journals/landig/article/PIIS2589-7500(22)00147-9/fulltext#seccestitle30">information</a> on the trajectory of the COVID pandemic helped coordinate a <a href="https://www.instituteforgovernment.org.uk/publication/government-data-sharing-pandemic">nationwide response</a>. (And some of these new capabilities were actually <a href="https://www.england.nhs.uk/contact-us/privacy-notice/how-we-use-your-information/covid-19-response/nhs-covid-19-data-store/">facilitated by Palantir</a>.)</p>
<p>Sadly, the post-pandemic benefits of data sharing for patients with other conditions have been short-lived. Regulations have, for the most part, returned to pre-pandemic restrictions and data put back in silos.</p>
<h2>Palantir’s trust problem</h2>
<p>So a new system for sharing data across the NHS is vital. The issue highlighted by awarding the new contract to Palantir is how important public trust is to successful reform, and how missteps could damage that trust.</p>
<p>Palantir’s detractors, such as <a href="https://www.youtube.com/watch?v=HlHPOH2s4Xg">Conservative MP David Davis</a>, say questions remain over whether it can be trusted with private information due, in part, to its <a href="https://www.washingtonpost.com/business/2019/08/22/war-inside-palantir-data-mining-firms-ties-ice-under-attack-by-employees/">record</a> of working with intelligence, immigration and military organisations in the US and its founder’s financial backing for the successful 2016 Trump <a href="https://www.washingtonpost.com/business/2019/08/22/war-inside-palantir-data-mining-firms-ties-ice-under-attack-by-employees/">presidential campaign</a>. </p>
<p>Privacy concerns have also been raised, by groups <a href="https://www.theguardian.com/society/2023/nov/20/nhs-england-gives-key-role-in-handling-patient-data-to-us-spy-tech-firm-palantir">including the British Medical Association</a>, about whether confidential data will be seen by Palantir and other organisations outside of the NHS. </p>
<p>In a <a href="https://www.youtube.com/watch?v=HlHPOH2s4Xg">television interview</a> with Palantir’s CEO Alex Karp shortly before the announcement, concerns were raised about them selling NHS patient data. In response, Karp <a href="https://www.bbc.co.uk/news/technology-67254010">told the BBC</a>: “We’re the only company of our size and scale that doesn’t buy your data, doesn’t sell your data, doesn’t transfer it to any other company … That data belongs to the government of the United Kingdom.”</p>
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<p>However, if the public start to feel that their data will not be protected, it could erode the already limited trust they have in private companies to be involved in the NHS.</p>
<p>Our research is attempting to identify public attitudes to NHS data sharing. We work on Datamind – the Medical Research Council and Health Data Research UK’s Mental Health Data Hub. We have published <a href="https://bmjopen.bmj.com/content/12/4/e057579">a large-scale assessment</a> of UK public opinion on NHS data sharing, which consulted almost 30,000 people. While the public are highly supportive of data sharing with the NHS, charities and university researchers, they are less trustful of private companies. </p>
<p>Meanwhile, previous examples of NHS-industry data sharing collaborations have not helped and show what can happen if trust isn’t secured. <a href="https://www.england.nhs.uk/wp-content/uploads/2015/07/care-data-Quick-reference-guide-v1.0.pdf">Care.data</a> was a programme that aimed to increase the range of health information collected across all NHS funded services, including general practice, for service planning and research. </p>
<p>It was explicitly stated that information would only be shared with industry for the benefit of health and care, such as developing new drugs, but not where it was solely for commercial purposes, such as insurance or marketing. Despite this, the <a href="https://www.theguardian.com/technology/2016/jul/06/nhs-to-scrap-single-database-of-patients-medical-details">programme was scrapped</a> because of remaining concerns over who would be allowed to see confidential patient data, what it would be used for and whether patients would have the ability to opt-out. </p>
<h2>What can be done to improve trust?</h2>
<p>We believe that the sharing of patient data across NHS datasets could have enormous public health benefits that improve outcomes across the whole of medicine. But to achieve that, there has to be trust in the private companies that will inevitably be involved.</p>
<p>As we sit in our clinics, medical staff view and enter electronic health records on a Dell computer running Windows software manufactured by Microsoft that uses a patient record management system provided by the <a href="https://www.intersystems.com/uk/about-us/">InterSystems</a> Corporation. In other words, many services in the NHS are already provided by commercial companies. </p>
<p>There is a pressing need for the public to have the knowledge, language and skills to properly engage in nuanced conversations about the use of their data and to build trust in its responsible use where appropriate. </p>
<p>We developed an online <a href="https://datamind.org.uk/patients-and-public/data-literacy-short-course-2/">data literacy course</a> for the public with our <a href="https://datamind.org.uk/patients-and-public/the-super-research-advisory-group/">Research Advisory Group</a> and the patient engagement charity <a href="https://mcpin.org/">McPin</a>. We also developed a <a href="https://datamind.org.uk/glossary/">glossary tool</a> so people could quickly look up data science terms in easily understandable language. These allow people to effectively understand the information presented to them and ask difficult questions. </p>
<p>These conversations need to happen now. Otherwise we will lurch from one apparently misinformed data sharing crisis to another, further eroding public trust. This risks all the opportunities responsible safe and secure data sharing could provide. </p>
<p>Fundamentally, however, both government and industry need to prove that they are worthy of public trust. They need to commit to engaging the public as equal partners on the potential beneficiaries of this and other data sharing initiatives. We all need to know who stands to benefit from sharing our health data so that we can make truly informed decisions.</p><img src="https://counter.theconversation.com/content/218629/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Andrew M McIntosh receives funding from The Wellcome Trust, UKRI, The European Commission and the US National Institutes of Health. He is the Chief Scientist of Datamind, the Health Data Research UK Hub for Mental Health. </span></em></p><p class="fine-print"><em><span>Ann John receives funding from the MRC, MQ and Wellcome and is Principal investigator and Co-director of Datamind. She is a former Trustee at Samaritans and MQ.</span></em></p>The public are ambivalent about their medical data going to private companies, and missteps could erode vital trust.Andrew M McIntosh, Professor of Biological Psychiatry, The University of EdinburghAnn John, Clinical Professor of Public Health and Psychiatry, Swansea UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2184082023-11-27T17:01:47Z2023-11-27T17:01:47ZA Peruvian farmer is trying to hold energy giant RWE responsible for climate change – the inside story of his groundbreaking court case<p>On a crisp, sunny day high in the Peruvian Andes, two German judges gaze across a mountain lake to the towering white glaciers in the distance. Dark spots are visible on the pristine ice and, in quiet moments, the cold wind carries the sounds of creaking and cracking.</p>
<p>The judges, from the German city of Hamm, have flown more than 6,500 miles to witness the melting glaciers for themselves. It is May 2022 and their visit has taken more than three years to organise – and some intensive diplomatic negotiations between Peru and Germany. Also here, more than 4,500 metres above sea level, are five German and Austrian scientific experts flying drones to assess whether Lake Palcacocha poses a significant risk of flooding to the thousands of people in the valley below.</p>
<p>A throng of local Peruvian officials have tagged along too, to share their concerns about <a href="https://glacierlab.uoregon.edu/glacier-hazards-and-disasters/">glacier hazards</a> with the judges. Around two-dozen international journalists and four documentary film teams are in the area to <a href="https://www.washingtonpost.com/climate-environment/interactive/2022/peru-climate-lawsuit-melting-glacier/">cover the event</a>. But the judges have requested they stay away from the lake so the court can do its work.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/561132/original/file-20231122-15-2fn2tp.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A high-altitude blue lake surrounded by snow-capped mountains." src="https://images.theconversation.com/files/561132/original/file-20231122-15-2fn2tp.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/561132/original/file-20231122-15-2fn2tp.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/561132/original/file-20231122-15-2fn2tp.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/561132/original/file-20231122-15-2fn2tp.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/561132/original/file-20231122-15-2fn2tp.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/561132/original/file-20231122-15-2fn2tp.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/561132/original/file-20231122-15-2fn2tp.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Lake Palcacocha is fed by the region’s accelerating glacial melt.</span>
<span class="attribution"><a class="source" href="https://www.germanwatch.org/de/medienservice">Alexander Luna/Germanwatch</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
</figcaption>
</figure>
<p>The deep-blue water glistens ominously in the sunshine. The lake is fed by the region’s accelerating <a href="https://www.ipcc.ch/srocc/chapter/chapter-2/">glacial melt</a>, powered by warming temperatures that were long ago shown to be the <a href="https://par.nsf.gov/servlets/purl/10299146">result of human climate emissions</a>.</p>
<p>Lake Palcacocha is the subject of an <a href="https://climatecasechart.com/non-us-case/lliuya-v-rwe-ag/">unprecedented climate justice lawsuit</a>. On one side, a German energy giant that is said to be responsible for 0.47% of the world’s industrial greenhouse gas emissions. On the other, a Quechua-speaking farmer who had never travelled outside Peru until he joined this <a href="https://climatecase.org/en">groundbreaking legal challenge</a>.</p>
<h2>The unlikely plaintiff</h2>
<p>The Cordillera Blanca mountain range in the northern Peruvian Andes is a region shaped by disaster. In 1941, Lake Palcacocha’s banks broke, probably due to an avalanche, devastating the city of Huaraz downstream and killing around 2,000 people.</p>
<p>The region’s most devastating disaster occurred three decades later in 1970, when an earthquake caused another massive avalanche that <a href="https://en.wikipedia.org/wiki/1970_Huascar%C3%A1n_debris_avalanche">destroyed the town of Yungay</a> and nearby villages, burying 30,000 people (although many of the town’s children survived because they were attending a nearby circus show). The disaster left a deep impact on the area’s social and cultural fabric. Yungay was permanently relocated and authorities stepped up their efforts to monitor glacial hazards.</p>
<p>As well as being a farmer, Saúl Luciano Lliuya works here as a mountain guide, leading tourists up the icy peaks year after year. Now in his early 40s, he came of age at a time of unprecedented environmental change in his homeland. Avalanches and glacial floods <a href="https://www.preventionweb.net/news/peru-dangers-glacial-lake-floods-pioneering-and-capitulation#:%7E:text=Climate%20change%20is%20creating%20new,Cordillera%20Blanca%20to%20expand%20rapidly.">happen more and more often</a>, and he has lost a number of colleagues and friends. <a href="https://hess.copernicus.org/articles/20/2519/2016/">Flood modelling studies</a> show that Luciano Lliuya’s family home is in the danger zone if another large avalanche was to fall into Lake Palcacocha, causing its banks to burst.</p>
<p>As in many parts of the world, climate change has intensified existing vulnerabilities in the rural Andes while creating new dimensions of risk. Luciano Lliuya comes from an Indigenous population subjugated by Spanish colonisers that still faces marginalisation today. He grew up speaking Quechua at home and faced discrimination at school in Huaraz. Teachers only used Spanish and beat children for speaking their Indigenous language.</p>
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
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<p>In recent decades, an upsurge in mountain climbing tourism has created new opportunities for villagers such as Luciano Lliuya, who have traversed high altitudes since an early age. To them, mountains are more than just boulders and ice. “A mountain is a geological formation,” he says, “but another perspective is that the mountains nurture us. They are powerful beings of some sort … For me, the mountain is someone who gives you everything.”</p>
<p>Many of the local people make tribute payments to these mountains, hoping to avoid their wrath and guarantee plentiful harvests. Up at Lake Palcacocha, the villagers who oversee an early-warning flooding system installed by the Ancash region’s government also present ritual offerings to the mountains every month. They say that when they missed one in 2017, an avalanche crashed into the lake causing waves of several metres – but that time, the old safety dams held steady.</p>
<p>Luciano Lliuya too feels a deep responsibility for the mountains that are suffering as they <a href="https://www.mdpi.com/2071-1050/15/9/7610">lose their white covers</a>. Before summiting a peak on a climbing tour, he pays respect by laying coca leaves on the glacial ice. If he fails to show respect, he fears the mountain will show its anger.</p>
<p>Almost ten years ago, Luciano Lliuya was introduced via his father to a group of climate activists from the environmental NGO <a href="https://www.germanwatch.org/en/about">Germanwatch</a>. They discussed the chance to ask one of the world’s biggest greenhouse gas emitters, German energy giant RWE, to make a tribute payment to these mountains too.</p>
<p>If the case succeeds, it could set a global precedent to hold major polluters responsible for the effects of climate change, even on the other side of the world. Already, it has had a significant impact. After the case was <a href="https://www.theguardian.com/environment/2017/nov/30/german-court-to-hear-peruvian-farmers-climate-case-against-rwe">declared admissible by the German judges</a> in November 2017 – meaning that Luciano Lliuya had won a key legal argument, if not yet the scientific ones – RWE’s stock value <a href="https://www.lse.ac.uk/granthaminstitute/wp-content/uploads/2023/05/working-paper-397_-Sato-Gostlow-Higham-Setzer-Venmans.pdf">took a hit</a>. This reflects a broader trend: international companies and their investors are waking up to the <a href="https://greencentralbanking.com/research/impacts-of-climate-litigation-on-firm-value/">financial risks posed by climate litigation</a>.</p>
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<h2>Taking on a German energy giant</h2>
<p>Meeting Luciano Lliuya in his tiny village of Llupa, you’d hardly think he’d become something of a climate justice celebrity. The case has taken him to German courts and international UN summits. Having once been nervous about speaking at his local village assemblies, he has now addressed thousands of people at major climate marches and given countless interviews to the world’s press.</p>
<p>At home, his quiet life is periodically disturbed by <a href="https://www.youtube.com/watch?v=oAcJile4Idk">visiting film teams</a>. He says he doesn’t care much for stardom, but appreciates the interest in his legal case:</p>
<blockquote>
<p>I want people to know what we’re facing here in Peru. The people in wealthy countries like Germany should understand how climate change is making our lives more dangerous. Perhaps that will motivate them to stop polluting so much.</p>
</blockquote>
<p>I first visited his two-storey family home in December 2014, when I was asked to interpret for three representatives from Germanwatch (I’ve since worked with Luciano Lliuya as a legal strategist, scientific adviser and academic researcher). We were treated to a special meal of guinea pig and potatoes with red chilli sauce. Half-way through, he smiled and glanced around the table at his fellow diners including his father, Julio. Then he told us all quietly: “I’ll do it. I’ll do the claim.”</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/561128/original/file-20231122-29-c8epap.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Peruvian man standing amid mountains." src="https://images.theconversation.com/files/561128/original/file-20231122-29-c8epap.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/561128/original/file-20231122-29-c8epap.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/561128/original/file-20231122-29-c8epap.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/561128/original/file-20231122-29-c8epap.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/561128/original/file-20231122-29-c8epap.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/561128/original/file-20231122-29-c8epap.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/561128/original/file-20231122-29-c8epap.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Saúl Luciano Lliuya in his mountain home.</span>
<span class="attribution"><a class="source" href="https://www.germanwatch.org/de/medienservice">Alexander Luna/Germanwatch</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
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<p>That moment marked a transformation of Luciano Lliuya’s life – and mine. In the run-up to the <a href="https://en.wikipedia.org/wiki/2014_United_Nations_Climate_Change_Conference">2014 UN Climate Summit</a> (COP20) in Peru’s capital, Lima, Germanwatch employees had been taking an interest in the Cordillera Blanca mountain range – a region of particular concern for its vulnerability to climate change. Having recently lived in Peru, I joined the team as they looked for local people in the Andes to help voice this concern.</p>
<p>A Peruvian friend who was working with local farmers in the region suggested Julio Luciano Lliuya, who had recently told him how badly climate change was affecting their community’s livelihood. Following two weeks of intense UN negotiations at the COP20 summit, I embarked on an eight-hour bus ride to Huaraz with three Germanwatch representatives.</p>
<p>Father and son met us in the city with their rickety old Toyota van. Navigating uneven dirt-track roads, they took us on a tour of the mountains and told us about their climate-related concerns: in the short term, glacial retreat causing disastrous avalanches and floods; in the longer term, water scarcity threatening their very way of being.</p>
<p>Keen to show us the glaciers up close, Julio’s only son Saúl took us on a six-hour trek up to Lake Palcacocha. The hike was so strenuous that two of my colleagues had to turn around halfway, struggling with altitude sickness. Whatever breath I had left was taken away when I first glimpsed the lake, with those shiny white glaciers framing its deep blue water.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/561156/original/file-20231122-19-goicyt.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A mountain lake and the glaciers that feed it." src="https://images.theconversation.com/files/561156/original/file-20231122-19-goicyt.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/561156/original/file-20231122-19-goicyt.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/561156/original/file-20231122-19-goicyt.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/561156/original/file-20231122-19-goicyt.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/561156/original/file-20231122-19-goicyt.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/561156/original/file-20231122-19-goicyt.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/561156/original/file-20231122-19-goicyt.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Lake Palcacocha has previously flooded the valley below with catastrophic results.</span>
<span class="attribution"><a class="source" href="https://www.germanwatch.org/de/medienservice">Germanwatch</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
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<p>Walking along the lake’s edge, a distant crash broke the silence. “It’s just a small avalanche – that happens all the time,” explained one of the villagers working for the local government who are present here around the clock to watch over the lake. Far away on the glacier, I spotted a flurry of falling snow. “You see? This one didn’t even reach the lake.” I wondered about the consequences of a bigger avalanche on the residents of the valley below, including the Luciano Lliuya family.</p>
<p>Back down in the village over our guinea pig lunch, Julio (who was in his seventies) explained he had transferred his property in the flood danger zone to his seven children. To our surprise, the youngest of them, Saúl, offered to make the claim against RWE.</p>
<p>“All right then,” said Christoph Bals, Germanwatch’s policy director. “We’re going to court!”</p>
<h2>An outlandish idea</h2>
<p>When I began working on this project nearly a decade ago, holding a major emitter responsible for climate change occurring across the world seemed an outlandish idea. <a href="https://dialnet.unirioja.es/servlet/articulo?codigo=3351365">German lawyers</a> had come up with the idea of bringing a claim under the country’s <a href="https://jur-law.de/en/2022/04/neighborhood-right-federation-state-berlin-2/">neighbourhood law</a> (part of the extensive <a href="https://www.gesetze-im-internet.de/englisch_bgb/englisch_bgb.html#p3704">German Civil Code</a>) – but this idea had yet to be tested in court.</p>
<p>When Saúl Luciano Lliuya first heard about this option, he said his preferred option was to confront a major polluter, so we settled on a claim against the <a href="https://en.wikipedia.org/wiki/RWE">German multinational RWE</a>. Based some 6,500 miles away in the industrial city of Essen, RWE has produced coal-fired energy since it was founded in the 19th century. Much more recently, its plans for the huge new Garzweiler open-cast coalmine in western Germany have been met with <a href="https://www.theguardian.com/artanddesign/2023/jan/24/eviction-lutzerath-village-destroyed-coalmine-a-photo-essay">sustained protests</a> and some controversy about <a href="https://theconversation.com/german-police-have-long-collaborated-with-energy-giant-rwe-to-enforce-ecological-catastrophe-198095">RWE’s relationship with the regional police</a>.</p>
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Read more:
<a href="https://theconversation.com/german-police-have-long-collaborated-with-energy-giant-rwe-to-enforce-ecological-catastrophe-198095">German police have long collaborated with energy giant RWE to enforce ecological catastrophe</a>
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<p>Over the past 25 years, the energy company has diversified into renewable energy, and states that it will be “<a href="https://www.rwe.com/en/responsibility-and-sustainability/environmental-protection/climate-protection/#:%7E:text=RWE%20will%20be%20climate%20neutral,with%20the%20Paris%20Climate%20Agreement.">climate neutral by 2040</a>”. A <a href="https://climateaccountability.org/pdf/MRR%209.1%20Apr14R.pdf">2014 study</a>, commissioned by the <a href="https://climatejustice.org.au/about-us">Climate Justice Programme</a> in Australia, estimated that RWE had produced 0.47% of all the world’s industrial greenhouse gas emissions between 1854 and 2010. </p>
<p>In Luciano Lliuya’s homeland, the local government plans to build a new dam and drainage system at Lake Palcacocha to reduce the risk of flooding, at a projected cost of about US$4 million. Luciano Lliuya, via the lawsuit, wants RWE to cover 0.47% of that sum, or around US$20,000.</p>
<p>The case’s central argument is simple: that climate change makes <a href="https://journals.sagepub.com/doi/full/10.1177/14634996221138338">everyone in the world potential neighbours</a> – so, RWE should be a good neighbour and accept its responsibility for contributing to climate change impacts in Peru.</p>
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<a href="https://images.theconversation.com/files/561149/original/file-20231122-25-nqchrr.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Judges and photographers in a German courtroom" src="https://images.theconversation.com/files/561149/original/file-20231122-25-nqchrr.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/561149/original/file-20231122-25-nqchrr.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/561149/original/file-20231122-25-nqchrr.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/561149/original/file-20231122-25-nqchrr.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/561149/original/file-20231122-25-nqchrr.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/561149/original/file-20231122-25-nqchrr.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/561149/original/file-20231122-25-nqchrr.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Judges hear the climate lawsuit against RWE in Hamm’s higher regional court, November 2017.</span>
<span class="attribution"><a class="source" href="https://www.germanwatch.org/de/medienservice">Alexander Luna/Germanwatch</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
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<p>Initially, a lower court in Essen <a href="https://www.germanwatch.org/en/13887">ruled</a> (in December 2016) that the lawsuit against the energy giant was <a href="https://rwe.climatecase.org/en/material/district-court-essen-decision">unfounded</a>. However, the following November, this was <a href="https://rwe.climatecase.org/en/material/higher-regional-court-hamm-indicative-court-order-and-order-hearing-evidence">overruled</a> by the Higher Regional Court in Hamm, which declared the case admissible and began examining the evidence.</p>
<p>The requested sum of US$20,000 is a symbolic amount of money, of course – RWE’s legal costs are likely to go much higher. Yet, when the judges suggested an out-of-court settlement at a hearing in 2017, the company’s lawyer refused, stating: “This is a matter of precedent.”</p>
<p>The estimated cost of future climate-related claims extends <a href="https://www.ft.com/content/055ef9f4-5fb7-4746-bebd-7bfa00b20c82">into the billions</a>.</p>
<h2>The legal strategy</h2>
<p>“This feels like we’re at 5,000 metres in the Andes,” remarks Saúl Luciano Lliuya as, fighting a biting wind, we walk to the Essen courthouse. It is November 2015 and this is his first trip outside Peru – accompanied by his father. Acting as guide and interpreter, I freeze alongside them in my thick winter coat while these two hardy Peruvians sport only light jackets.</p>
<p>A TV crew is filming as Luciano Lliuya enters the courthouse with his lawyer to submit the claim against RWE. They emerge a few minutes later, and he gives a statement to the awaiting journalists and TV cameras:</p>
<blockquote>
<p>I’m making this claim because the mountains in Peru are suffering. The glaciers are melting. We haven’t caused this problem – it’s big companies like RWE. Now they must take responsibility.</p>
</blockquote>
<p>Speaking to the press is a new and nerve-wracking experience for him. But when he thinks about the mountains and why he is taking this action, a fire seems to light up inside.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/561146/original/file-20231122-25-uj4iya.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Two Peruvian men outside a courthouse, one holding a large envelope." src="https://images.theconversation.com/files/561146/original/file-20231122-25-uj4iya.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/561146/original/file-20231122-25-uj4iya.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/561146/original/file-20231122-25-uj4iya.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/561146/original/file-20231122-25-uj4iya.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/561146/original/file-20231122-25-uj4iya.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/561146/original/file-20231122-25-uj4iya.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/561146/original/file-20231122-25-uj4iya.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Saúl Luciano Lliuya and his father Julio file the lawsuit at Essen courthouse, November 2015.</span>
<span class="attribution"><a class="source" href="https://www.germanwatch.org/de/medienservice">Hubert Perschke/Germanwatch</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
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<p>Later that day, after we escape the cameras, I ask what his neighbours back in Peru think about the lawsuit. His only aim, after all, is to benefit his community in the face of dramatic changes to their Andean environment. He seeks no personal gain; only that RWE covers part of the costs of a public infrastructure project to reduce the risk of flooding from Lake Palcacocha.</p>
<p>“I don’t know what [my fellow villagers] think,” Luciano Lliuya replies. “I haven’t told anyone.” Acknowledging my surprise, he says he isn’t sure how to explain it to them:</p>
<blockquote>
<p>They live with climate change in their own way, but they don’t all have the scientific facts. I’m afraid that some people might not understand how me going to Germany helps us in Peru.</p>
</blockquote>
<p>It turns out that his fear is well-founded. When his neighbours find out about his legal claim – whether from news reports, social media or word of mouth – some are confused by it. Rumours begin to spread: that he is making lots of money from the claim, or selling the lake to the Germans. Upon his return home, he explains to his neighbours that nobody is paying him to make the claim, and that success would ultimately help them all. Still, many remain suspicious.</p>
<p>The irony that this case, revolving around <a href="https://www.everestate.com/blog/neighbourhood-law">neighbourhood law</a>, risks upsetting his own neighbours in Peru is not lost on Luciano Lliuya. The lawsuit applies <a href="https://southerncalifornialawreview.com/2019/05/01/from-nuisance-to-environmental-protection-in-continental-europe-article-by-vanessa-casado-perez-carlos-gomez-liguerre/">nuisance law</a>, which is typically applied in neighbourhood disputes, to climate change impacts.</p>
<p>Imagine this: your neighbour has a wall that borders on your property. The wall is old and crumbling, and you’re afraid it could fall over and damage your house. If that happens, you can sue your neighbour for damages. But you’d rather not wait – you don’t want to live with the uncertainty. So instead, you sue your neighbour using the nuisance law. If you win, the court will order them to fix the wall – or in Luciano Lliuya’s case, get rid of the flood hazard.</p>
<p>Around the world, others have attempted similar lawsuits before, to no avail. In 2008, for example, the Native Alaskan community of Kivalina <a href="https://climatecasechart.com/case/native-village-of-kivalina-v-exxonmobil-corp/">filed a claim</a> against ExxonMobil and other oil majors in the US. Their village is threatened by rising sea levels, so the complainants demanded support for adaptation costs – but that case was dismissed on the grounds that climate change is a political issue that should not be resolved in the courts.</p>
<p>Since then, political progress has proved largely inadequate in mobilising support for those who are most vulnerable to climate change. At the same time, <a href="https://www.nature.com/articles/s41558-021-01086-7">climate science has evolved rapidly</a>, drawing ever more precise links between major emitters and impacts around the world.</p>
<p>Since 2017, around 40 US states and cities have <a href="https://theconversation.com/more-than-two-dozen-cities-and-states-are-suing-big-oil-over-climate-change-they-just-got-a-boost-from-the-us-supreme-court-205009">filed lawsuits</a> against the fossil fuel industry, arguing that companies such as ExxonMobil <a href="https://theconversation.com/exxon-scientists-accurately-forecast-climate-change-back-in-the-1970s-what-if-we-had-listened-to-them-and-acted-then-197944">knew about the dangers of climate change decades ago</a> but hid this knowledge from consumers. The plaintiffs have included cities such as New York and San Francisco that are threatened by sea level rise and have demanded billions of dollars to cover their adaptation costs. Their actions have received support from US president Joe Biden’s administration, and earlier in 2023, <a href="https://www.theguardian.com/environment/2023/apr/25/experts-hail-decision-us-climate-lawsuits-advance">the Supreme Court ruled</a> the cases should be heard in state rather than federal courts. Many legal analysts believe these cases have a better chance of success in state courts, and they are likely to go to trial soon.</p>
<p>After Dutch NGO <a href="https://en.milieudefensie.nl/about-us">Milieudefensie</a> filed a lawsuit against the oil and gas multinational Shell, in 2021 a <a href="https://www.theguardian.com/business/2021/may/26/court-orders-royal-dutch-shell-to-cut-carbon-emissions-by-45-by-2030">Dutch court ordered</a> that the company should reduce its emissions by 45% by 2030. (There are, though, enforcement challenges with multinational corporations, and since the verdict Shell has moved its corporate headquarters from the Netherlands to the UK.) Lawsuits in numerous countries have forced governments to increase climate action. But, almost eight years after he delivered the complaint to the snowy Essen courthouse in November 2015, Luciano Lliuya’s case has made it furthest of all.</p>
<p>Most fossil fuel companies are no longer engaging in <a href="https://www.theguardian.com/environment/ng-interactive/2019/oct/09/half-century-dither-denial-climate-crisis-timeline">climate denial</a>. RWE acknowledges the dangers of global warming and claims to be <a href="https://www.rwe.com/-/media/RWE/documents/09-verantwortung-nachhaltigkeit/cr-berichte/sustainability-strategy-report-2022.pdf">“at the leading edge of the shift to sustainable energy.”</a> Yet the company is still making massive profits with fossil fuels, and refuses to pay up for damage caused by past emissions.</p>
<h2>A battle over the science</h2>
<blockquote>
<p>I know of no other case where attribution science is so important. This is a real battle of science. (Roda Verheyen, Luciano Lliuya’s lead lawyer)</p>
</blockquote>
<p>In early 2021, Luciano Lliuya’s legal team submitted a new piece of impartial evidence: a <a href="https://www.nature.com/articles/s41561-021-00686-4">scientific study</a> linking flood risk in the Peruvian Andes to global warming. It found that around 95% of the glacier’s retreat at Lake Palcacocha is <a href="https://www.theguardian.com/environment/2021/feb/04/global-heating-to-blame-for-threat-of-deadly-flood-in-peru-study-says">due to human-made climate change</a>. One media article called it a “<a href="https://insideclimatenews.org/news/04022021/for-a-city-staring-down-the-barrel-of-a-climate-driven-flood-a-new-study-could-be-the-smoking-gun/">smoking gun</a>”.</p>
<p>After RWE’s lawyers challenged the legal validity of the study, in July 2021 the court <a href="https://climatecase.org/en/material/higher-regional-court-hamm-order-and-reference-order">acknowledged it</a> as a piece of independently produced evidence, meaning it is “of higher value than private expert opinions commissioned by the parties”.</p>
<p>In response, RWE’s legal team presented a <a href="https://www.mdpi.com/2072-4292/13/14/2694">study in the scientific journal Remote Sensing</a>, which analysed satellite data for the glacier above Lake Palcacocha and found there was “no evidence of significant glacial instability” within a three-year observation period. RWE’s lawyers used this study to argue that a large avalanche is unlikely – a position that has been strongly contested by Luciano Lliuya’s legal team.</p>
<p>RWE states that as well as modernising its coal-fired power plants to reduce CO₂ emissions, it has invested billions in renewable energy, reflecting <a href="https://www.bundesregierung.de/breg-en/issues/climate-action/government-climate-policy-1779414">Germany’s policy to phase out fossil fuels</a>. Within an article about the case on the <a href="https://www.source-material.org/battle-of-science-rages-over-peru-glacier/">climate investigations website SourceMaterial</a>, RWE spokesperson Guido Steffen commented:</p>
<blockquote>
<p>Individual emitters are not liable for universally rooted and globally effective processes like climate change. It is judicially impossible to relate specific or individual consequences of climate change to a single person.</p>
</blockquote>
<h2>‘This close to winning’</h2>
<p>In the years since I first met Luciano Lliuya in 2014, as well as working with him as a legal adviser and strategist, I’ve also <a href="https://www.escholar.manchester.ac.uk/uk-ac-man-scw:327995">completed a PhD</a> on how climate change affects people in the Peruvian Andes, linking their concerns with legal and political discussions across the world. But the case is still far from over: legal proceedings move slowly, and the next hearing is due to be held in the first half of 2024.</p>
<p>But the case has already inspired other claims: in July 2022, Indonesian islanders threatened by sea-level rise filed a <a href="https://www.theguardian.com/world/2022/jul/20/indonesian-islanders-sue-cement-holcim-climate-damages">similar lawsuit</a> against the Swiss cement producer Holcim. A <a href="https://climatecasechart.com/non-us-case/greenpeace-italy-et-al-v-eni-spa-the-italian-ministry-of-economy-and-finance-and-cassa-depositi-e-prestiti-spa/">recent case</a> in Italy asks for a declaration of responsibility for climate damage from ENI, an Italian oil company. And in September 2023, the <a href="https://theconversation.com/portuguese-youths-sue-33-european-governments-at-eu-court-in-largest-climate-case-ever-214092">European Court of Human Rights heard a legal action</a> posed by Portuguese young people aged 11-24 against 33 European governments over what they claim is a failure to adequately tackle global heating.</p>
<p>Meanwhile, the plight of Luciano Lliuya’s community has been covered by <a href="https://rwe.climatecase.org/en/press-review">media outlets across the planet</a>. When his lawsuit began, it felt to all involved that victory was nearly impossible – we might get past a few legal hurdles, then move on to the next case. Almost a decade on, we never imagined we’d get this far, and be this close to winning the case.</p>
<p>Back in Luciano Lliuya’s village, the criticism of his motives has slowly subsided. “A big step was when the court came to visit us [in 2022],” Luciano Lliuya explains. “People saw that this is something serious. It wasn’t just me.”</p>
<p>Community leaders joined the court’s inspection at Lake Palcacocha and shook the judges’ hands. At the same time, Luciano Lliuya has helped establish a local NGO that supports farmers in adapting to climate change through sustainable agriculture. The organisation is called <a href="https://www.wayintsikperu.org/en">Wayintsik</a> – Quechua for “our house”.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/561158/original/file-20231122-29-l0o584.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Peruvian man with grassy mountains behind." src="https://images.theconversation.com/files/561158/original/file-20231122-29-l0o584.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/561158/original/file-20231122-29-l0o584.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/561158/original/file-20231122-29-l0o584.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/561158/original/file-20231122-29-l0o584.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/561158/original/file-20231122-29-l0o584.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/561158/original/file-20231122-29-l0o584.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/561158/original/file-20231122-29-l0o584.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Luciano Lliuya says he feels responsibility for the mountains that are suffering as they lose their white covers.</span>
<span class="attribution"><a class="source" href="https://www.germanwatch.org/de/medienservice">Germanwatch</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
</figcaption>
</figure>
<p>While the legal process moves slowly on, they have no choice but to adapt – and not just to the threat posed by the lake. Weather patterns are becoming less reliable. The Peruvian Andes usually have a dry season from May to August, and farmers rely on the first rains in September to plant their crops. Now, the rains sometimes begin too early, or not until November. New pests are also harming their potato harvests – the warming climate has brought rats to higher altitudes, for example.</p>
<p>In the long term, climate change could have even more devastating impacts on Luciano Lliuya’s community. Glaciers are natural water storage devices so, as they disappear, the people here will face <a href="https://www.sciencedirect.com/science/article/pii/S2214581822000763">water scarcity</a>. “If there’s no more water,” he says, “we’ll lose our livelihoods. There will be nothing left.” No water for the fields, no glaciers to climb.</p>
<p>But Luciano Lliuya is stubborn. In the face of malicious rumours and unwanted attention, others might have given up. He just climbed more mountains.</p>
<p>After attending COP27 in Sharm El-Sheikh in November 2022, he went on an all-night trek which included climbing Mount Sinai, following in the steps of Moses. The sandy landscape was a sharp contrast to the glaciers and green pastures he is used to in Peru. Squinting into the rising sun, he reflected on the perils of life on a warming planet.</p>
<p>He said it made him imagine a bleak future in which the whole world resembles these surroundings: “That’s why I’ll continue fighting – so that our mountains back home don’t turn to desert too one day.”</p>
<hr>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
</figcaption>
</figure>
<p><em>For you: more from our <a href="https://theconversation.com/uk/topics/insights-series-71218?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insights series</a>:</em></p>
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<li><p><em><a href="https://theconversation.com/victims-of-the-green-energy-boom-the-indonesians-facing-eviction-over-a-china-backed-plan-to-turn-their-island-into-a-solar-panel-ecocity-214755?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Victims of the green energy boom? The Indonesians facing eviction over a China-backed plan to turn their island into a solar panel ‘ecocity’
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<p><em>To hear about new Insights articles, join the hundreds of thousands of people who value The Conversation’s evidence-based news. <a href="https://theconversation.com/uk/newsletters/the-daily-newsletter-2?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK"><strong>Subscribe to our newsletter</strong></a>.</em></p><img src="https://counter.theconversation.com/content/218408/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Noah Walker-Crawford receives funding from the Economic and Social Research Council of the United Kingdom and the Foundation for International Law for the Environment. He is a member of the Board of Trustees at Stiftung Zukunftsfähigkeit (Foundation for Sustainability). He was previously employed by and has acted as a consultant for Germanwatch. </span></em></p>If this case succeeds, it could set a precedent to hold major polluters responsible for the effects of climate change – even on the other side of the world.Noah Walker-Crawford, Postdoctoral Research Fellow in Political Science, UCLLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2175862023-11-27T16:58:05Z2023-11-27T16:58:05ZHow AI ‘sees’ the world – what happened when we trained a deep learning model to identify poverty<figure><img src="https://images.theconversation.com/files/559642/original/file-20231115-23-snwbk5.png?ixlib=rb-1.1.0&rect=29%2C7%2C864%2C524&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Visualising wealth and poverty through AI.</span> <span class="attribution"><span class="source">Authors</span>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>To most effectively deliver aid to alleviate poverty, you have to know where the people most in need are. In many countries, this is often done with household surveys. But these are usually infrequent and cover limited locations.</p>
<p>Recent advances in artificial intelligence (AI) have created a step change in how to measure poverty and other human development indicators. <a href="https://www.cell.com/patterns/pdf/S2666-3899(22)00225-2.pdf">Our team</a> has used a type of AI known as a deep convolutional neural network (DCNN) to study <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1002/jid.3751">satellite imagery</a> and identify some types of poverty with a level of accuracy close to that of household surveys.</p>
<p>The use of this AI technology could help, for example, in developing countries where there has been a rapid change of land use. The AI could monitor via satellite and potentially spot areas that are in need of aid. This would be much quicker than relying on ground surveys.</p>
<p>Plus, the <a href="https://ieeexplore.ieee.org/stamp/stamp.jsp?arnumber=10302541">dreamy images</a> our deep learning model has produced give us a unique insight into how AI visualises the world.</p>
<figure class="align-center ">
<img alt="Two satellite images of a villages." src="https://images.theconversation.com/files/559609/original/file-20231115-27-o4k8xg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/559609/original/file-20231115-27-o4k8xg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=301&fit=crop&dpr=1 600w, https://images.theconversation.com/files/559609/original/file-20231115-27-o4k8xg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=301&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/559609/original/file-20231115-27-o4k8xg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=301&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/559609/original/file-20231115-27-o4k8xg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=378&fit=crop&dpr=1 754w, https://images.theconversation.com/files/559609/original/file-20231115-27-o4k8xg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=378&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/559609/original/file-20231115-27-o4k8xg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=378&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Two villages with different wealth ratings as seen from space. The ‘poor’ village is on the left, the ‘wealthy’ on the right.</span>
<span class="attribution"><span class="source">Authors/Google</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>A DCNN is a type of advanced AI algorithm commonly used in processing and analysing visual imagery. The “deep” in its name refers to the multiple layers through which data is processed, making it part of the broader family of deep learning technologies.</p>
<p>Earlier this year our team made an important discovery using the DCNN. This network was initially trained on the vast array of labelled images from the <a href="https://www.image-net.org/about.php">ImageNet</a> repository: a <a href="https://qz.com/1034972/the-data-that-changed-the-direction-of-ai-research-and-possibly-the-world">huge pictorial dataset</a> of objects and living things used to train algorithms. After this initial phase, where the network learned to recognise various objects, we fine-tuned it using daylight satellite images of populated places. </p>
<p><a href="https://arxiv.org/pdf/2210.08785.pdf">Our findings</a> revealed that the DCNN, enhanced by this specialised training, could surpass human performance in accurately assessing poverty levels from satellite imagery. Specifically, the AI system demonstrated an ability to deduce poverty levels from low-resolution daytime satellite images with greater precision than <a href="https://arxiv.org/pdf/2210.08785.pdf">humans analysing</a> high-resolution images.</p>
<p>Such proficiency echoes the superhuman achievements of AI in other realms, such as the <a href="https://www.science.org/doi/pdf/10.1126/science.aar6404?casa_token=1eQBH-8ZrRsAAAAA:4qQXVzp-45bhgMGGNXpEv6uewbihGzDkRzC4pc-k1-u2-lO5sjenv84TArnmw9YPYDlQwWpolndV-DU">Chess and Go</a> engines that consistently outwit human players. </p>
<p>After the training phase was complete, we engaged in an exploration to try to understand what characteristics the DCNN was identifying in the satellite images as being indicative of “high wealth”. This process began with what we referred to as a “blank slate” – an image composed entirely of random noise, devoid of any discernible features.</p>
<p>In a step-by-step manner, the model “adjusts” this noisy image. Each adjustment is a move towards what the model considers a satellite image of a more wealthy place than the previous image. These modifications are driven by the model’s internal understanding and learning from its training data.</p>
<p>As the adjustments continue, the initially random image gradually morphs into one that the model confidently classifies as indicating high wealth. This transformation was revelatory because it unveiled the specific features, patterns, and elements that the model associates with wealth in satellite imagery. </p>
<p>Such features might include (but are not limited to) the density of roads, the layout of urban areas, or other subtle cues that have been learned during the model’s training.</p>
<figure class="align-center ">
<img alt="A block of four images, progressing from a satellite to more abstract AI versions of the original, explainer in paragraph below." src="https://images.theconversation.com/files/559911/original/file-20231116-27-idgukm.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/559911/original/file-20231116-27-idgukm.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=152&fit=crop&dpr=1 600w, https://images.theconversation.com/files/559911/original/file-20231116-27-idgukm.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=152&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/559911/original/file-20231116-27-idgukm.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=152&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/559911/original/file-20231116-27-idgukm.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=191&fit=crop&dpr=1 754w, https://images.theconversation.com/files/559911/original/file-20231116-27-idgukm.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=191&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/559911/original/file-20231116-27-idgukm.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=191&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Satellite image (left) of ‘poor’ village, then moves from left to right adding signs of wealth, like roads, progressing towards what the AI ‘sees’ as wealth.</span>
<span class="attribution"><span class="source">Authors/Google</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>The sequence of images displayed above serves a crucial purpose in our research. It begins with a baseline satellite image of a village in Tanzania, which our AI model categorises as “poor”, probably due to the sparse presence of roads and buildings.</p>
<p>To test and confirm this hypothesis, we progressively modify each subsequent image in the sequence, methodically enhancing them with additional features such as buildings and roads. These augmentations represent increased wealth and development as perceived by the AI model.</p>
<p>This visual progression shows how the AI is visualising “wealth” as we add things like more roads and houses. The characteristics we deduced from the model’s “ideal” wealth image (such as roads and buildings) are indeed influential in the model’s assessment of wealth.</p>
<p>This step is essential in ensuring that the features we believe to be significant in the AI’s decision-making process do, in fact, correspond to higher wealth predictions.</p>
<p>So by repeatedly adjusting the image, the resulting visualisation gradually evolves into what the network “thinks” wealth looks like. This outcome is often abstract or surreal.</p>
<figure class="align-center ">
<img alt="Abstract image created by AI portraying poverty." src="https://images.theconversation.com/files/559639/original/file-20231115-23-rxgd5r.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/559639/original/file-20231115-23-rxgd5r.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/559639/original/file-20231115-23-rxgd5r.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/559639/original/file-20231115-23-rxgd5r.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/559639/original/file-20231115-23-rxgd5r.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/559639/original/file-20231115-23-rxgd5r.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/559639/original/file-20231115-23-rxgd5r.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">What a neural network ‘thinks’ wealth looks like.</span>
<span class="attribution"><span class="source">Authors</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>The image above was generated from a blank slate when we asked the DCNN what it associated with “high wealth”. These images have an ethereal quality and don’t closely resemble typical daytime satellite photos. Yet, the presence of “blobs” and “lines” suggests clusters of homes interconnected by roads and streets. The blue hue might even hint at coastal areas.</p>
<h2>Dreamy images</h2>
<p>Inherent in this method is an element of randomness. This randomness ensures that each attempt at visualisation creates a unique image, though all are anchored in the same underlying concept as understood by the network.</p>
<p>However, it is important to note that these visualisations are more a reflection of the network’s “thought process” rather than an objective representation of wealth. They’re constrained by the network’s training and may not accurately align with human interpretations. </p>
<p>It is crucial to understand that while AI feature visualisation offers intriguing insights into neural networks, it also highlights the complexities and limitations of machine learning in mirroring human perception and understanding.</p>
<p>Understanding poverty, particularly in its geographical or regional context, is a complex endeavour. While traditional studies have focused more on individual aspects of poverty, AI, leveraging satellite imagery, has made significant strides in highlighting regional poverty’s geographical patterns.</p>
<p>This is where the real value of AI in poverty assessment lies, in offering a spatially nuanced perspective that complements existing poverty research and aids in formulating more targeted and effective interventions.</p><img src="https://counter.theconversation.com/content/217586/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ola Hall receives funding from Stiftelsen Riksbankens Jubileumsfond, Swedish Research Council and Formas. </span></em></p><p class="fine-print"><em><span>Hamid Sarmadi receives funding from Riksbankens Jubileumsfond.</span></em></p><p class="fine-print"><em><span>Thorsteinn Rögnvaldsson receives funding from the Knowledge Foundation and from Riksbankens Jubileumsfond.</span></em></p>Researchers fed an advanced AI algorithm with satellite photographs to see if it could identify areas of poverty and it interpreted the data through abstract images.Ola Hall, Head of the Department of Human Geography, Lund UniversityHamid Sarmadi, Assistant Professor, School of Information Technology, Halmstad UniversityThorsteinn Rögnvaldsson, Professor, School of Information Technology, Halmstad UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2183132023-11-23T17:24:29Z2023-11-23T17:24:29ZFinancial crises damage people’s mental health – our global review shows who is worst affected<figure><img src="https://images.theconversation.com/files/560841/original/file-20231121-4482-cd2rlp.jpg?ixlib=rb-1.1.0&rect=317%2C238%2C6929%2C4547&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/depressed-business-man-looking-down-falling-751698157">pathdoc/Shutterstock</a></span></figcaption></figure><p>Financial crises are periods characterised by devastating losses of income, work, a certain future, and a stable family life. The effect on mental health can be catastrophic. But what does the evidence tell us about who is most at risk, and in what ways?</p>
<p>We are the first team to do a systematic <a href="https://www.tandfonline.com/doi/full/10.1080/09638237.2023.2278104">review of global research linking financial crises and mental harms</a>. The evidence from almost 100 eligible studies (out of nearly 7,000 we considered) shows that these crises have consistent, long-term negative effects on the wellbeing of whole groups of people, including increases in depression, anxiety and risk of suicide.</p>
<p>But <a href="https://www.bps.org.uk/news/bps-responds-new-government-back-work-plan">not everyone is affected equally</a>. Your gender, age, job and whether you have a family are all key factors in determining how vulnerable you are to the stress and poor mental health associated with financial loss and insecurity.</p>
<hr>
<p><em>Across the world, we’re seeing unprecedented levels of mental illness at all ages, from children to the very old – with huge costs to families, communities and economies. <a href="https://theconversation.com/uk/topics/tackling-the-mental-health-crisis-147216?utm_source=TCUK&utm_medium=ArticleTop&utm_campaign=MentalHealthSeries">In this series</a>, we investigate what’s causing this crisis, and report on the latest research to improve people’s mental health at all stages of life.</em></p>
<hr>
<p><a href="https://doi.org/10.1186/s12888-015-0608-5">Manual workers</a> (such as farmers, tradespeople and those working minimum-wage jobs) are vulnerable as they typically have less of a safety net, while <a href="https://www.researchgate.net/profile/Susannah-Minutillo/publication/340673303_Small_Business_Ownership_and_Mental_Health/links/602334f292851c4ed55eb474/Small-Business-Ownership-and-Mental-Health.pdf">small business owners</a> are particularly susceptible to financial pressures and worries. </p>
<p><a href="https://doi.org/10.1136/bmj.f5239">People at either end of the age spectrum</a> are also more vulnerable as they have fewer resources. Others at higher risk include <a href="https://doi.org/10.1002/ajim.22210">families</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4399497/">people with lower levels of formal education</a>, and those with <a href="https://www.bma.org.uk/media/6520/the-country-is-getting-sicker-bma.pdf">long-term health conditions</a>.</p>
<p>Suicide mortality rates <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4473496/#:%7E:text=CONCLUSION%3A%20Economic%20recession%20periods%20appear,particularly%20in%20low%20income%20countries.&text=Core%20tip%3A%20This%20review%20provides,suicide%20at%20the%20ecological%20level.">increase</a> both during and after periods of financial crisis – a risk that is always <a href="https://www.priorygroup.com/blog/why-are-suicides-so-high-amongst-men">higher among men</a>. </p>
<p>However, <a href="https://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/women-and-mental-health">women</a> are more at risk of suffering poorer mental health in general during a financial crisis, as they tend to take on more responsibilities both at work and home – including <a href="https://theconversation.com/emotional-labour-what-it-is-and-why-it-falls-to-women-in-the-workplace-and-at-home-195965">increased emotional labour</a> supporting others who may be struggling financially.</p>
<h2>Stigma, stress and social roles</h2>
<p>Our research highlights three broad challenges to the mental wellbeing of people struggling in a financial crisis. Understanding how to address them could help make people more psychologically resilient in the face of future financial downturns. Here are some recommendations based both on the study’s findings and our combined research knowledge and expertise in health psychology.</p>
<p><strong>1. Social stigma and support</strong></p>
<p>The stigma of mental illness is decreasing in many societies, as we’ve become <a href="https://www.letstalkcampaign.com/">more comfortable talking about our wellbeing</a>. It’s less clear, though, if we are okay talking about our finances. Encouraging people to be more open about financial distress with trusted friends, family members and partners, free of any judgment, can be especially important during periods of economic uncertainty.</p>
<p><a href="https://doi.org/10.1111/bjop.12448">Higher levels of trust in other people</a> offer another defence against mental distress during periods of financial crisis. The reduced stigma around discussing mental health and suicide can buffer against some of the most devastating outcomes. Research shows that talking about suicide can <a href="https://doi.org/10.1017/s0033291714001299">save lives</a>.</p>
<p><strong>2. Stress and insecurity from loss of resources</strong></p>
<p>Even if your job feels secure, financial downturns can lead to <a href="https://doi.org/10.1016/j.ehb.2019.02.008">increasing pressures at work</a> as a result of greater workloads and reduced staff. </p>
<p>If you are an employee, check whether your employer subscribes to an <a href="https://www.hrdept.co.uk/services/employee-assistance-programme/">employee assistance programme</a> that delivers legal and financial advice and psychological support when needed. </p>
<p>Alternatively, <a href="https://www.tuc.org.uk/join-a-union">join a union</a> – most provide legal advice and financial support. Practical support for business owners is <a href="https://www.gov.uk/browse/business/finance-support">also</a> <a href="https://www.gov.uk/browse/business/finance-support">available</a>.</p>
<p>When feeling threatened with loss of income or job security, connecting with people in similar positions both in-person and online, such as via <a href="https://www.mumsnet.com/">parent groups</a>, can help you feel you’re not alone and is a good way of sharing resources. You should also be able to get help from your <a href="https://www.gov.uk/cost-living-help-local-council">local council</a>.</p>
<p><strong>3. Challenges to identity, social roles and meaning</strong></p>
<p>Losing your job or income understandably damages your sense of self. But identity and meaning can be found in various aspects of life, not only work. </p>
<p>Be careful not to think of yourself as “just one thing” – whether a breadwinner or a carer – as this can create a sense of fragility. Strive to <a href="https://positivepsychology.com/live-meaningful-life/">find greater meaning</a> through family, hobbies, organisations and community work.</p>
<p>And we all need to encourage understanding that it’s not the sole responsibility of women to be the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4804270/">emotional caregivers</a> in families and other care situations – a perception that can damage their sense of identity. <a href="https://journals.sagepub.com/doi/full/10.1177/09500170221096586">Household work and childcare</a> should be divided as evenly as possible at all times, but especially among periods of crisis when people are feeling highly stressed.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/560846/original/file-20231121-19-5nbtox.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A line of depressed men slumped on a bench in front of a city street" src="https://images.theconversation.com/files/560846/original/file-20231121-19-5nbtox.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/560846/original/file-20231121-19-5nbtox.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=478&fit=crop&dpr=1 600w, https://images.theconversation.com/files/560846/original/file-20231121-19-5nbtox.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=478&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/560846/original/file-20231121-19-5nbtox.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=478&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/560846/original/file-20231121-19-5nbtox.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=601&fit=crop&dpr=1 754w, https://images.theconversation.com/files/560846/original/file-20231121-19-5nbtox.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=601&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/560846/original/file-20231121-19-5nbtox.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=601&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The enduring pain of the Great Depression.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Service-pnp-cph-3a30000-3a30000-3a30400-3a30490r.jpg">Mark Benedict Barry via Wikimedia Commons</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<h2>Saving lives and the economy</h2>
<p>Declines in mental health should not be regarded as an unavoidable cost of financial crises – this is wrong economically as well as morally. Supporting a nation’s wellbeing could <a href="https://www.lse.ac.uk/News/Latest-news-from-LSE/2022/c-Mar-22/Mental-health-problems-cost-UK-economy-at-least-118-billion-a-year-new-research">save a struggling economy billions</a> by reducing mental illness-related sickness and disability, and ensuring that optimal work practices can continue.</p>
<p>Our review highlights that the way societies are structured affects the impact of financial crises on their populations’ mental health. It is perhaps not surprising, for example, that countries with particularly strong welfare systems, such as Iceland, reported <a href="https://doi.org/10.1093/eurpub/ckaa121">minimal to no increases in suicide rates following a financial crisis</a>.</p>
<p>At a national level, having <a href="https://doi.org/10.1186/s12889-017-4702-0">strong welfare</a>, <a href="https://doi.org/10.2471%2FBLT.20.273383">accessible health services</a> and <a href="https://doi.org/10.3389/fpsyt.2017.00035">progressive attitudes towards mental health</a> are shown to reduce suicide and mental illness. On an individual basis, reaching out to others, having supportive social networks, rethinking our identities and developing financial knowledge may help us all weather current and future crises.</p>
<p>Whatever stage in life you are in, it’s a good idea to familiarise yourself with available mental health services. In the UK, for professional help, contact your GP, use the <a href="https://www.nhs.uk/mental-health/social-care-and-your-rights/how-to-access-mental-health-services/">NHS e-referral platform</a> or check out the <a href="https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/nhs-talking-therapies/">NHS talking therapies services</a>. Charities and organisations such as <a href="https://www.mind.org.uk/">Mind</a>, <a href="https://www.samaritans.org/">Samaritans</a> and the <a href="https://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/online-mental-health-support">Mental Health Foundation</a> also provide expert advice and professional support.</p><img src="https://counter.theconversation.com/content/218313/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Our global review of research into the link between financial crises and mental health highlights three key challenges: stigma, stress and social rolesBen Gibson, Lecturer in Applied Psychology, De Montfort UniversityJekaterina Schneider, Research Fellow, University of the West of EnglandMark Forshaw, Professor of Health Psychology, Edge Hill UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2149242023-11-14T16:33:17Z2023-11-14T16:33:17ZHow music heals us, even when it’s sad – by a neuroscientist leading a new study of musical therapy<figure><img src="https://images.theconversation.com/files/557134/original/file-20231101-27-vcga1e.jpg?ixlib=rb-1.1.0&rect=0%2C152%2C5998%2C3677&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/music-activates-brain-listening-playing-stimulates-1353984893">Sangoiri/Shutterstock</a></span></figcaption></figure><blockquote>
<p>When I hear Shania Twain’s <a href="https://www.youtube.com/watch?v=KNZH-emehxA">You’re Still The One</a>, it takes me back to when I was 15, playing on my Dad’s PC. I was tidying up the mess after he had tried to [take his own life]. He’d been listening to her album, and I played it as I tidied up. Whenever I hear the song, I’m taken back – the sadness and anger comes flooding back.</p>
</blockquote>
<p>There is a renewed fascination with the healing powers of music. This resurgence can primarily be attributed to recent breakthroughs in neuroscientific research, which have substantiated music’s therapeutic properties such as emotional regulation and brain re-engagement. This has led to a <a href="https://link.springer.com/article/10.1007/s10560-022-00893-x">growing integration</a> of music therapy with conventional mental health treatments.</p>
<p>Such musical interventions have already been shown to help people with <a href="https://www.proquest.com/openview/f42a82f350c32a106111ca17ac5db5fe/1?pq-origsite=gscholar&cbl=37213">cancer</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/29149141/">chronic pain</a> and <a href="https://www.tandfonline.com/doi/abs/10.1080/15401383.2012.685020">depression</a>. The debilitating consequences of stress, such as elevated blood pressure and muscle tension, can also be <a href="https://www.tandfonline.com/doi/full/10.1080/17437199.2020.1846580">alleviated through the power of music</a>.</p>
<hr>
<p><em>Across the world, we’re seeing unprecedented levels of mental illness at all ages, from children to the very old – with huge costs to families, communities and economies. <a href="https://theconversation.com/uk/topics/tackling-the-mental-health-crisis-147216?utm_source=TCUK&utm_medium=ArticleTop&utm_campaign=MentalHealthSeries">In this series</a>, we investigate what’s causing this crisis, and report on the latest research to improve people’s mental health at all stages of life.</em></p>
<hr>
<p>As both a longtime music fan and neuroscientist, I believe music has a special status among all the arts in terms of the breadth and depth of its impact on people. One critical aspect is its powers of <a href="https://www.sciencedirect.com/science/article/pii/S0166432821005222">autobiographical memory retrieval</a> – encouraging often highly personal recollections of past experiences. We can all recount an instance where a tune transports us back in time, rekindling recollections and often imbuing them with a range of powerful emotions.</p>
<p>But enhanced recollection can also occur in dementia patients, for whom the <a href="https://www.theguardian.com/lifeandstyle/2023/sep/20/a-moment-that-changed-me-i-played-my-way-to-people-with-dementia-the-effect-was-magic">transformative impact of music therapy</a> sometimes opens a floodgate of memories – from cherished childhood experiences and the aromas and tastes of a mother’s kitchen, to lazy summer afternoons spent with family or the atmosphere and energy of a music festival.</p>
<p>One remarkable example is a widely shared <a href="https://www.youtube.com/watch?v=IT_tW3EVDK8">video</a> made by the <a href="https://musicaparadespertar.com/">Asociación Música para Despertar</a>, which is thought to feature the Spanish-Cuban ballerina Martha González Saldaña (though there has been <a href="https://www.npr.org/2020/11/10/933387878/struck-with-memory-loss-a-dancer-remembers-swan-lake-but-who-is-she">some controversy</a> about her identity). The music of Swan Lake by Tchaikovsky appears to reactivate cherished memories and even motor responses in this former prima ballerina, who is moved to rehearse some of her former dance motions on camera.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/IT_tW3EVDK8?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Tchaikovsky’s Swan Lake appears to reactivate long-unused motor responses in this former ballerina.</span></figcaption>
</figure>
<p>In our laboratory at Northumbria University, we aim to harness these recent neuroscience advances to deepen our understanding of the intricate connection between music, the brain and mental wellbeing. We want to answer specific questions such as why <a href="https://www.frontiersin.org/articles/10.3389/fpain.2023.1210572/full">sad or bittersweet music</a> plays a unique therapeutic role for some people, and which parts of the brain it “touches” compared with happier compositions.</p>
<p><a href="https://www.sciencedirect.com/science/article/abs/pii/S1053811919301284?via%3Dihub">Advanced research tools</a> such as high-density electroencephalogram (EEG) monitors enable us to record how the brain regions “talk” to each other in real-time as someone listens to a song or symphony. These regions are stimulated by different aspects of the music, from its emotional content to its melodic structure, its lyrics to its rhythmic patterns.</p>
<p>Of course, everyone’s response to music is deeply personal, so our research also necessitates getting our study participants to describe how a particular piece of music makes them feel – including its ability to encourage profound introspection and evoke meaningful memories.</p>
<p>Ludwig van Beethoven once proclaimed: “Music is the one incorporeal entrance into the higher world of knowledge which comprehends mankind, but which mankind cannot comprehend.” With the help of neuroscience, we hope to help change that.</p>
<h2>A brief history of music therapy</h2>
<p>Music’s ancient origins predate aspects of language and rational thinking. Its roots can be traced back to the Paleolithic Era more than 10,000 years ago, when early humans used it for communication and emotional expression. <a href="https://news.cnrs.fr/articles/the-sound-of-palaeolithic-music">Archaeological finds</a> include ancient bone flutes and percussion instruments made from bones and stones, as well as markings noting the <a href="https://www.sciencedaily.com/releases/2008/07/080704130439.htm">most accoustically resonant place within a cave</a> and even <a href="https://theconversation.com/how-the-music-of-an-ancient-rock-painting-was-brought-to-life-185475">paintings depicting musical gatherings</a>.</p>
<p>Music in the subsequent Neolithic Era went through <a href="https://theconversation.com/what-archaeology-tells-us-about-the-music-and-sounds-made-by-africas-ancestors-143809">significant development</a> within permanent settlements across the world. Excavations have revealed various musical instruments including harps and complex percussion instruments, highlighting music’s growing importance in religious ceremonies and social gatherings during this period – alongside the emergence of rudimentary forms of music notation, evident in <a href="https://www.asor.org/anetoday/2022/04/music-ancient-mesopotamia">clay tablets from ancient Mesopotamia</a> in western Asia.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/557113/original/file-20231101-21-el7lrd.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Four prehistoric musical instruments" src="https://images.theconversation.com/files/557113/original/file-20231101-21-el7lrd.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/557113/original/file-20231101-21-el7lrd.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=368&fit=crop&dpr=1 600w, https://images.theconversation.com/files/557113/original/file-20231101-21-el7lrd.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=368&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/557113/original/file-20231101-21-el7lrd.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=368&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/557113/original/file-20231101-21-el7lrd.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=463&fit=crop&dpr=1 754w, https://images.theconversation.com/files/557113/original/file-20231101-21-el7lrd.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=463&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/557113/original/file-20231101-21-el7lrd.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=463&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Prehistoric musical instruments.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Musical_instruments_of_prehistory.jpg">Musée d'Archéologie Nationale/Wikimedia</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
</figcaption>
</figure>
<p>Ancient Greek philosophers Plato and Aristotle both recognised music’s central role in the human experience. Plato outlined the power of music as a pleasurable and healing stimulus, stating: “Music is a moral law. It gives soul to the universe, wings to the mind, flight to the imagination.” More practically, Aristotle suggested that: “Music has the power of forming the character, and should therefore be introduced into the education of the young.”</p>
<p>Throughout history, many cultures have embraced the healing powers of music. Ancient Egyptians incorporated music into their religious ceremonies, considering it a therapeutic force. Native American tribes, such as the Navajo, used music and dance in their healing rituals, relying on drumming and chanting to promote physical and spiritual wellbeing. In traditional Chinese medicine, specific musical tones and rhythms were believed to balance the body’s energy (qi) and enhance health. </p>
<p>During the Middle Ages and the Renaissance, the Christian church was pivotal in popularising “music for the masses”. Congregational hymn singing allowed worshippers to engage in communal music during church services. This shared musical expression was a powerful medium for religious devotion and teaching, bridging the gap for a largely non-literate population to connect with their faith through melody and lyrics. Communal singing is not only a cultural and religious tradition, but it has also been <a href="https://journals.co.za/doi/abs/10.4102/ve.v40i1.1910">recognised as a therapeutic experience</a>.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/557117/original/file-20231101-25-aqs9xd.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Grey-haired man in jacket sitting at a desk reading," src="https://images.theconversation.com/files/557117/original/file-20231101-25-aqs9xd.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/557117/original/file-20231101-25-aqs9xd.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=604&fit=crop&dpr=1 600w, https://images.theconversation.com/files/557117/original/file-20231101-25-aqs9xd.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=604&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/557117/original/file-20231101-25-aqs9xd.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=604&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/557117/original/file-20231101-25-aqs9xd.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=759&fit=crop&dpr=1 754w, https://images.theconversation.com/files/557117/original/file-20231101-25-aqs9xd.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=759&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/557117/original/file-20231101-25-aqs9xd.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=759&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Benjamin Rush.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Benjamin_Rush_by_Sully.jpg">NYPL Digital Gallery/Wikimedia</a></span>
</figcaption>
</figure>
<p>In the 18th and 19th centuries, early investigations into the human nervous system paralleled the <a href="https://www.musictherapy.org/about/history/">emergence of music therapy</a> as a field of study. Pioneers such as American physician <a href="https://www.britannica.com/biography/Benjamin-Rush">Benjamin Rush</a>, a signatory of the US Declaration of Independence in 1776, recognised the therapeutic potential of music to improve mental health.</p>
<p>Soon afterwards, figures such as Samuel Mathews (one of Rush’s students) began conducting experiments exploring <a href="https://collections.nlm.nih.gov/catalog/nlm:nlmuid-2562064R-bk">music’s effects on the nervous system</a>, laying the foundation for modern music therapy. This early work provided the springboard for <a href="https://journals.sagepub.com/doi/10.2307/3345004#:%7E:text=Abstract-,E.,relating%20music%20education%20to%20medicine.">E. Thayer Gaston</a>, known as the “father of music therapy”, to promote it as a legitimate discipline in the US. These developments inspired similar endeavours in the UK, where <a href="https://academic.oup.com/mtp/article-abstract/36/1/1/4916024">Mary Priestley</a> made significant contributions to the development of music therapy as a respected field.</p>
<p>The insights gained from these early explorations have continued to influence psychologists and neuroscientists ever since – including the late, great neurologist and <a href="https://www.oliversacks.com/oliver-sacks-books/musicophilia-oliver-sacks/">best-selling author</a> Oliver Sacks, who observed that:</p>
<blockquote>
<p>Music can lift us out of depression or move us to tears. It is a remedy, a tonic, orange juice for the ear.</p>
</blockquote>
<h2>The ‘Mozart effect’</h2>
<blockquote>
<p>Music was my profession, but it was also a special and deeply personal pursuit … Most importantly, it gave me a way to cope with life’s challenges, learning to channel my feelings and express them safely. Music taught me how to take my thoughts, both the pleasant and the painful ones, and turn them into something beautiful.</p>
</blockquote>
<p>Studying and understanding all the brain mechanisms involved in listening to music, and its effects, requires more than just neuroscientists. Our diverse team includes music experts such as Dimana Kardzhieva (quoted above), who started playing the piano aged five and went on to study at the National School of Music in Sofia, Bulgaria. Now a cognitive psychologist, her combined understanding of music and cognitive processes helps us delve into the complex mechanisms through which music affects (and soothes) our minds. A neuroscientist alone might fall short in this endeavour.</p>
<p>The starting point of our research was the so-called “Mozart effect” – the suggestion that exposure to intricate musical compositions, especially classical pieces, stimulates brain activity and ultimately <a href="https://files.eric.ed.gov/fulltext/ED390733.pdf">enhances cognitive abilities</a>. While there have been subsequent mixed findings as to <a href="https://psycnet.apa.org/record/2018-20917-004">whether the Mozart effect is real</a>, due to the different methods employed by researchers over the years, this work has nonetheless triggered significant advances in our understanding of music’s effect on the brain.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/VIItKRaP2vc?wmode=transparent&start=23" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Listening to Mozart’s Sonata for Two Pianos in D was found in one study to enhance cognitive abilities.</span></figcaption>
</figure>
<p>In the original 1993 study by <a href="https://www.nature.com/articles/365611a0">Frances Rauscher and colleagues</a>, participants experienced enhancement in spatial reasoning ability after just ten minutes of listening to Mozart’s Sonata for Two Pianos in D.</p>
<p>In <a href="https://psycnet.apa.org/record/2007-18075-020">our 1997 study</a>, which used Beethoven’s <a href="https://www.youtube.com/watch?v=bEiYmeeV6sI">second symphony</a> and rock guitarist Steve Vai’s instrumental track <a href="https://www.youtube.com/watch?v=9IrWyZ0KZuk">For the Love of God</a>, we found similar direct effects in our listeners – as measured both by <a href="https://www.nhs.uk/conditions/electroencephalogram/">EEG</a> activity associated with attention levels and the release of the hormone <a href="https://www.health.harvard.edu/mind-and-mood/dopamine-the-pathway-to-pleasure">dopamine</a> (the brain’s messenger for feelings of joy, satisfaction and the reinforcement of specific actions). Our research found that classical music in particular enhances attention to how we process the world around us, regardless of one’s musical expertise or preferences.</p>
<p>The beauty of EEG methodology lies in its capacity to track brain processes with millisecond accuracy – allowing us to distinguish unconscious neural responses from conscious ones. When we repeatedly showed simple shapes to a person, we found that classical music sped up their early (pre-300 millisecond) processing of these stimuli. Other music did not have the same effect – and nor did our subjects’ prior knowledge of, or liking for, classical music. For example, both professional rock and classical musicians who took part in our study improved their automatic, unconscious cognitive processes while listening to classical music.</p>
<p>But we also found indirect effects related to arousal. When people immerse themselves in the music they personally enjoy, they experience a dramatic shift in their alertness and mood. This phenomenon <a href="https://journals.sagepub.com/doi/10.1111/1467-9280.00345">shares similarities</a> with the increased cognitive performance often linked to other enjoyable experiences. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/aryDMAP6oug?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Vivaldi’s Four Seasons in full.</span></figcaption>
</figure>
<p>In a further study, we explored the particular influence of “<a href="https://www.britannica.com/art/program-music">program music</a>” – the term for instrumental music that “carries some extramusical meaning”, and which is said to possess a remarkable ability to engage memory, imagination and self-reflection. When our participants listened to Antonio Vivaldi’s Four Seasons, they reported experiencing a <a href="https://psycnet.apa.org/doiLanding?doi=10.1027%2F1618-3169%2Fa000166">vivid representation of the changing seasons</a> through the music – including those who were unfamiliar with these concertos. Our study concluded, for example, that:</p>
<blockquote>
<p>Spring – particularly the well-recognised, vibrant, emotive and uplifting first movement – had the ability to enhance mental alertness and brain measures of attention and memory.</p>
</blockquote>
<h2>What’s going on inside our brain?</h2>
<p>Music’s emotional and therapeutic qualities are highly related to the release of neurochemicals. A number of these are associated with happiness, including oxytocin, serotonin and endorphins. However, dopamine is central to the enhancing properties of music.</p>
<p>It triggers the release of dopamine in regions of the brain devoted to <a href="https://rewardfoundation.org/brain-basics/reward-system/#:%7E:text=The%20Striatum&text=It%20is%20the%20region%20of,%2C%20reinforcement%2C%20and%20reward%20perception.">reward and pleasure</a>, generating sensations of joy and euphoria akin to the impact of other pleasurable activities such as eating or having sex. But unlike these activities, which have clear value related to survival and reproduction, the evolutionary advantage of music is less obvious.</p>
<p>Its strong social function is acknowledged as the main factor behind music’s development and preservation in human communities. So, this protective quality may explain why it taps into the same neural mechanisms as other pleasurable activities.</p>
<hr>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
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</figure>
<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
<hr>
<p>The brain’s reward system consists of interconnected regions, with the <a href="https://link.springer.com/article/10.1007/s00276-014-1360-0">nucleus accumbens</a> serving as its powerhouse. It is situated deep within the subcortical region, and its location hints at its significant involvement in emotion processing, given its proximity to other key regions related to this.</p>
<p>When we engage with music, whether playing or listening, the nucleus accumbens responds to its pleasurable aspects by triggering the release of dopamine. This process, known as the dopamine reward pathway, is critical for experiencing and reinforcing positive emotions such as the feelings of happiness, joy or excitement that music can bring.</p>
<p>We are still learning about the full impact of music on different parts of the brain, as Jonathan Smallwood, professor of psychology at Queen’s University, Ontario, explains:</p>
<blockquote>
<p>Music can be complicated to understand from a neuroscience perspective. A piece of music encompasses many domains that are typically studied in isolation – such as auditory function, emotion, language and meaning.</p>
</blockquote>
<p>That said, we can see how music’s effect on the brain extends beyond mere pleasure. The <a href="https://www.britannica.com/science/amygdala">amygdala</a>, a region of the brain renowned for its involvement in emotion, generates and regulates emotional responses to music, from the heartwarming nostalgia of a familiar melody to the exhilarating excitement of a crescendoing symphony or the spine-tingling fear of an eerie, haunting tune.</p>
<p><a href="https://www.sciencedirect.com/science/article/pii/S1053811920308363?pes=vor">Research</a> has also demonstrated that, when stimulated by music, these regions can encourage us to have autobiographical memories that elicit positive self-reflection that makes us feel better – as we saw in the video of former ballerina Martha González Saldaña.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-to-solve-our-mental-health-crisis-214776">How to solve our mental health crisis</a>
</strong>
</em>
</p>
<hr>
<p>Our own research points to the <a href="https://www.britannica.com/science/hippocampus">hippocampus</a>, crucial for memory formation, as the part of the brain that stores music-related memories and associations. Simultaneously, the <a href="https://neuroscientificallychallenged.com/posts/know-your-brain-prefrontal-cortex">prefrontal cortex</a>, responsible for higher cognitive functions, closely collaborates with the hippocampus to retrieve these musical memories and assess their autobiographical significance. During music listening, this interplay between the brain’s memory and emotion centres creates a powerful and unique experience, elevating music to a distinctive and pleasurable stimulus.</p>
<p>Visual art, like paintings and sculptures, lacks music’s temporal and multisensory engagement, diminishing its ability to form strong, lasting emotional-memory connections. Art may evoke emotions and memories but often remains rooted in the moment. Music – perhaps uniquely – forms enduring, emotionally charged memories that can be summoned with the replaying of a particular song years later.</p>
<h2>Personal perspectives</h2>
<p>Music therapy can change people’s lives in profound ways. We have had the privilege of hearing many personal stories and reflections from our study participants, and even our researchers. In some cases, such as the memories of a father’s attempted suicide elicited by Shania Twain’s You’re Still The One, these are profound and deeply personal accounts. They show us the power of music to help regulate emotions, even when the memories it triggers are negative and painful.</p>
<p>In the face of severe physical and emotional challenges, another participant in our study explained how they had felt an unexpected boost to their wellbeing from listening to a favourite track from their past – despite the apparently negative content of the song’s title and lyrics:</p>
<blockquote>
<p>Exercise has been crucial for me post-stroke. In the midst of my rehab workout, feeling low and in pain, an old favourite, What Have I Done To Deserve This? by the Pet Shop Boys, gave me an instant boost. It not only lifted my spirits but sent my heart racing with excitement – I could feel the tingles of motivation coursing through my veins.</p>
</blockquote>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/Wn9E5i7l-Eg?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">The Pet Shop Boys gave added motivation to a post-stroke rehab workout.</span></figcaption>
</figure>
<p>Music can serve as a cathartic outlet, a source of empowerment, allowing individuals to process and cope with their emotions while supplying solace and release. One participant described how a little-known tune from 1983 serves as a deliberate mood inducer – a tool to boost their wellbeing:</p>
<blockquote>
<p>Whenever I’m down or in need of a pick me up, I play <a href="https://www.youtube.com/watch?v=EXmABxvHTG4">Dolce Vita by Ryan Paris</a>. It is like a magic button for generating positive emotions within myself - it always lifts me up in a matter of moments.</p>
</blockquote>
<p>As each person has their own tastes and emotional connections with certain types of music, a personalised approach is essential when designing music therapy interventions, to ensure they resonate with individuals deeply. Even personal accounts from our researchers, such as this from Sam Fenwick, have proved fruitful in generating hypotheses for experimental work:</p>
<blockquote>
<p>If I had to pick a single song that really strikes a chord, it would be <a href="https://www.youtube.com/watch?v=UNjO3sZ-85w">Alpenglow by Nightwish</a>. This song gives me shivers. I can’t help but sing along and every time I do, it brings tears to my eyes. When life is good, it triggers feelings of inner strength and reminds me of nature’s beauty. When I feel low, it instils a sense of longing and loneliness, like I am trying to conquer my problems all alone when I could really use some support.</p>
</blockquote>
<p>Stimulated by such observations, our latest investigation compares the effects of sad and happy music on people and their brains, in order to better understand the nature of these different emotional experiences. We have found that sombre melodies can have particular therapeutic effects, offering listeners a special platform for emotional release and meaningful introspection.</p>
<h2>Exploring the effects of happy and sad music</h2>
<p>Drawing inspiration from <a href="https://www.sciencedirect.com/science/article/abs/pii/S0031938418308576">studies</a> on emotionally intense cinematic experiences, we recently <a href="https://www.mdpi.com/2673-4087/4/2/14">published a study</a> highlighting the effects of complex musical compositions, particularly Vivaldi’s Four Seasons, on dopamine responses and emotional states. This was designed to help us understand how happy and sad music affects people in different ways.</p>
<p>One major challenge was how to measure our participants’ dopamine levels non-invasively. Traditional functional brain imaging has been a common tool to track dopamine in response to music – for example, positron emission tomography (PET) imaging. However, this involves the injection of a radiotracer into the bloodstream, which attaches to dopamine receptors in the brain. Such a process also has limitations in terms of cost and availability.</p>
<p>In the field of psychology and dopamine research, one alternative, non-invasive approach involves studying how often people blink, and how the rate of blinking varies when different music is played.</p>
<p>Blinking is controlled by the <a href="https://www.britannica.com/science/basal-ganglion">basal ganglia</a>, a brain region that regulates dopamine. Dopamine dysregulation in conditions such as Parkinson’s disease can affect the regular blink rate. Studies have found that individuals with Parkinson’s often exhibit <a href="https://n.neurology.org/content/34/5/677#">reduced blink rates or increased variability in blink rates</a>, compared with healthy individuals. These findings suggest that blink rate can serve as an indirect proxy indicator of dopamine release or impairment.</p>
<p>While blink rate may not provide the same level of precision as direct neurochemical measurements, it offers a practical and accessible proxy measure that can complement traditional imaging techniques. This alternative approach has shown promise in enhancing our understanding of dopamine’s role in various cognitive and behavioural processes.</p>
<p>Our study revealed that the sombre <a href="https://www.youtube.com/watch?v=ZPdk5GaIDjo">Winter movement</a> elicited a particularly strong dopamine response, challenging our preconceived notions and shedding light on the interplay between music and emotions. Arguably you could have predicted a heightened response to the familiar and uplifting <a href="https://www.youtube.com/watch?v=3LiztfE1X7E">Spring concerto</a>, but this was not the case.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/ZPdk5GaIDjo?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Vivaldi’s Winter movement was found to elicit a particularly strong dopamine response.</span></figcaption>
</figure>
<p>Our approach extended beyond dopamine measurement to gain a comprehensive understanding of the effects of sad and happy music. We also used <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10044923/">EEG network analysis</a> to study how different regions of the brain communicate and synchronise their activity while listening to different music. For instance, regions associated with the appreciation of music, the triggering of positive emotions and the retrieval of rich personal memories may “talk” to each other. It is like watching a symphony of brain activity unfold, as individuals subjectively experienced a diverse range of musical stimuli.</p>
<p>In parallel, <a href="https://journals.plos.org/plosone/article/comments?id=10.1371/journal.pone.0110490">self-reports of subjective experiences</a> gave us insights into the personal impact of each piece of music, including the timeframe of thoughts (past, present, or future), their focus (self or others), their form (images or words), and their emotional content. Categorising these thoughts and emotions, and analysing their correlation with brain data, can provide valuable information for future therapeutic interventions.</p>
<p>Our <a href="https://www.mdpi.com/2673-4087/4/2/14">preliminary data</a> reveals that happy music sparks present and future-oriented thoughts, positive emotions, and an outward focus on others. These thoughts were associated with heightened frontal brain activity and reduced posterior brain activity. In contrast, sad tunes caused self-focused reflection on past events, aligning with increased neural activity in brain areas tied to introspection and memory retrieval. </p>
<p>So why does sad music have the power to impact psychological wellbeing? The immersive experience of sombre melodies provides a platform for emotional release and processing. By evoking deep emotions, sad music allows listeners to find solace, introspect, and effectively navigate their emotional states.</p>
<p>This understanding forms the basis for developing future targeted music therapy interventions that cater to people facing difficulties with emotional regulation, rumination and even depression. In other words, even sad music can be a tool for personal growth and reflection.</p>
<h2>What music therapy can offer in the future</h2>
<p>While not a panacea, music listening offers substantial therapeutic effects, potentially leading to increased adoption of music therapy sessions alongside traditional talk therapy. Integrating technology into music therapy, notably through emerging app-based services, is poised to transform how people access personalised, on-demand therapeutic music interventions, providing a convenient and effective avenue for self-improvement and wellbeing.</p>
<p>And looking even further ahead, artificial intelligence (AI) integration holds the potential to revolutionise music therapy. AI can dynamically adapt therapy interventions based on a person’s evolving emotional responses. Imagine a therapy session that uses AI to select and adjust music in real-time, precisely tailored to the patient’s emotional needs, creating a highly personalised and effective therapeutic experience. These innovations are poised to <a href="https://www.frontiersin.org/articles/10.3389/frai.2020.497864/full">reshape the field of music therapy</a>, unlocking its full therapeutic potential.</p>
<figure class="align-center ">
<img alt="Woman listening to music with wireless headphones." src="https://images.theconversation.com/files/557136/original/file-20231101-17-6t5sr7.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/557136/original/file-20231101-17-6t5sr7.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/557136/original/file-20231101-17-6t5sr7.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/557136/original/file-20231101-17-6t5sr7.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/557136/original/file-20231101-17-6t5sr7.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/557136/original/file-20231101-17-6t5sr7.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/557136/original/file-20231101-17-6t5sr7.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Neurofeedback technology could create individual ‘music-brain maps’ that aid self-therapy.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Woman_listening_to_music_with_wireless_headphones_neon_light_(50810419882).jpg">Vu Hoang/Wikimedia</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>In addition, an emerging technology called <a href="https://www.britannica.com/science/neurofeedback">neurofeedback</a> has shown promise. Neurofeedback involves observing a person’s EEG in real-time and teaching them how to regulate and improve their neural patterns. Combining this technology with music therapy could enable people to “map” the musical characteristics that are most beneficial for them, and thus understand how best to help themselves.</p>
<p>In each music therapy session, learning occurs while participants get feedback regarding the status of their brain activity. Optimal brain activity associated with wellbeing and also specific musical qualities – such as a piece’s rhythm, tempo or melody – is learned over time. This innovative approach is being developed in <a href="https://www.urncst.com/index.php/urncst/article/view/345">our lab and elsewhere</a>.</p>
<p>As with any form of therapy, recognising the limitations and individual differences is paramount. However, there are compelling reasons to believe music therapy can lead to new breakthroughs. <a href="https://www.mdpi.com/2076-3425/8/6/107">Recent strides in research methodologies</a>, driven partly by our lab’s contributions, have significantly deepened our understanding of how music can facilitate healing. </p>
<p>We are beginning to identify two core elements: emotional regulation, and the powerful link to personal autobiographical memories. Our ongoing research is concentrated on unravelling the intricate interactions between these essential elements and the specific brain regions responsible for the observed effects.</p>
<p>Of course, the impact of music therapy extends beyond these new developments in the neurosciences. The sheer pleasure of listening to music, the emotional connection it fosters, and the comfort it provides are qualities that go beyond what can be solely measured by scientific methods. Music deeply influences our basic emotions and experiences, transcending scientific measurement. It speaks to the core of our human experience, offering impacts that cannot easily be defined or documented.</p>
<p>Or, as one of our study participants so perfectly put it:</p>
<blockquote>
<p>Music is like that reliable friend who never lets me down. When I’m low, it lifts me up with its sweet melody. In chaos, it calms with a soothing rhythm. It’s not just in my head; it’s a soul-stirring [magic]. Music has no boundaries – one day it will effortlessly pick me up from the bottom, and the next it can enhance every single moment of the activity I’m engaged in.</p>
</blockquote>
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<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p class="fine-print"><em><span>Leigh Riby does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Music therapy has been shown to help people suffering with cancer, chronic pain and depression. Our research is testing which parts of the brain are affected by different kinds of musicLeigh Riby, Professor of Cognitive-Neuroscience , Department of Psychology, Northumbria University, NewcastleLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2161242023-11-08T17:02:39Z2023-11-08T17:02:39ZFootball fans fighting food poverty: how a ‘lifesaving’ mobile pantry scheme spread across the country<figure><img src="https://images.theconversation.com/files/557423/original/file-20231103-19-7o2tvl.jpg?ixlib=rb-1.1.0&rect=27%2C126%2C1441%2C1839&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Volunteers load up a van with food for the next 'mobile pantry'.</span> <span class="attribution"><a class="source" href="https://twitter.com/SFoodbanks">@SFoodbanks</a></span></figcaption></figure><p>It’s 9am in December on Tiber Square, a community space at the centre of one of Liverpool’s most diverse postcodes. The temperature is -5°C. Braving the cold, a small crowd is forming, sharing jokes amid anxious glances at the square’s frozen floor. Their concern is warranted. Given the icy surface, it is unlikely the community food pantry will be going ahead as normal.</p>
<p>Anticipation builds as the mobile pantry arrives, a purple van embossed with the logo of Fans Supporting Foodbanks (FSF) – a red and blue hand clasped to indicate the unity of rival Everton (blue) and Liverpool (red) fans – alongside slogans, including: “Hunger doesn’t wear club colours.”</p>
<p>Out jumps a woman called Cherise to give orders to the volunteers, indiscernible from the crowd in their coats and gloves. “We are just giving out halal chicken, cakes and milk today”, she announces as an orderly queue forms to the side of the square away from the ice. There is no pantry today, but those in attendance will not go hungry.</p>
<p>The regular food pantries are a bit like mobile food banks – mini-markets which set up in various locations across the city. These are areas which could be classified as “<a href="https://www.sheffield.ac.uk/social-sciences/news/12-million-living-uk-food-deserts-studys-shows">food deserts</a>” where cheap, healthy food options are scarce. The mobility of the vans allows FSF to access needy and isolated people within these areas. Patrons pay a fee of £3.50 for which they get a shopping basket and can choose ten ambient (long shelf-life) items. They also receive a bag of mixed vegetables and a bag of selected meat, providing a total shop worth about £25.</p>
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<img alt="" src="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
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<p>Combined with music streaming from the van, along with other community activities such as book and clothes exchanges, health screenings and cooking classes, the model serves to remove the stigma around food bank usage and helps people reconnect with their community.</p>
<p>As one of the users tells us when asked how they would describe their pantry: “(It’s) friendly; supportive. (People are) always asking where I’ve been when I’ve not been down for a couple of weeks.”</p>
<p>Beginning with a single wheelie bin for donations, the FSF movement has inspired an expanded network of similar organisations across the UK. Now, there are around 20 other fan-led groups regularly collecting in support of food banks or pantries from Kilmarnock to Southampton. While in Belfast stronger partisan lines are being crossed with fans uniting across the sectarian divide to fight hunger in both communities.</p>
<figure class="align-center ">
<img alt="Volunteers hand out food at a mobile pantry for people in need" src="https://images.theconversation.com/files/557120/original/file-20231101-23-r70htz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/557120/original/file-20231101-23-r70htz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/557120/original/file-20231101-23-r70htz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/557120/original/file-20231101-23-r70htz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/557120/original/file-20231101-23-r70htz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/557120/original/file-20231101-23-r70htz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/557120/original/file-20231101-23-r70htz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The pop-up market style pantry gets going in Liverpool’s Tiber Square.</span>
<span class="attribution"><span class="source">Jack Sugden</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
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<p>But the contradiction between the economic wealth of the Premier League clubs and local levels of poverty is not lost on the organisers. As Everton fan and FSF co-founder, Robbie Daniels, pointed out to us: </p>
<blockquote>
<p>There’s a massive disparity and the clubs may have thought they were doing enough through their own charities, but we’ve shown them fans collecting for other fans of the club who are starving, and they have started to listen and get involved.</p>
</blockquote>
<h2>Hungry Britain</h2>
<p>Within the past decade, food bank usage has become commonplace in Britain with food poverty moving from the exception to the norm. Between 2014 and 2015, for the first time, <a href="https://www.trusselltrust.org/2015/04/22/foodbank-use-tops-one-million-for-first-time-says-trussell-trust/#:%7E:text=What%20the%20figures%20show,an%20increase%20of%2019%20percent./">over a million people</a> received an emergency food parcel from a charitable food distribution centre. Between April 2022 and March 2023 this number had risen to just under <a href="https://www.trusselltrust.org/news-and-blog/latest-stats/end-year-stats/">3 million</a>, with around a third going to children. </p>
<p>Elsewhere in football, it was a campaign launched by Manchester United’s Marcus Rashford that helped <a href="https://www.bbc.co.uk/sport/football/54670212">spark a national conversation</a> about the need to provide free school meals during the COVID pandemic to children from households on universal credit.</p>
<p>The north-west of England has been badly hit by high levels of food insecurity, and – along with Wales and the north-east – has the highest levels of accesses to <a href="https://www.trusselltrust.org/wp-content/uploads/sites/2/2023/08/2023-The-Trussell-Trust-Hunger-in-the-UK-report-web-updated-10Aug23.pdf">emergency food services in the UK</a>. These areas, along with households across the UK, continue to feel the economic pinch driven by over a decade of <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00061-4/fulltext">government austerity</a> measures brought in by David Cameron’s coalition government in May 2010. </p>
<p>This pinch was exacerbated by the pandemic, higher utility bills and cuts to welfare in the form of <a href="https://www.theguardian.com/society/2021/sep/26/universal-credit-cut-will-lead-to-more-uk-children-in-care-study">reduced universal credit</a> payments to the nation’s poorest. Compounding this situation even further is the highest level of inflation in over 40 years deepening the cost-of-living crisis. This rise means the average basket of food from a supermarket <a href="https://foodfoundation.org.uk/news/food-prices-tracking-july-update">has increased by around 12%</a> in the 12 months leading up to July, with some staples increasing by up to 34%. </p>
<p>In addition, by October 2022 annual energy bills trebled to more than £3,500 in 18 months. By April 2023 this rose to £6,600 and by spring 2024 a typical family will potentially face bills which are <a href="https://www.theguardian.com/business/2022/sep/05/a-crisis-is-coming-for-uk-energy-prices-and-this-is-what-has-to-be-done">500% greater than pre-pandemic prices</a>, with <a href="https://theconversation.com/the-cost-of-living-crisis-cant-wait-for-the-next-election-three-key-issues-the-uk-government-needs-to-tackle-now-215379">six in ten families</a> on the lowest income living in “fuel poverty”. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1717468292196000009"}"></div></p>
<p>The fact is British household earnings are failing to keep pace with household costs at a time when state support is at its most inaccessible. In 2023, in certain parts of the UK, just having a healthy meal and staving off the cold poses a serious challenge. As one pantry user told us: “I take my last medication at seven, then read in bed as it’s warmer.” </p>
<h2>Joy and heartbreak</h2>
<p>Within this series of grim realities, the FSF network operates to support its local communities. Since April 2021 our small team of researchers from the Sport Business Scool at LJMU, which included <a href="https://www.ljmu.ac.uk/about-us/staff-profiles/faculty-of-business-and-law/liverpool-business-school/clay-gransden">Clay Gransden</a> and <a href="https://www.ljmu.ac.uk/about-us/staff-profiles/faculty-of-business-and-law/liverpool-business-school/matthew-hindmarsh">Matthew Hindmarsh</a>, has spent time with the network, volunteering at pantries, and interviewing other volunteers to understand their roles. We have also been surveying 176 food pantry users to measure the impact of the movement. Many of the people we spoke to experienced a great deal of joy from supporting others, but there was no escaping a pervading feeling of sadness caused by the impact of food poverty.</p>
<p>We volunteered at each location for between two and six months before carrying out the surveys. We did this to build trust as we believe: the more trust, the more honest the answers. We collected responses and short stories about the realities people were living and the role of the FSF service in their lives.</p>
<p>The majority of pantry users were aged over 40 with 39% over 65. While a quarter were in full-time employment, and 73% were either retired or unemployed. Asked how important the service was to them out of ten (with ten being the most important), over 80% selected eight or above, the most common answer being ten. But, overall, the results we gathered were heartbreaking. Take Paul for example. Paul was in his early 40s and was using the pantry for the first time when we spoke to him. </p>
<blockquote>
<p>I have got depression, anxiety and I really have nothing … I didn’t eat yesterday and have £5 in my account that I’ve been given … but then I’ve seen this … this is great it’s what I need to feel better … I am going to come next week to see if I can volunteer. </p>
</blockquote>
<p>Our survey was an attempt at capturing people’s experience and one of the hardest questions was, “how do you feel when you are here?”. To assist a list of emotions was offered such as anger, fear, embarrassment, joy, acceptance, and sadness. Somewhat surprisingly the most common answer was joy (36%), followed by acceptance (33%).</p>
<p>As one pantry user offered: “Everyone is in the same boat and [the pantry] creates a neighbourhood feel … [There’s] no stigma in coming to use the pantry.” Due to the environment, many respondents said initial feelings, such as embarrassment, had been replaced by joy and acceptance as they moved to regular attendance. As another user told us:</p>
<blockquote>
<p>It’s eye-opening. A year ago, it was lifesaving. It was hard to go to initially but it has helped me keep my head above water. I’m really grateful for the service. Been part of allowing me to get back on track. </p>
</blockquote>
<p>Our surveys also underlined how some 63% of respondents had been frequenting the pantries for over a year. This indicated how important the pantries have become in the medium to long-term survival of the communities they serve. </p>
<h2>‘Football supporters as a force for good’</h2>
<p>FSF first emerged in 2015 from the two Liverpool boroughs of Walton and Anfield in recognition of the growing issue of food poverty. These areas are synonymous with both football and deprivation, playing host to two of the Premier League’s closest rivals, Everton and Liverpool respectively, along with two of the UK’s most deprived communities. </p>
<p>In recognition of the growing food poverty crisis, an unlikely alliance between two grassroots supporter groups – The Blue Union (Everton) and The Spirit of Shankly (Liverpool) was formed. Since then, the organisation has grown in both size and importance. </p>
<p>The monolithic stadiums of Goodison Park and Anfield, the respective homes of Everton and Liverpool, sit 896 metres from each other across Stanley Park nestled within rows of terraced housing like two spaceships from another world.</p>
<p>Standing to the side of the mobile pantry van as patrons wound their way around the pop-up market set up on cold and windy day in late February, its driver is co-founder Daniels, who works full time for the charity, a rare staff member the organisation desperately needs but struggles to afford. </p>
<p>Daniels is a former taxi driver in his 50s. Short, with greying hair, what he lacks in stature he makes up for in personality as he hands out bags of fresh meat with a smile and a line or two of banter alongside his wife Linda. Daniels talked passionately about the movement: “We got into this because things are bad right … and we need to change the perceptions around who football fans really are.” </p>
<p>With both groups of fans, there is a sense of pride in acting without corporate support as they have stood in solidarity against several issues over the years, such as the fight for truth around the <a href="https://www.bbc.co.uk/news/uk-england-merseyside-47697569">Hillsborough disaster</a> and the <a href="https://www.theanfieldwrap.com/2014/02/footballticketprices/">“twenty is plenty” campaign</a> (a battle against overpriced away tickets). Sitting in the van as the Wednesday pantry was winding down, Daniels said:</p>
<blockquote>
<p>It is a movement, it’s fan activism, we’ve all protested together against our own clubs … trying to get the price of away tickets down with fans from Newcastle, Manchester and that … it’s showing football supporters as a force for good; look how it’s spreading.</p>
</blockquote>
<p>This spread is seen as vital considering the compounding crises faced by communities. Merseyside is host to areas of the UK hardest hit by the rises in the cost-of-living, a region consistently left behind by a central government which has <a href="https://www.theguardian.com/inequality/2022/feb/02/levelling-up-funding-inequality-exposed-by-guardian-research">faced accusations</a> of <a href="https://www.youtube.com/watch?v=jwqQvrqunp8">favouring wealthier Conservative areas</a> in the south-east when it comes to <a href="https://www.bbc.co.uk/news/uk-politics-64321755">allocating funding</a>. </p>
<p>It is within this context that FSF, and its army of over 60 volunteers, has sought to stave off some of the worst affects of food poverty by building a service which in the words of another co-founder, Dave Kelly, “helps people up, not just out”.</p>
<p>FSF has met this aim through a successful programme of grassroots fundraising and activism which supports the successful application of the “food pantry model”. A model that champions a community atmosphere and a market format which can make the experience more positive for users. After finishing his stint handing out numbered tickets to patrons so that they wouldn’t need to queue, a man in his 60s nodded his head to the sounds of ELO and added:</p>
<blockquote>
<p>This is a much better way of doing it … I have worked at food banks and places, this pantry and the difference is incredible.</p>
</blockquote>
<p>FSF was born partly out of disaffection with the way regular food banks were run via a system of referrals that can present a <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-6951-6">barrier to some</a>. This is because local health and social care providers tend to hold the keys to many food banks and ask probing questions or set limits on attendance (for example, three times in six months). So the fans decided to go it alone, establishing the first FSF pantry in April 2019. From then, due to the efforts of the fan organisation, grassroots activism and other community groups, funding and resources have been raised to start and maintain other pantries across the city.</p>
<p>There are currently six pantries run by FSF in deprived areas of the city, plus a Sunday breakfast club in Birkenhead. Each pantry serves between 80 and 150 people, but this figure is rising as the economic crisis affects the financial stability of more households. </p>
<p>Together, FSF pantries serve between 6-700 people per week with a basket of food, meat, vegetables and other essential items. This figure rises in winter due to higher energy bills. At the lower end, FSF provides for around 33,400 people per year, and has so far served an estimated 90,000 people in 2023 - an increase from 75,000 over the previous 12 months. Most pantry users are regulars and in the surveys talked about how the service affected their lives. One user wrote: “It’s very helpful. The opportunity to get support with food, particularly with the increases in costs of everything. £3.50 to get food is lifesaving.”</p>
<p>“Lifesaving” or “lifeline” were common terms used when describing the pantries, indicating how close many people are to destitution when faced with the price of living in the UK today. And the format of the pantry as a social space reduces stigma, as one anonymous user described:</p>
<blockquote>
<p>You don’t feel embarrassed, even people who work have to rely on the food pantry. There will always be someone to chat to if you are struggling. You will never ever be judged.</p>
</blockquote>
<h2>Hunger doesn’t wear club colours</h2>
<p>The establishment of FSF is one part of the changing face of football fandom. In the UK, fans have come a long way since the 1970 and 80s when fighting between rival supporters on the terraces and in the streets surrounding the grounds was commonplace. Fan culture during this era was also a far cry from social and racial tolerance and could be a vessel for <a href="https://www.tandfonline.com/doi/full/10.1080/1369183X.2013.777524?casa_token=YX8Q3fugEuEAAAAA%3AZwp5Oa73U_VvpEIPhpzLf5tAlRKTKidtUG71uws5fpZKzPJYZeDeEoENxdRE0r0vd9J4TK09nUZc">the opposite</a>. </p>
<figure class="align-right ">
<img alt="A logo for Fans Supporting Foodbanks." src="https://images.theconversation.com/files/557146/original/file-20231101-27-3ptgup.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/557146/original/file-20231101-27-3ptgup.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/557146/original/file-20231101-27-3ptgup.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/557146/original/file-20231101-27-3ptgup.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/557146/original/file-20231101-27-3ptgup.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/557146/original/file-20231101-27-3ptgup.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/557146/original/file-20231101-27-3ptgup.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The FSF logo emblazoned across its vans.</span>
<span class="attribution"><span class="source">Jack Sugden</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>However, in 1989 the Hillsborough disaster would send shockwaves through Liverpool and the wider football community, reverberating across the country and sowing the seeds for the sense of unity and solidarity we see in evidence with FSF today. Ian Byrne MP is the former head of the Spirit of Shankly supporters’ group and co-founder of FSF. He was there on the day of the disaster which was caused by <a href="https://www.bbc.co.uk/news/uk-england-merseyside-47697569">poor event management and policing</a> and which lead to the deaths of 97 fans. But the truth of what happened at Hillsborough would not come to light for decades. As Byrne pointed out while we chatted over mugs of tea in his sparse constituency office: </p>
<blockquote>
<p>Hillsborough changed everything … your political awareness goes off the scale and you see injustices everywhere … you start contemplating the power of football.</p>
</blockquote>
<p>While not as ferocious as other football rivalries, this fandom divides families and the city, with Merseyside council bins being coloured purple, a blend of red and blue to avoid disagreement.</p>
<p>The Hillsborough disaster brought the fans together in collective mourning and has remained an example of solidarity with both clubs showing signs of open unity each anniversary and throughout <a href="https://books.google.co.uk/books?hl=en&lr=&id=_APdCgAAQBAJ&oi=fnd&pg=PT10&dq=hillsborough+campaign&ots=KHKi7PRIlx&sig=-UZS4xasslLGYiuIHoc61QQrnOI#v=onepage&q=hillsborough%20campaign&f=false">the ongoing campaign for justice</a>.</p>
<p>Indeed, earlier in 2023, <a href="https://twitter.com/DavefcKelly">Kelly</a> broke his lower back in a freak accident on the day of Everton’s Hillsborough anniversary game. Many would regard Kelly, a man in his late 60s, as the engine behind the FSF movement. He’s a tireless campaigner and despite the serious injury, he refused to get in an ambulance until after he had laid a wreath at the memorial on behalf of the Everton fans. This not only gives an insight into Kelly’s character, but also denotes just how deep the solidarity runs when it comes to Hillsborough.</p>
<figure class="align-center ">
<img alt="Three men holding a banner about food poverty" src="https://images.theconversation.com/files/557310/original/file-20231102-17-me1qvx.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/557310/original/file-20231102-17-me1qvx.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=366&fit=crop&dpr=1 600w, https://images.theconversation.com/files/557310/original/file-20231102-17-me1qvx.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=366&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/557310/original/file-20231102-17-me1qvx.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=366&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/557310/original/file-20231102-17-me1qvx.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=460&fit=crop&dpr=1 754w, https://images.theconversation.com/files/557310/original/file-20231102-17-me1qvx.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=460&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/557310/original/file-20231102-17-me1qvx.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=460&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Co-founder of Fans Supporting Foodbanks and Everton Fan Advisory Board chair Dave Kelly (right) with Southend fan Alex Small (left) and West Ham fan John Ratomski (centre) putting club differences aside in the fight against food poverty.</span>
<span class="attribution"><a class="source" href="https://twitter.com/DavefcKelly/status/1570462141697736713">@IFoodbanks</a></span>
</figcaption>
</figure>
<h2>Catholics and protestants united</h2>
<p>Sitting in the <a href="https://www.irishnews.com/news/northernirelandnews/2023/01/14/news/belfast_foodbank_service_opens_community_solidarity_hub-2996793/">“solidarity café” in West Belfast</a>, a community space set up by local councillor and head of FSF Northern Ireland, Paul Doherty, that began in his garage, he explained how they have united catholic and protestant fans in the fight against hunger. “Both communities are suffering,” he said. Rival groups now spend time together collecting food and funds outside football stadiums. Doherty added:</p>
<blockquote>
<p>There used to be fights outside the grounds here, now these are spaces we use to break down barriers … you notice when we go to deliver the food the exited reaction of the children is the same regardless of which community you are in. </p>
</blockquote>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1637087686870675461"}"></div></p>
<p>In Belfast, as elsewhere, hunger pays no heed to allegiances, food poverty is pervasive and fans are beginning to take notice of the power they have to provoke change.</p>
<p>In Liverpool, like many cities across the UK and Europe, football is woven into the fabric of social life. As Pauline, a middle aged woman who runs Vauxhall food pantry with a quiet determination, told us on a day after the pantry: </p>
<blockquote>
<p>You have to have interest in football. It’s part of everyday life. When you grow up and you haven’t got a lot, you focus on football … are you a red or are you a blue? </p>
</blockquote>
<h2>Fan power</h2>
<p>Set against this backdrop, fan activism in these communities links to a wider shift in the perception of fans and their ability to enact social change. <a href="https://journals.sagepub.com/doi/full/10.1177/10126902221077188">Recent research</a> focusing on activism in the English Premier League (EPL) shows how in the past football fans have been perceived as a vocal minority, passive and a-political. </p>
<p>However, they have awoken to a shift in the identity of their clubs. Faced with a commercial onslaught, often coupled with overseas ownership, elite clubs are increasingly distanced from the communities that birthed them. Fans today are consequently facing up to this reality, as well as the power they hold and the possibilities unity affords them.</p>
<p>Partly because of fan movements like “<a href="https://link.springer.com/chapter/10.1007/978-3-319-48734-2_2">Fans Against Modern Football</a>”, “<a href="https://journals.sagepub.com/doi/abs/10.1177/0038026120977809">Movement for Safe Standing</a>”, <a href="https://you.38degrees.org.uk/efforts/football-supporters-against-gambling-ads">Football Supporters against Gambling ads</a>, and the widespread campaign <a href="https://www.espn.co.uk/football/story/_/id/37616441/how-fan-reaction-revolt-helped-end-english-clubs-breakaway">against the European Super League</a>, there are now safe-standing terraces in existence or planned at various UK clubs, gambling adverts will be withdrawn from the front of EPL club’s matchday shirts from 2026 and the ESL was dead within 48 hours of its “launch”.</p>
<p>Combined support for the ongoing “<a href="https://thefsa.org.uk/petition/twentys-plenty-away-ticket-petition/#:%7E:text=What%20is%20Twenty's%20Plenty%3F,(%C2%A315%20for%20concessions).">Twenty is Plenty</a>” campaign also saw the Premier League cap away tickets at £30 from the 2016-17 season, a fall from uncapped tickets that rose to £77 for some away fans.</p>
<p>This brings us back to the north-west, where the Everton and Liverpool supporters groups who energised the “Twenty is Plenty” campaign are the very same people who would go on to build FSF. Indeed, it was through organising a boycott of excessive charges to watch Premier League games on television that FSF was able to raise funds to help with the purchase of two mobile pantries and a lorry to spread solidarity throughout the city and around the country. </p>
<h2>Dignity and respect</h2>
<p>Often travelling to away games, the FSF crew from Liverpool utilises these strengthening networks to take donations to the collections of other fan groups. The symbolism of, for example, Liverpool fans bringing food to donate to the Manchester City fans is meaningful and has spurred other groups to follow suit. As Donna Scully, a Liverpool fan in her 50s and FSF volunteer, told us:</p>
<blockquote>
<p>The deprivation is everywhere, and none of us [fans] at any club can say that it’s not impacting my community … it’s in every corner of this country.</p>
</blockquote>
<p>Scully knows this better than most. During the week she is a director of a law firm but for the last seven years, every Sunday morning she has donated her own time, along with resources of the firm, to run The Wirral Breakfast Club alongside FSF.</p>
<p>Beginning at 8am the club predominantly serves the homeless, but this demographic has shifted to include those in work and and with homes as the cost-of-living crisis bites. Married couple Robbie and Linda volunteer in the kitchen and pump out between 70-100 cooked breakfasts which are served by a small team led by Scully who, in her Liverpool shirt, fizzes about the community hall. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1553682649771909121"}"></div></p>
<p>She serves tea and breakfast with a smile, knows all their names and their stories and checks up on everyone. She listens to their painful battles to gain support – nobody is turned away. It’s enough to make you weep. When asked about her motivation Scully replied:</p>
<blockquote>
<p>We are all about treating people with dignity and respect … everyone thinks fans are about rioting and getting drunk but we want to show how we can really do something here, show how much we care about each other.</p>
</blockquote>
<p>Speaking to other FSF movements from around the UK it has become clear how important the network has become. For FSF Dundee founder Marty Smith, a young man in his early 20s with a thick Dundee accent, “it’s genuinely really inspiring”. </p>
<p>The Scottish network has grown from five to eight fan organisations in the past 18 months, including Glasgow Rangers and Celtic groups working together. There are similar stories elsewhere in the UK, motivated by a passion for their communities and a desire for change.</p>
<p>Along with a healthy dose of competitiveness that still exists as <a href="https://twitter.com/BillCorcoran5/media">Bill Corcoran</a>, from the <a href="https://twitter.com/Nufcfoodbank">Newcastle FSF</a> joked: “We saw the scousers doing it, so we thought we better too!”.</p>
<p>Despite the playful competitiveness, there is a serious mission shared by all we spoke to and volunteered alongside highlighted by Paul Khan, head of the Liverpool Supporters Association, the volunteer back in Liverpool: “Our vision is to eradicate food poverty.”</p>
<h2>#RightToFood</h2>
<p>One of the criticisms faced by the FSF movement is by stepping into the void of government to bring food and essential services to underserved communities, they are legitimating a laissez-faire approach towards the welfare state which many argue sits neatly within the Conservative government’s ideology.</p>
<p>However, FSF is all too aware of this critique and has tied the movement to a broader fight against food poverty – the “<a href="https://www.bigissue.com/news/social-justice/what-is-the-right-to-food/">Right to Food</a>” campaign.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1717073843347411285"}"></div></p>
<p>The campaign is led by Byrne and supported by several institutions including the Unite Union and city councils in Manchester, Brighton and Newcastle. Its goals include, bringing in universal free school meals for every child, rolling out “community kitchens” in much-needed areas and encouraging the government to reveal their <a href="https://www.theguardian.com/politics/2022/jun/13/food-plan-for-england-condemned-by-its-own-lead-adviser">plans for spending on food</a>.</p>
<p>Tying the FSF movement to a campaign such as this is typical for social movements <a href="https://www.taylorfrancis.com/books/mono/10.4324/9781315632070/social-movements-1768-2012-charles-tilly-lesley-wood">throughout history</a>, however, never has a football fan-led movement taken on an issue of such scale and importance as national hunger and child poverty. </p>
<p>Enshrining the right to food in law would begin with children and then spread upwards, with the goal of ensuring that everyone has the resources or ability to <a href="https://www.ianbyrne.org/righttofood">access the food they need</a> to live well. Indeed, the health benefits of simply eating enough food for the day are well known, as are the impacts on <a href="https://srcd.onlinelibrary.wiley.com/doi/full/10.1111/j.1467-8624.2009.01396.x?casa_token=2f9OfRPEf-UAAAAA%3ALgHWrW34JKTAbxVAL4SuwhBhGKszbEe-BoqmEFlje2duPLpQcVARbPaBzalJIxioHzkK8KMvuw6-lF8">school attendance and long-term attainment</a>.</p>
<p>As Byrne told us, the health benefits are obvious, “less measurable – but no less important – is the effect on individual human dignity and social cohesion over time in our polarised nations of food banks next to investment banks”.</p>
<h2>Hunger marching on</h2>
<p>The communities at the heart of FSF’s work display the changing face of fandom in the UK within cities where football is part of daily life. </p>
<p>What the activities surrounding the food banks show is the ability for local solutions to national problems. Where successive governments and policy responses have failed areas such as Toxteth in Liverpool (home of the Lodge Lane pantry), groups of football fans have been able to turn their care for the community into action. But as all organisers were fond of saying “we are just a sticking plaster”.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/liverpools-unsung-covid-heroes-how-the-citys-arts-scene-became-a-life-support-network-192776">Liverpool's unsung COVID heroes: how the city's arts scene became a life support network</a>
</strong>
</em>
</p>
<hr>
<p>The national campaign is an attempt to heal these wounds for good. On a clear day in late September 2023, we joined the March for Hunger that wound its way through Liverpool led by local school children. Parallel marches took place in London and Belfast demanding universal free school meals. Among the crowds were community and church groups, individual activists, and of course football fans, who added the voice of the terraces to the universal chant demanding the right to food.</p>
<p>What this represents is a change in the way we see football fans and perhaps the way they see themselves. After all, football, like all social endeavours, is a malleable beast open to remaking and reimagining.</p>
<p>Though, at times, it has played host to a multitude of wrongs, right now - up and down the country and across the Irish Sea - football fans are deciding to remake themselves and their communities in the image of service and solidarity, regardless of club colours. </p>
<hr>
<p><em>If you want to donate or find out more about your local FSF network, there is more information <a href="https://www.gofundme.com/f/se4nx-fans-supporting-foodbanks">here</a>.</em></p>
<hr>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
</figcaption>
</figure>
<p><em>For you: more from our <a href="https://theconversation.com/uk/topics/insights-series-71218?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insights series</a>:</em></p>
<ul>
<li><p><em><a href="https://theconversation.com/unlocking-new-clues-to-how-dementia-and-alzheimers-work-in-the-brain-uncharted-brain-podcast-series-194773?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Unlocking new clues to how dementia and Alzheimer’s work in the brain – Uncharted Brain podcast series
</a></em></p></li>
<li><p><em><a href="https://theconversation.com/existential-crisis-how-long-covid-patients-helped-us-understand-what-its-like-to-lose-your-sense-of-identity-and-purpose-in-life-211223?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Existential crisis: how long COVID patients helped us understand what it’s like to lose your sense of identity and purpose in life
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<li><p><em><a href="https://theconversation.com/gp-crisis-how-did-things-go-so-wrong-and-what-needs-to-change-208197?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">GP crisis: how did things go so wrong, and what needs to change?
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<li><p><em><a href="https://theconversation.com/its-like-being-in-a-warzone-aande-nurses-open-up-about-the-emotional-cost-of-working-on-the-nhs-frontline-194197?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">‘It’s like being in a warzone’ – A&E nurses open up about the emotional cost of working on the NHS frontline</a></em></p></li>
<li><p><em><a href="https://theconversation.com/loneliness-loss-and-regret-what-getting-old-really-feels-like-new-study-157731?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Loneliness, loss and regret: what getting old really feels like – new study
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<p><em>To hear about new Insights articles, join the hundreds of thousands of people who value The Conversation’s evidence-based news. <a href="https://theconversation.com/uk/newsletters/the-daily-newsletter-2?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK"><strong>Subscribe to our newsletter</strong></a>.</em></p><img src="https://counter.theconversation.com/content/216124/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jack Sugden receives funding from The British Academy. </span></em></p><p class="fine-print"><em><span>Christopher Faulkner does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Researchers spent months volunteering with Fans Supporting Foodbanks to see how left-behind communities were fighting food poverty.Jack Sugden, Senior Lecturer in Sport Governance and Law, Liverpool John Moores UniversityChristopher Faulkner, Senior Lecturer in Sport Business, Liverpool John Moores UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2147762023-10-27T10:44:22Z2023-10-27T10:44:22ZHow to solve our mental health crisis<figure><img src="https://images.theconversation.com/files/554870/original/file-20231019-21-lgmepp.jpeg?ixlib=rb-1.1.0&rect=298%2C51%2C3414%2C2098&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Advert for a universal basic income (UBI) scheme in New York, May 2016. Such schemes could offer significant benefits for recipients' mental health.</span> <span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:BASIC_INCOME_COMMING_SOON_-_31857924093.jpg">Generation Grundeinkommen via Wikimedia</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>When BBC journalist Rory Carson <a href="https://www.bbc.co.uk/programmes/m001m0f9">sought online consultations</a> for a potential mental health issue, three private clinics diagnosed him with <a href="https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/">attention deficit hyperactivity disorder</a> (ADHD). They charged between £685 and £1,095 for these consultations, which lasted between 45 and 100 minutes, and all prescribed him medication.</p>
<p>ADHD is a <a href="https://reaktionbooks.co.uk/work/hyperactive">highly controversial disorder</a> which emerged in the US in the late 1950s during the <a href="https://theconversation.com/adhd-how-race-for-the-moon-revealed-americas-first-hyperactive-children-120393">cold war</a>, and quickly became associated with stimulant drugs such as <a href="https://theconversation.com/ritalin-at-75-what-does-the-future-hold-121591">Ritalin</a>. Now diagnosed <a href="https://academic.oup.com/shm/article/30/4/767/2919401">throughout the world</a>, ADHD is central to many debates about <a href="https://www.autisticuk.org/neurodiversity">neurodiversity</a>.</p>
<p>While Carson’s Panorama investigation into its treatment attracted <a href="https://www.huffingtonpost.co.uk/entry/bbc-panorama-adhd-diagnosis-twitter_uk_64621f2fe4b018d846bf19ee">plenty of criticism</a>, the fact that this disorder could apparently be diagnosed quite casually online is concerning. When he subsequently had a more rigorous (but free) three-hour, in-person consultation with an NHS psychiatrist, he was told that he did not, in fact, have ADHD.</p>
<hr>
<p><em>Across the world, we’re seeing unprecedented levels of mental illness at all ages, from children to the very old – with huge costs to families, communities and economies. <a href="https://theconversation.com/uk/topics/tackling-the-mental-health-crisis-147216?utm_source=TCUK&utm_medium=ArticleTop&utm_campaign=MentalHealthSeries">In this series</a>, we investigate what’s causing this crisis, and report on the latest research to improve people’s mental health at all stages of life.</em></p>
<hr>
<p>Society’s increasing <a href="https://www.sciencedirect.com/science/article/pii/S0732118X2300003X">awareness of mental health issues</a> and <a href="https://www.nhsconfed.org/articles/analysis-rise-mental-health-demand">demand for mental health support</a> has been driven, in part, by social media and easier access to information online. While this is no bad thing in many ways, the related <a href="https://www.psychologytoday.com/gb/blog/our-new-discontents/202209/the-appeal-and-the-peril-self-diagnosis">increase in self-diagnosis</a> (including among <a href="https://www.sciencedirect.com/science/article/pii/S0010440X22000682">children and adolescents</a>) is clearly open to abuse by some organisations offering costly diagnoses and treatments.</p>
<p>But there is another reason for this <a href="https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/mental-health-pressures-data-analysis#:%7E:text=Mental%20health%20services%20in%20England,mental%20health%20services%20steadily%20rising.">rapid growth in private mental healthcare</a>. In England alone, the NHS spends around <a href="https://www.theguardian.com/society/2022/apr/24/nhs-paying-2bn-pounds-a-year-to-private-hospitals-for-mental-health-patients">£2 billion per year</a> on private hospital care for mental health patients – equating to 13.5% of its total mental health spend. Due to the reduction in <a href="https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/hospital-beds">NHS bed provision</a>, nine out of ten privately-run mental health beds are now filled by NHS patients.</p>
<p>While the UK government says it is committed to <a href="https://www.gov.uk/government/news/mental-health-services-boosted-by-150-million-government-funding">spending more money on mental health</a>, private investment companies are <a href="https://www.theguardian.com/commentisfree/2023/aug/17/private-equity-nhs-hospital-crisis">reportedly</a> queuing up to “seize the opportunities offered up to them by the NHS crisis”. <a href="https://www.business-reporter.co.uk/management/tackling-the-mental-health-crisis-how-the-private-sector-can-help-improve-nhs-mental-health-services">Private providers</a> say they can do more to help avert a mental health emergency exacerbated by the COVID pandemic, yet a dozen of the <a href="https://www.carehome.co.uk/mental-health-hospitals/index.cfm/searchcountry/England/orderid/-1">80-odd</a> privately-run mental health hospitals in England were <a href="https://www.independent.co.uk/news/uk/home-news/mental-health-hospitals-inadequate-map-cqq-b2360777.html">rated as “inadequate”</a> in the Care Quality Commission’s latest report, which has <a href="https://www.bbc.co.uk/news/uk-65761273">warned of possible closures</a>.</p>
<p>As a health historian, I find our worsening <a href="https://www.bma.org.uk/bma-media-centre/shameful-statistics-show-a-mental-health-crisis-that-is-spiralling-out-of-control-as-demand-far-outweighs-capacity-warns-bma">mental health crisis</a> sadly predictable. Governments around the world have been involved in tackling mental illness <a href="https://www.britannica.com/science/mental-disorder/Treatment-of-mental-disorders">since at least the early 19th century</a>. While not all of their attempts were successful, many important lessons remain unlearned.</p>
<p>At the heart of them is this: amid ageing populations and the spiralling <a href="https://www.lse.ac.uk/News/Latest-news-from-LSE/2022/c-Mar-22/Mental-health-problems-cost-UK-economy-at-least-118-billion-a-year-new-research">costs of mental illness</a> to national economies, investing in people’s future mental health, based on what the key <a href="https://www.mentalhealth.org.uk/explore-mental-health/statistics/poverty-statistics">socioeconomic factors</a> that we know are underlying it, is the only effective, long-term way to reduce this burden. As a major coalition of UK mental health organisations <a href="https://www.centreformentalhealth.org.uk/wp-content/uploads/2023/09/AMentallyHealthierNation_Digital.pdf">recently reported</a>: </p>
<blockquote>
<p>The risks to mental health, and the poor outcomes that follow, do not fall evenly across the population. People living in poverty, those with physical disabilities and illnesses, people with neurodevelopmental conditions, children in care, people from racialised communities, and LGBTQ+ people all experience much poorer mental health outcomes because of intersecting disadvantage and discrimination.</p>
</blockquote>
<p>This all adds up to the life expectancy of a person with a severe mental illness being about 20 years shorter than someone without a diagnosis – and that gap is getting bigger. We understand the reasons why – so why do we seem unable to do anything about it?</p>
<h2>Learning from history: the emergence of asylums</h2>
<p>The first asylum in Britain was <a href="https://en.wikipedia.org/wiki/Bethlem_Royal_Hospital">Bethlehem Hospital</a> near London’s Bishopsgate, which began to specialise in insanity by the 15th century. Commonly referred to as “Bedlam”, what is now Bethlem Royal Hospital was often depicted negatively – including in <a href="https://www.tate.org.uk/research/features/hogarth-rakes-progress-paintings-to-prints">A Rake’s Progress</a>, a series of eight paintings by the 18th-century English artist William Hogarth.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/554873/original/file-20231019-17-935x2j.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Painting of naked man being attended to in a madhouse." src="https://images.theconversation.com/files/554873/original/file-20231019-17-935x2j.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/554873/original/file-20231019-17-935x2j.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/554873/original/file-20231019-17-935x2j.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/554873/original/file-20231019-17-935x2j.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/554873/original/file-20231019-17-935x2j.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/554873/original/file-20231019-17-935x2j.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/554873/original/file-20231019-17-935x2j.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">‘In The Madhouse’ (1732-1735) by William Hogarth, from his series A Rake’s Progress.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:William_Hogarth_019.jpg">Wikimedia</a></span>
</figcaption>
</figure>
<p>Across the Atlantic, the treatment of patients in American asylums also proved very controversial. When Ebenezer Haskell escaped the Pennsylvania Hospital for the Insane in 1868, he immediately sued the hospital for unjust confinement and published an <a href="https://wellcomecollection.org/works/h367tupx/items?canvas=109">account of his ordeal</a>, writing in the foreword:</p>
<blockquote>
<p>The object of these pages is … simply to speak a few plain unvarnished truths [on] behalf of the poor, helpless and suffering patients put in these [institutions], and to show why a strong and positive legislative action should be taken for their protection.</p>
</blockquote>
<p>The pamphlet included depictions of Haskell being punished and tortured, sometimes in the guise of treatment. In one, he is shown naked and lying on his back on the floor, restrained by four men while another performs “<a href="https://www.psychologytoday.com/gb/blog/short-history-mental-health/201510/the-healing-waters">hydrotherapy</a>” – dumping a bucket of water on Haskell’s face as a second man stands ready with another bucket.</p>
<p>Public perceptions of the brutal forms of care provided in mental asylums – and private “<a href="https://historicengland.org.uk/research/inclusive-heritage/disability-history/1660-1832/the-age-of-the-madhouse/">madhouses</a>” – continue to be heavily influenced by films such as <a href="https://www.imdb.com/title/tt1130884/">Shutter Island</a> (2010), <a href="https://www.imdb.com/title/tt0172493/">Girl, Interrupted</a> (1999) and, perhaps most notably, <a href="https://www.imdb.com/title/tt0073486/">One Flew Over the Cuckoo’s Nest</a> (1975). Such films, and the novels that inspired them, portray asylums as harsh, unforgiving places run by mostly callous or sadistic staff. While this is justified in some cases, such portrayals mask the impressive ambition, care and expense that went into the building of many asylums by governments around the world during the 19th century.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/OXrcDonY-B8?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Trailer for One Flew Over the Cuckoo’s Nest (1975)</span></figcaption>
</figure>
<p>The provision of care for the mentally ill has long been considered a public responsibility. In Britain, the <a href="https://en.wikipedia.org/wiki/Madhouses_Act_1774">1774 Madhouses Act</a> was a response to concerns about abuse in private madhouses. Soon after, the <a href="https://www.countyasylums.co.uk/history/">County Asylum Act of 1808</a> and <a href="https://en.wikipedia.org/wiki/Lunacy_Act_1845">Lunacy Act of 1845</a> were passed in England and Wales to create dedicated public facilities for the mentally ill, so they wouldn’t languish in <a href="https://en.wikipedia.org/wiki/Workhouse">workhouses</a>. Dozens of asylums began popping up all over Britain, regulated by the newly established <a href="https://en.wikipedia.org/wiki/Commissioners_in_Lunacy">Lunacy Commission</a>.</p>
<p>Encouraged by the <a href="https://www.bl.uk/restoration-18th-century-literature/articles/the-enlightenment">Age of Enlightenment</a>, which spurred the idea that science could solve most of the world’s problems, Britain was among the pioneers embracing the concept of <a href="https://www.healthcareers.nhs.uk/career-planning/resources/brief-history-public-health">public health</a>, with governments investing in public infrastructure to prevent infectious disease. In the case of asylums, <a href="https://www.glasgowlive.co.uk/news/history/inside-glasgows-abandoned-gartloch-hospital-24459623">little expense was spared</a> even for so-called “pauper lunatics”. </p>
<p>At this time, asylums would have been among the <a href="https://www.psychologytoday.com/gb/blog/short-history-mental-health/201901/cathedrals-the-mind">most impressive buildings</a> people would have seen – overshadowed only by cathedrals. However controversial, they were the first concerted, state-led effort to deal with mental illness. And while few mental health experts would recommend a return to the asylum era today, they might well envy the commitment that governments in Britain and elsewhere demonstrated in the facilities they provided for their mentally ill. </p>
<h2>The disease that linked mental illness to poverty</h2>
<p>Nineteenth-century experts provided numerous explanations for insanity. Some, such as <a href="https://wellcomecollection.org/works/b4y4n6pn">masturbation</a>, we would laugh at today. But financial insecurity, <a href="https://en.wikipedia.org/wiki/Neurasthenia">overstudy and overwork</a>, or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8953002/pdf/atlantajrecmed141958-0005.pdf">problems related to giving birth</a> seem much more reasonable and still relevant. Just as <a href="https://www.britannica.com/science/heredity-genetics">heredity</a> was cited as a cause in the past, today we cite <a href="https://www.nimh.nih.gov/health/publications/looking-at-my-genes#:%7E:text=Certain%20mental%20disorders%20tend%20to,factors%20also%20play%20a%20role.">genetic predisposition</a>.</p>
<p>As governments began to invest more in hospital infrastructure to treat physical ills, due in particular to advancements in germ theory and surgery, asylum buildings and care standards were often left to deteriorate. In Alabama’s <a href="https://en.wikipedia.org/wiki/Searcy_Hospital">Mount Vernon Insane Hospital</a>, for example, scandal surrounded the death of 57 African-American patients in 1906. But the cause of these deaths, pellagra – a disease that <a href="https://www.psychiatrist.com/blog/pellagra-niacin-deficiency-and-mental-illness/#:%7E:text=The%20relevance%20of%20pellagra%20to,it%20may%20lead%20to%20death.">can affect the brain</a> and cause severe psychiatric symptoms – has an important place in the history of public mental health treatment.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/554936/original/file-20231020-25-pr3fqp.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Wax head-and-shoulders model of a woman with pellagra" src="https://images.theconversation.com/files/554936/original/file-20231020-25-pr3fqp.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/554936/original/file-20231020-25-pr3fqp.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=845&fit=crop&dpr=1 600w, https://images.theconversation.com/files/554936/original/file-20231020-25-pr3fqp.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=845&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/554936/original/file-20231020-25-pr3fqp.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=845&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/554936/original/file-20231020-25-pr3fqp.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1061&fit=crop&dpr=1 754w, https://images.theconversation.com/files/554936/original/file-20231020-25-pr3fqp.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1061&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/554936/original/file-20231020-25-pr3fqp.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1061&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Waxwork model of a pellagra patient in Bologna, Italy.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Museo_delle_cere_anatomiche_(Bologna)_abc2_pellagra.jpg">Patafisik via Wikimedia</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
</figcaption>
</figure>
<p>In northern Italy from the 1850s and the American South from the 1900s, asylums were suddenly filling up with pellagra sufferers. At this time, the disease was thought to be hereditary or contagious, and those afflicted, known as pellagrins, <a href="https://www.psychiatrist.com/blog/pellagra-niacin-deficiency-and-mental-illness/#:%7E:text=The%20relevance%20of%20pellagra%20to,it%20may%20lead%20to%20death.">were shunned</a>. </p>
<p>In fact, the real reason they were succumbing to pellagra was poverty. In both regions, landowners had introduced corn due to its high yields and attractiveness as a cash crop. At the same time, in <a href="https://link.springer.com/book/10.1007/978-3-031-22496-6">Italy</a>, a deterioration in agricultural working conditions meant that, by the 1870s, many workers relied on cheap corn for food in the form of <a href="https://en.wikipedia.org/wiki/Polenta">polenta</a>.</p>
<p>Similarly, in the post-Civil War <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451741/">American South</a>, landowners devoted most of their property to growing cotton, leaving little room for other crops or livestock. So, tenant farmers relied on corn for food in the form of grits or <a href="https://www.bloomsbury.com/us/us-history-in-15-foods-9781350211971/">corn pone</a>, which left many suffering from malnutrition and, in particular, a severe deficiency of vitamin B3 (niacin). </p>
<p>This was the real cause of pellagra – but at this time, the role of <a href="https://www.nytimes.com/2013/12/12/science/learning-from-the-history-of-vitamins.html">vitamins</a> in health was little understood. And even when the link between people’s over-reliance on corn in their diets, lack of niacin and mental illness <a href="https://www.ncbi.nlm.nih.gov/books/NBK557728/">was established by scientists</a>, policymakers were hesitant to acknowledge the role of poverty and malnutrition in this explosion of mental illness.</p>
<p>In the US, New York physician Joseph Goldberger discovered the <a href="https://history.nih.gov/pages/viewpage.action?pageId=8883184">link between pellagra and poor diet</a> in the mid-1910s – yet the overwhelming evidence he provided was rejected in the American South. For nearly 20 years, southerners <a href="https://www.jstor.org/stable/25605634">were too proud</a> to accept the disease was rooted in poverty, and continued to conduct fruitless research on other causes.</p>
<p>Even today, knowing that a poor diet contributes to poor mental health is one thing; tackling the poverty that leads to a bad diet is quite another. As researchers crystallise the link between <a href="https://journals.sagepub.com/doi/full/10.1177/2167702616641050">diet and mental health</a> – now widely framed in terms of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641835/">gut-brain axis</a> – the need for governments to tackle the social determinants of a poor diet is <a href="https://commonslibrary.parliament.uk/research-briefings/cbp-9209/#:%7E:text=According%20to%20the%20Department%20for,%2C%20including%2021%25%20of%20children.">clear and urgent</a>. Namely, <a href="https://www.theguardian.com/society/2023/oct/24/more-than-1-million-uk-children-experienced-destitution-last-year-study-finds">poverty</a> and the <a href="https://health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/food-insecurity">food insecurity</a> that goes with it.</p>
<h2>When governments got serious about prevention</h2>
<p>In 1929, a 13-year-old girl turned up to a Chicago social service agency, reporting that she had been raped by her brother-in-law. After a medical examination, <a href="https://cup.columbia.edu/book/the-first-resort/9780231203937">her case was taken on</a> by a team of social workers who visited her and her family, all Polish immigrants. The social workers took note of the family’s financial circumstances and helped the family press charges against the rapist, who was given a prison sentence. The girl attended counselling sessions for many months.</p>
<p>The agency overseeing this case was one of hundreds of <a href="https://ajph.aphapublications.org/doi/pdfplus/10.2105/AJPH.16.1.22">mental hygiene and child guidance clinics</a> founded in the US during its “<a href="https://en.wikipedia.org/wiki/Progressive_Era#:%7E:text=The%20Progressive%20Era%20(1896%E2%80%931917,monopoly%2C%20waste%2C%20and%20inefficiency.">Progressive Era</a>” in the early 20th century. This was a period of political reform and social activism dedicated to countering the problems associated with industrialisation, urbanisation and immigration, and these child guidance and mental hygiene movements soon spread to <a href="https://www.routledge.com/Child-Guidance-in-Britain-19181955-The-Dangerous-Age-of-Childhood/Stewart/p/book/9781138662315">Britain</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5287990/">elsewhere</a>.</p>
<hr>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
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<p>Prevention was the cornerstone of these movements, which espoused that it was much more efficient <a href="https://pubmed.ncbi.nlm.nih.gov/30601725/">to prevent mental illness</a> than treat it. In the US, the clinics were often funded by charities such as the <a href="https://www.commonwealthfund.org/">Commonwealth Fund</a> and the <a href="https://dimes.rockarch.org/collections/kpoaALEcdxhvPyFBRby8nS">Laura Spelman Rockefeller Fund</a>. But the state played an important role too – more so in other parts of the world.</p>
<p>In Britain, social welfare departments established to run similar clinics began to hire new types of mental health worker, such as psychiatric social workers and psychiatric nurses. From the 1930s, <a href="https://www.historyandpolicy.org/docs/john_stewart.pdf">education authorities</a> became more involved in child guidance activities, which were included in the <a href="https://journals.sagepub.com/doi/abs/10.1177/146642404606600204?journalCode=rsha">1944 Education Act</a>. </p>
<p>While some conclusions drawn at this time appear shocking today – some mental hygienists and child guiders, for example, were sympathetic to <a href="https://www.genome.gov/about-genomics/fact-sheets/Eugenics-and-Scientific-Racism#:%7E:text=Eugenics%20is%20the%20scientifically%20erroneous,ills%20through%20genetics%20and%20heredity.">eugenic explanations</a> for mental illness, even if they also acknowledged the role of environmental causes – overall, the existence of child guidance and mental hygiene during the first half of the 20th century demonstrates how seriously preventive mental health was taken. </p>
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Read more:
<a href="https://theconversation.com/unlocking-new-clues-to-how-dementia-and-alzheimers-work-in-the-brain-uncharted-brain-podcast-series-194773">Unlocking new clues to how dementia and Alzheimer's work in the brain – Uncharted Brain podcast series</a>
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<p>Today, this is not the case. As in most areas of healthcare, the majority of public and private funding for mental health is funnelled towards <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4471962/">researching and prescribing pharmaceutical treatments</a>, rather than prevention.</p>
<p>Such investment has resulted in some effective medications, such as drugs to reduce the symptoms of schizophrenia or bi-polar disorder - although there <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8751557/">are heated debates</a> about this. But it has also distracted from the need to prevent upstream causes of mental illness, while pharmaceutical companies continue to aggressively lobby governments and politicians <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8224875/">in the UK</a>, <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2762509">US</a> and elsewhere for more funding.</p>
<h2>The peak of care in the community</h2>
<p>In 1948, American journalist Albert Deutsch’s landmark book <a href="https://en.wikipedia.org/wiki/The_Shame_of_the_States">The Shame of the States</a> exposed the parlous position of state-run mental hospitals throughout the US. In contrast to the good intentions that had led to the asylum era, Deutsch showed that many of these hospitals were now under-resourced, overcrowded and poorly staffed institutions characterised by deprivation, violence and abuse.</p>
<p>Around the same time, <a href="http://cup.columbia.edu/book/the-first-resort/9780231203937">social psychiatry research</a> was confirming what reformers had long believed: that poor socioeconomic conditions were a <a href="https://apps.who.int/iris/bitstream/handle/10665/112828/9789241506809_eng.pdf">significant factor in the mental illness</a> suffered by millions of people.</p>
<p>Dissatisfaction with mental hospitals and faith in psychiatry’s ability to prevent mental illness led to the <a href="https://en.wikipedia.org/wiki/Community_mental_health_service">community mental health movement</a>. Proponents had two main arguments: that the mentally ill were best treated in their home communities, and that such illness could largely be prevented through community intervention.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/X3vkV9P2rAg?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">JFK’s ‘special message’ to the US on mental illness and mental retardation, February 5 1963.</span></figcaption>
</figure>
<p>In the US and elsewhere, political will for radical change was strong. In February 1963, President <a href="https://www.jfklibrary.org/asset-viewer/archives/JFKPOF/052/JFKPOF-052-012">John F. Kennedy argued</a> that prevention should be central to the US’s approach to mental illness, highlighting the “harsh environmental conditions” in which it flourished. This momentum culminated in the 1963 <a href="https://en.wikipedia.org/wiki/Community_Mental_Health_Act">Community Mental Health Act</a> – the first time the US federal government had invested significantly in mental healthcare. Its ambition was to replace the traditional asylum system with some 2,000 community mental health centres, designed to both provide treatment and engage in preventive work. Fewer than 800 were ultimately built.</p>
<p>Not every psychiatrist wanted to work in community mental health, so other mental health workers were recruited including social workers, psychologists, nurses and “<a href="https://scholarworks.wmich.edu/cgi/viewcontent.cgi?article=1214&context=jssw#:%7E:text=The%20indigenous%20paraprofessionals%20can%20be,those%20experienced%20by%20their%20clients.">indigenous paraprofessionals</a>” – people from the local community who lacked formal mental health qualifications. They worked closely with members of the public to help resolve the socioeconomic problems that were fuelling their poor mental health, and also liaised with schools, landlords, welfare officers, the justice system and medical professionals on behalf of their patients.</p>
<p>Yet despite their <a href="https://link.springer.com/article/10.1007/BF00125554">effectiveness</a>, indigenous paraprofessionals were often an awkward fit within community mental health centres. In New York’s South Bronx neighbourhood, for example, their attempts to unionise, receive training and be respected resulted in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5024401/">rising tensions</a> with the professional healthcare staff. Racism was one of the contributing factors, as most of these paraprofessionals were black or Latinx, while most of the professional staff were white.</p>
<p>In 1969, the South Bronx <a href="https://footagefarm.com/reel-details/personalities/albert-einstein/lincoln-hospital#/">paraprofessionals went so far as to lock out</a> their centre’s managers and run it themselves for more than two weeks, supported by the <a href="https://en.wikipedia.org/wiki/Black_Panther_Party">Black Panther Party</a> – which further irked the management. While they eventually agreed to some of the paraprofessionals’ demands, the underlying tensions were not resolved and, when funding for community mental health decreased, the budgets for paraprofessionals were the <a href="https://pubmed.ncbi.nlm.nih.gov/758837/">first to be cut</a>.</p>
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<figcaption><span class="caption">The story of the Lincoln Hospital occupation. Documentary by the New York Times.</span></figcaption>
</figure>
<p>By 1970, little preventive activity was occurring in community mental health centres. It turned out that President Lyndon B. Johnson’s “<a href="https://en.wikipedia.org/wiki/War_on_poverty">war on poverty</a>” was more focused on “improving” the poor than progressive structural reform. Many social psychiatrists agreed that disadvantaged people <a href="https://psyche.co/ideas/mental-health-is-not-an-individual-matter-but-a-political-one">needed to be “transformed”</a> into upstanding citizens, rather than given material resources. This centuries-old idea of <a href="https://theconversation.com/free-school-meals-debate-shows-how-victorian-attitudes-about-undeserving-poor-persist-149130">deserving and undeserving poor</a> persists today throughout most of the world.</p>
<p>In the US, an increasing number of mentally ill people became <a href="https://pubmed.ncbi.nlm.nih.gov/6479924/">homeless</a>. Others ended up <a href="https://www.apa.org/monitor/2014/10/incarceration#:%7E:text=The%20committee%20found%20that%20the,to%20prisons%20and%20jails%20instead.">in prison</a> or in <a href="https://journals.sagepub.com/doi/full/10.1177/23337214221101260">nursing homes</a>, while an increasing number were cared for <a href="https://link.springer.com/chapter/10.1007/978-3-319-45360-6_12">by family members</a>. In short, this marked a gradual return to the situation prior to the asylum era, when there was little public support for the mentally ill.</p>
<h2>A shift towards treating the individual</h2>
<p>The rise and fall of community mental health in the US is a cautionary tale. In the UK too, history shows that preventive approaches to mental health are soon weakened if not accompanied by <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6025145/">genuinely progressive social policies</a> that reduce poverty, inequality, racism, social isolation and community disintegration.</p>
<p>Following the election of US president Ronald Reagan in 1981 with a promise to <a href="https://www.govinfo.gov/content/pkg/COMPS-10576/pdf/COMPS-10576.pdf">reduce the role of government</a> in most areas including healthcare and social support, and not long after his political soulmate Margaret Thatcher had come to power in the UK, the community mental health movement lost all momentum on both sides of the Atlantic. </p>
<p>But there was another reason for this: the publication, in 1980, of the third edition of the <a href="https://www.psychiatry.org/psychiatrists/practice/dsm/about-dsm/history-of-the-dsm">Diagnostic and Statistical Manual of Mental Disorders</a> (DSM-III). This “bible of psychiatry”, published by the American Psychiatric Association (a new edition emerges roughly every couple of decades), determines what constitutes a psychiatric disorder and how to diagnose it. In the US, if you want your psychiatric treatment covered by health insurance, you must be diagnosed with a disorder found in DSM.</p>
<p>Its third edition marked a major shift away from addressing mental health at a population-wide level, in favour of a focus on individual mental disorders. This led psychiatrists and patients away from environmental explanations for mental illness towards genetic and neurological explanations, or <a href="https://en.wikipedia.org/wiki/Biological_psychiatry">biological psychiatry</a>.</p>
<p>This shift was mirrored by the rise of <a href="https://en.wikipedia.org/wiki/Psychopharmacology">psychopharmacology</a> – the ever-growing use of drug therapies to treat psychiatric patients. <a href="https://en.wikipedia.org/wiki/Listening_to_Prozac">Faith in these medications</a> – in particular, antidepressants such as Prozac – further reduced demands for preventive psychiatry. A <a href="https://www.health.harvard.edu/blog/astounding-increase-in-antidepressant-use-by-americans-201110203624">2011 study</a> found that antidepressant use in the US roughly quadrupled over two decades from 1998. More recently, <a href="https://pharmaceutical-journal.com/article/news/antidepressant-prescribing-increases-by-35-in-six-years#:%7E:text=Prescriptions%20of%20antidepressants%20rose%20by,the%20sixth%20consecutive%20annual%20increase.&text=The%20number%20of%20antidepressants%20prescribed,annual%20increase%20in%20a%20row.">antidepressant use</a> in England rose by 35% between 2015 and 2021.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/u3F928a9jdE?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">The role of fentanyl in the US opioid crisis. (Bloomberg)</span></figcaption>
</figure>
<p>But psychopharmacology has not proved the panacea the pharmaceutical companies promised. One <a href="https://www.bmj.com/content/378/bmj-2021-067606">major study in 2022</a> found that only around 15% of participants in randomised, placebo-controlled trials experienced a substantial antidepressant effect. The fact that long-term use of antidepressants is <a href="https://www.sciencedirect.com/science/article/pii/S0924977X13001454?casa_token=Ti1Ee8v4NagAAAAA:0aYFC0HuA-2CjPooL5_Lxhl8MHSYnQYqIMd0nza66klDbCT6Fz8iLJgs34R3ijoCGZnYaKkHJVk">likely to cause side effects</a>, such as weight gain and sexual dysfunction, also raises questions about their widespread use.</p>
<p>The <a href="https://www.cdc.gov/opioids/basics/epidemic.html">opioid crisis</a> in the US indicates that we cannot rely on pharmaceutical companies to always do what is in our best interest. Sadly, it has also showed us that <a href="https://www.ncbi.nlm.nih.gov/books/NBK448203/#:%7E:text=Three%20million%20US%20citizens%20and,in%20a%20year%20time%20period.">millions of Americans</a>, and countless millions more around the world, are struggling to cope with mental as well as physical pain, and are desperate for solutions.</p>
<h2>The dangers of privatised mental healthcare</h2>
<p>In the UK, US and most other countries, there has probably never been more awareness of mental health issues among the general public – particularly in the wake of the COVID pandemic, whose impact on mental health has often led <a href="https://www.theguardian.com/world/2022/aug/27/covid-pandemic-mental-health">media headlines</a> and dominated <a href="https://www.mind.org.uk/about-us/our-policy-work/coronavirus-research/">scientific discussions</a>.</p>
<p>There is also much better evidence for what works – including, for example, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5942544/">efficacy of talking therapies</a>. In part because of concerns about the overprescription and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6998955/">ineffectiveness</a> of drugs used to treat mental illness, the 21st century has seen a growth in popularity of talking therapies such as <a href="https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/cognitive-behavioural-therapy-cbt/#:%7E:text=work%20for%20me%3F-,What%20is%20CBT%3F,affect%20your%20feelings%20and%20actions.">cognitive behavioural therapy</a> (CBT) in the west.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/554939/original/file-20231020-29-wl67fd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Cycle diagram explaining cognitive behavioural therapy (CBT)" src="https://images.theconversation.com/files/554939/original/file-20231020-29-wl67fd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/554939/original/file-20231020-29-wl67fd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/554939/original/file-20231020-29-wl67fd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/554939/original/file-20231020-29-wl67fd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/554939/original/file-20231020-29-wl67fd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=753&fit=crop&dpr=1 754w, https://images.theconversation.com/files/554939/original/file-20231020-29-wl67fd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=753&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/554939/original/file-20231020-29-wl67fd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=753&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Cycle diagram explaining cognitive behavioural therapy (CBT)</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/cbt-cognitive-behavioral-therapy-cycle-diagram-320312924">artellia/Shutterstock</a></span>
</figcaption>
</figure>
<p>However, accessing state-provided psychoanalytic treatments is very difficult, particularly in less well-off regions. In the UK, average waiting times for the NHS’s <a href="https://www.england.nhs.uk/mental-health/adults/nhs-talking-therapies/">Talking Therapies</a> programme <a href="https://www.theguardian.com/society/2020/jan/25/mental-health-care-postcode-lottery-nhs-talking-therapies">vary enormously</a> depending on where you live. There are nearly <a href="https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2017/09/11/postcode-lottery-for-psychiatric-care">three times</a> as many NHS consultant psychiatrists per 100,000 people in parts of London than there are in Yorkshire. <a href="https://www.independent.co.uk/news/health/child-mental-health-waiting-times-b1972830.html">Vulnerable children</a> in some parts of the UK can wait two years for a first appointment, while those elsewhere are seen within a week.</p>
<p>Overall, while the number of successful referrals for talking therapies such as CBT have increased since the NHS programme’s inception in 2008, so have demands, and it has recently been <a href="https://www.nuffieldtrust.org.uk/resource/improving-access-to-psychological-therapies-iapt-programme">missing its targets</a> by about a third. As a result, an increasing number of people are reported to be seeking <a href="https://www.mentalhealthtoday.co.uk/news/awareness/rise-in-demand-for-private-counsellors-as-patients-say-nhs-waiting-lists-are-too-long">private treatment</a> – despite the expense, and amid concerns about the reliability of some services offering these treatments.</p>
<p>As with physical health services, people also opt out of the NHS by purchasing private health insurance or <a href="https://www.totalhealth.co.uk/blog/waiting-list-fast-passes">waiting list “fast passes”</a>. All of this creates a <a href="https://www.ippr.org/research/publications/state-of-health-and-care-2022">two-tier system</a> that undermines the principles of universality and accessibility that are meant to underpin the NHS.</p>
<p>Most private mental health providers, like drug companies, are also <a href="https://www.theguardian.com/society/2018/jul/04/who-profits-private-providers-health-services-nhs-70">motivated by profit</a> and the demands of their shareholders. It is not in their interest to invest in preventive strategies with long-term, non-<a href="https://www.investopedia.com/terms/c/commoditization.asp">commoditisable</a> outcomes. Equally, with people living longer and <a href="https://www.mentalhealth.org.uk/explore-mental-health/statistics/older-people-statistics#:%7E:text=Depression%20affects%20around%2022%25%20of,at%20all%20from%20the%20NHS.&text=It%20is%20estimated%20that%20the,predicted%20to%20double%20by%202030.">populations ageing rapidly</a>, the future cost of not investing in preventive mental healthcare that makes a difference across whole populations will only grow with every year that passes. The onus is on governments to act now.</p>
<h2>Three preventive strategies</h2>
<p>The annual <a href="https://www.lse.ac.uk/News/Latest-news-from-LSE/2022/c-Mar-22/Mental-health-problems-cost-UK-economy-at-least-118-billion-a-year-new-research">cost of mental illness</a> to the UK economy is estimated to be at least £117.9 billion, or 5% of the UK’s annual GDP. Almost three-quarters of this cost is <a href="https://www.mentalhealth.org.uk/sites/default/files/2022-06/MHF-Investing-in-Prevention-Full-Report.pdf">explained</a> by the lost productivity of people living with mental health conditions and the unpaid, informal carers who look after them.</p>
<p>A <a href="https://www.barnardos.org.uk/news/barnardos-calls-government-provide-missing-link-youth-mental-health-support">new report</a> by the children’s charity Barnardo’s has called for a national strategy for <a href="https://www.barnardos.org.uk/sites/default/files/2023-10/report-missing-link-social-prescribing-children-young-people.pdf">social prescribing</a>, suggesting that “every pound spent on helping young people access activities and support in the community could save nearly twice as much in dealing with longer-term mental health problems”.</p>
<p>There are many different potential strategies that could be introduced. Here are three of my favoured options – based not only on new research into the social determinants of health, but also on <a href="https://link.springer.com/book/10.1007/978-3-319-98699-9">historical approaches to preventive mental healthcare</a>.</p>
<p><strong>1. To address malnutrition, eradicate food inequality</strong></p>
<p>Today, we are returning to an idea that <a href="https://en.wikipedia.org/wiki/Food_and_diet_in_ancient_medicine">physicians of the past</a> would have taken for granted: that food is a major contributor to our <a href="https://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/diet-and-mental-health">brain’s health</a>, as well as our body’s. New research on diet and mental health often centres on the “<a href="https://www.health.harvard.edu/diseases-and-conditions/the-gut-brain-connection">gut-brain axis</a>”: a varied diet consisting of whole grains, legumes, nuts, seeds, fruits and vegetables is thought to provide the type of bacteria needed to maintain good <a href="https://www.bbc.com/future/article/20190218-how-the-bacteria-inside-you-could-affect-your-mental-health">gut-brain health</a>.</p>
<p>But people in deprived communities often live in so-called “<a href="https://www.theguardian.com/society/2018/oct/12/more-than-a-million-uk-residents-live-in-food-deserts-says-study">food deserts</a>”, where most of the food available is <a href="https://www.bbc.co.uk/iplayer/episode/m001mp67/panorama-ultraprocessed-food-a-recipe-for-ill-health">highly processed</a>, <a href="https://www.rutgersuniversitypress.org/an-alternative-history-of-hyperactivity/9780813550169">laden with chemicals</a> and high in sugar, salt and fat. A bolder approach to food policy is needed that ensures everyone has access to healthy food – and the skills and means to prepare it.</p>
<p>During the first world war, <a href="https://drbryceevans.wordpress.com/2017/03/29/the-national-kitchens-of-ww1/">national kitchens</a> were established to provide people with inexpensive, healthy food in attractive communal settings. The <a href="https://www.hippocraticpost.com/poverty/bring-back-wartime-era-national-kitchens/">return of such facilities</a> would be welcome today amid the cost of living crisis – and they could also play a role in preventing mental illness.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/554942/original/file-20231020-17-a2se2z.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Women serving food to children around a long table" src="https://images.theconversation.com/files/554942/original/file-20231020-17-a2se2z.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/554942/original/file-20231020-17-a2se2z.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=420&fit=crop&dpr=1 600w, https://images.theconversation.com/files/554942/original/file-20231020-17-a2se2z.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=420&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/554942/original/file-20231020-17-a2se2z.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=420&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/554942/original/file-20231020-17-a2se2z.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=528&fit=crop&dpr=1 754w, https://images.theconversation.com/files/554942/original/file-20231020-17-a2se2z.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=528&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/554942/original/file-20231020-17-a2se2z.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=528&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A first world war ‘national kitchen’ serving children in Kent.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Ministry_of_Information_First_World_War_Official_Collection_Q30637.jpg">Imperial War Museums via wikimedia</a></span>
</figcaption>
</figure>
<p><strong>2. To address poverty, introduce universal basic income</strong></p>
<p>Interest in <a href="https://theippo.co.uk/basic-income-what-is-it-and-what-it-isnt/">universal basic income schemes</a> (UBI) – which provide everyone with a guaranteed income with no conditions attached – surged during the pandemic, when many countries introduced furlough or other income replacement schemes. Although UBI pilots have rarely studied mental health specifically, <a href="https://www.sciencedirect.com/science/article/pii/S0277953621007061">there is still evidence</a> that a secure and sufficient income improves the mental health of participants.</p>
<p>UBI could <a href="https://www.thersa.org/reports/universal-basic-income-anxiety-depression-mental-health-crisis-interim-report">prevent mental illness</a> in <a href="https://www.compassonline.org.uk/publications/treating-causes-not-symptoms-basic-income-as-a-public-health-measure/">numerous ways</a> – from alleviating the stress associated with financial insecurity and which can cause <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6491771/">inflammation</a> in the brain, to reducing so-called <a href="https://pubmed.ncbi.nlm.nih.gov/31172197/">diseases of despair</a> that are associated with rising inequality, including the damaging <a href="https://cpag.org.uk/sites/default/files/CPAG-Povertyarticle-stigma-0213.pdf">stigma</a> associated with welfare benefits (and the stress for people who work in the welfare system as <a href="https://onlinelibrary.wiley.com/doi/10.1111/spol.12527">gatekeepers</a>).</p>
<p>It would also show people currently working as <a href="https://www.mind.org.uk/information-support/helping-someone-else/carers-friends-family-coping-support/your-mental-health/">unpaid carers</a> that their labour is valued. Many people find that <a href="https://newsroom.clevelandclinic.org/2022/11/28/why-volunteering-can-benefit-your-mental-health/">volunteering</a> benefits their mental health, and the efforts of volunteers <a href="https://independentsector.org/resource/value-of-volunteer-time/">contribute significantly</a> to our communities. But it is often a privilege for those with time and money. A UBI would empower everyone to contribute to rebuilding their communities.</p>
<p><strong>3. To tackle depression and isolation, get in touch with nature</strong></p>
<p>During the COVID lockdowns, many people remarked how <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(22)00282-0/fulltext">spending time in nature</a> was their <a href="https://www.bbc.co.uk/sounds/brand/m001ng76">salvation</a>. This built on <a href="https://www.nationaltrust.org.uk/our-cause/nature-climate/nature-conservation/everyone-needs-nature">existing evidence</a> about the <a href="https://www.cambridge.org/core/journals/journal-of-the-marine-biological-association-of-the-united-kingdom/article/blue-gym-what-can-blue-space-do-for-you-and-what-can-you-do-for-blue-space/2409C4FCED48391786A65146D8A5C51D">positive impact</a> nature can have on our mental health.</p>
<p>However, much like access to healthy food, not everyone has <a href="https://ww3.rics.org/uk/en/journals/land-journal/why-access-to-nature-is-a-social-justice-issue-.html">access</a> to natural beauty. Governments could do a great deal to reduce this inequality – for example, by providing inexpensive or free public transportation to national parks and other places of natural beauty. A priority should be ensuring that <a href="https://www.theguardian.com/teacher-network/2018/mar/01/improving-childrens-access-nature-addressing-inequality-bame-low-income-backgrounds">children from deprived urban backgrounds</a> have regular access to nature.</p>
<p>In addition, more can be done to create new areas of natural beauty while protecting existing areas. Schemes that tackle biodiversity loss and climate change would reduce the <a href="https://wellcome.org/news/explained-how-climate-change-affects-mental-health">clear impact</a> these issues have on some people’s mental health – in part because worries about the climate are also known to trigger <a href="https://www.imperial.ac.uk/news/240094/what-impact-climate-crisis-having-mental/">anxiety and depression</a>.</p>
<h2>Governments have a critical role to play</h2>
<p>Responsibility for mental health should not lie solely with the individual. Sure, most of us can do something to improve our own mental wellbeing. But our lifetime mental health course is largely determined by socioeconomic, genetic and other factors, such as exposure to traumatic events, that may be mostly out of our control.</p>
<p>As centuries of evidence have shown us, governments play a <a href="https://www.gov.wales/review-evidence-socio-economic-disadvantage-and-inequalities-outcome-summary-html">critical role</a> in creating the socioeconomic conditions that <a href="https://www.theguardian.com/society/2023/sep/27/policy-must-tackle-root-causes-of-englands-record-mental-ill-health-says-report">determine the mental health of their citizens</a>. Yet, relatively speaking, many are doing less to address this today than they were decades ago. Until and unless this changes, state health providers such as the NHS will never be able to cope with the resulting demand for individual treatments. Those fortunate enough to do so will turn to the private sector. But what about everyone else?</p>
<hr>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em>For you: more from our <a href="https://theconversation.com/uk/topics/insights-series-71218?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insights series</a>:</em></p>
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<li><p><em><a href="https://theconversation.com/unlocking-new-clues-to-how-dementia-and-alzheimers-work-in-the-brain-uncharted-brain-podcast-series-194773?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Unlocking new clues to how dementia and Alzheimer’s work in the brain – Uncharted Brain podcast series
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<li><p><em><a href="https://theconversation.com/gp-crisis-how-did-things-go-so-wrong-and-what-needs-to-change-208197?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">GP crisis: how did things go so wrong, and what needs to change?
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<li><p><em><a href="https://theconversation.com/its-like-being-in-a-warzone-aande-nurses-open-up-about-the-emotional-cost-of-working-on-the-nhs-frontline-194197?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">‘It’s like being in a warzone’ – A&E nurses open up about the emotional cost of working on the NHS frontline</a></em></p></li>
<li><p><em><a href="https://theconversation.com/loneliness-loss-and-regret-what-getting-old-really-feels-like-new-study-157731?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Loneliness, loss and regret: what getting old really feels like – new study
</a></em></p></li>
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<p class="fine-print"><em><span>Matthew Smith receives funding from the Royal Society of Edinburgh, the AHRC and the Wellcome Trust. He is affiliated with the Scottish Green Party. </span></em></p>Investing in people’s future mental health, based on the key socioeconomic factors underlying it, is the only way to address this rising problem.Matthew Smith, Professor in Health History, University of Strathclyde Licensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2147552023-10-23T07:55:17Z2023-10-23T07:55:17ZVictims of the green energy boom? The Indonesians facing eviction over a China-backed plan to turn their island into a solar panel ‘ecocity’<p>I first visited Rempang island in Summer 2022. Greeting me were lush fields lined with coconut and banana trees, picture-book fishing villages with houses jutting into the water on stilts, and boats carrying people between the dozens of islands that dot the Riau archipelago in western Indonesia. I had made the pleasant, one-hour ferry trip from bustling, glass-and-chrome Singapore. This felt like another world.</p>
<p>My hosts (an environmental lawyer and an indigenous Melayu community organiser) and I had reached Rempang from the economic hub of Riau Islands province: the special manufacturing, trade and logistics zone of <a href="https://www.indonesia.travel/uk/en/destinations/sumatra/batam">Batam</a>. We had gone from Batam to Rempang by crossing one of the six metal bridges that connect the islands of Batam, Rempang and Galang. This network of bridges has turned the islands into an economic zone, now called the Barelang region. </p>
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<p>
<em>
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Read more:
<a href="https://theconversation.com/konflik-rempang-bagaimana-proyek-transisi-energi-yang-didukung-cina-justru-merampas-lahan-rakyat-bagian-1-216178">Konflik Rempang: bagaimana proyek transisi energi yang didukung Cina justru merampas lahan rakyat (bagian 1)</a>
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<p>My ongoing research is investigating how the international quest for green energy is reliant on “sacrificial zones” in developing countries. The transition to green energy, far from creating a green new deal for all, is actually reinforcing entrenched inequalities and hierarchies.</p>
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<img alt="Large suspension bridge" src="https://images.theconversation.com/files/552772/original/file-20231009-19-qgpzcr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/552772/original/file-20231009-19-qgpzcr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/552772/original/file-20231009-19-qgpzcr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/552772/original/file-20231009-19-qgpzcr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/552772/original/file-20231009-19-qgpzcr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/552772/original/file-20231009-19-qgpzcr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/552772/original/file-20231009-19-qgpzcr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Batam Rempang Galang Bridge (Barelang). This bridge connects Batam Island with Rempang Island and Galang Island.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/batam-rempang-galang-bridge-barelang-this-2099136529">Shutterstock/NPCplastik</a></span>
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<p>I became interested in Rempang when I saw news reports heralding a renewable energy revolution. Companies from Singapore, Portugal and beyond were <a href="https://www.reuters.com/business/energy/sunseap-build-2-bln-floating-solar-farm-indonesia-worlds-largest-2021-07-22/">signing agreements</a> to build vast floating solar farms in local reservoirs in the Batam region. The plan was that the clean energy produced would be transported from the sunlit western Indonesian islands of Batam, Bulan, and Rempang to energy intensive Singapore via undersea cable.</p>
<p>But on reaching the islands, and visiting the sites named in the news reports, I saw no sign of green energy activity. The waters were placid. There was no solar farm in sight. I shrugged, met friends, ate the freshest possible seafood at a small <a href="https://en.wikipedia.org/wiki/Kelong">Kelong</a> restaurant that was half on land and half in the sea, and went back to Singapore on the ferry. </p>
<h2>‘A state-backed land grab’</h2>
<p>My return a year later could not have been more different. The atmosphere was tense and the roads were lined with armed police. Large military trucks moved ominously on the tar, monitoring the situation. Villagers stood around in clusters, anxious and clutching at straws of information trickling through on WhatsApp and word of mouth about what seemed to be a <a href="https://academic.oup.com/edited-volume/44609/chapter/393367359">state-backed land grab</a>.</p>
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<img alt="" src="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
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<p>People were protesting because the 16 villages and 7,500 inhabitants of Rempang are facing eviction, as plans to transform their home into the latest hub for the global green transition gather apace. The Indonesian government and a Chinese-backed business consortium want to <a href="https://time.com/6313609/indonesia-rempang-eco-city-protests-china/">move the entire community</a> to another island and turn their home into a huge solar panel manufacturing centre, solar farm, and “ecocity”.</p>
<p>Videos filmed by residents from sites of protest show armed military and police clashing with the farmers and fishers of Rempang. The videos, some of which have been posted on social media, show people being thrown to the ground, bleeding, apparently roughed up by state forces. There have been many arrests. I regularly hear from friends and acquaintances who tell me that police and government authorities have taken to summoning suspected protestors, examining their phones for incriminating evidence, and looking into their home, work lives and tax affairs. Residents are clear this is “harassment” and “pressure” to give up their land and withdraw from the struggle. </p>
<p>Alongside large and publicised confrontations, the residents of Rempang are resisting the everyday encroachments of the proposed project. In local, spontaneous opposition in affected villages, women, including mothers and grandmothers in veils, have blocked roads, preventing government officials from entering villages to measure their land. Videos show them wailing as armed police approach. In others, young girls and old women can be seen in a semi-conscious state, being taken to hospital after apparent tear gassing.</p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/03Wx_rxBKXg?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
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<p>But how did things move so fast? From April 2023, news had begun to filter in that a well-connected businessman from Jakarta, who reportedly made his money and reputation <a href="https://www.smh.com.au/world/dili-tycoon-deal-triggers-alarm-20090502-aqtj.html">through businesses operated</a> on behalf of the Indonesian military, before turning to <a href="https://www.tatlerasia.com/people/tomy-winata">banking and real estate</a>, was to build a “township” on Rempang.</p>
<p>By August, the better informed in the community had gathered that the planned Rempang project was to be a collaboration between Tomy Winata’s Artha Graha Group, and a Chinese “glass manufacturer”. By September, Winata himself <a href="https://en.tempo.co/read/1775361/tomy-winata-its-just-miscommunication">was granting interviews</a> and talking about his plans for an ecocity. <a href="https://futuresoutheastasia.com/rempang-eco-city/">The project</a> – which has the enthusiastic blessings of the Batam economic zone authorities, the provincial government of Riau Islands, and importantly, the central government in Jakarta – is imminent. </p>
<p>It will displace 16 villages on Rempang island and will cover a mind boggling 17,000 hectares (one square hectare is roughly equivalent to one rugby field). As residents discussed these figures among themselves, they lobbed questions at me: “Why do they need so much land?” and “what will they even do with it?”</p>
<p>An elderly, mild mannered fisherman I spoke to in August, who was trying to organise resistance to what was then still a mysterious investment pushed by Jakarta and China said he was worried about the community being relocated:</p>
<blockquote>
<p>People here have history. Their whole story is in this area. They love this land. They live here. You can make your project here. Welcome. But build it in an empty area. Whatever you do, don’t disturb us. Keep us here, give jobs to our children … When people ask me, where is your village, I say it is Bapke [pseudonym]. Later, what will I say? Our identity will be lost.</p>
</blockquote>
<h2>From trickles of information to violence</h2>
<p>On first learning about the Rempang project, residents petitioned different layers of government, sought meetings, and even went to Jakarta to try and meet officials. Finding them unresponsive, people contemplated taking to the streets.</p>
<p>By mid-August, groups were meeting at local cafes and in the homes of community leaders. They were determined not to give up their land. One member of a group that was congregating in Batam told me “there is a meeting of Melayu youth to plan a protest at Barelang [bridge], and at the mayor’s office [in Batam]. We are here to discuss the situation. We will protest in the coming days”.</p>
<p>By the last week of August, there were demonstrations organised by the community at various locations in Rempang and Batam, and by civil society organisations in Jakarta. Soon, my contacts were talking about “clashes between the community and BP Batam” (<a href="https://bpbatam.go.id/en/profile/background/">the authority in charge</a> of the Batam free trade zone), and larger and larger demonstrations involving not just Rempang residents, but ethnic Melayus from the surrounding islands as well. At these early protests, police forces were present, there was tension, but no violence.</p>
<p>Despite growing opposition, authorities dismissed popular discontent as “<a href="https://www.thejakartapost.com/indonesia/2023/09/14/jokowi-downplays-rempang-riot-as-miscommunication.html">miscommunication</a>”. As reported in the press, increasingly incensed residents began to resort to violence, <a href="https://www.channelnewsasia.com/asia/rempang-eco-city-batam-indonesia-riot-bp-xinyi-3764671?utm_source=flipboard&utm_content=channelnewsasia%2Fmagazine%2FCNA">using rocks and glass bottles</a>. These were desperate measures from increasingly desperate people facing the might of the state.</p>
<figure class="align-center ">
<img alt="Protestors on the streets holding banners." src="https://images.theconversation.com/files/552754/original/file-20231009-21-j7gcb9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/552754/original/file-20231009-21-j7gcb9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/552754/original/file-20231009-21-j7gcb9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/552754/original/file-20231009-21-j7gcb9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/552754/original/file-20231009-21-j7gcb9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/552754/original/file-20231009-21-j7gcb9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/552754/original/file-20231009-21-j7gcb9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Hundreds of people staged a protest against the Rempang ecocity project in central Jakarta on September 20, 2023.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/jakarta-indonesia-september-20-2023-hundreds-2365501927">Shutterstock/KevinHerbian</a></span>
</figcaption>
</figure>
<p><a href="https://www.thejakartapost.com/indonesia/2023/09/17/govt-insists-on-rempang-project-following-visit-by-ministers-police.html">Local</a> and <a href="https://www.aljazeera.com/news/2023/9/15/protests-in-indonesia-as-thousands-face-eviction-for-rempang-eco">international media</a>, which had initially ignored the Rempang issue, was finally <a href="https://time.com/6313609/indonesia-rempang-eco-city-protests-china/">covering it</a> amid escalating “<a href="https://www.thejakartapost.com/indonesia/2023/09/13/police-arrest-43-after-riot-over-china-backed-rempang-city-project.html">rioting</a>” at Rempang.</p>
<p>A Melayu youth messaged me on Whatsapp recently, saying: “I was called to the police station for questioning … I went through the investigation process [for many hours] regarding the case at [location X]. There was a clash between community and authorities which resulted in eight people being sent to prison.”</p>
<h2>Ecocity and mega solar panel production facility</h2>
<p>Meanwhile, preparations for the Rempang development have continued apace. It appears that as early as 2004, the Indonesian company PT Makmur Elok Graha (PT MEG), which is part of the Artha Graha Group, secured permission from the Batam Regional People’s Representative Council to <a href="https://ugm.ac.id/en/news/rempang-conflict-land-disputes-triggered-by-development-project/">develop Rempang</a>. The understanding at the time was for a tourism zone, covering <a href="https://www.aljazeera.com/news/2023/9/27/how-a-china-deal-put-the-homes-of-thousands-of-indonesians-at-risk">5,000 hectares</a>. Existing villages were to be preserved in this plan.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/552962/original/file-20231010-19-c6innt.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A tweet from Amnesty International." src="https://images.theconversation.com/files/552962/original/file-20231010-19-c6innt.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/552962/original/file-20231010-19-c6innt.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=952&fit=crop&dpr=1 600w, https://images.theconversation.com/files/552962/original/file-20231010-19-c6innt.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=952&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/552962/original/file-20231010-19-c6innt.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=952&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/552962/original/file-20231010-19-c6innt.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1196&fit=crop&dpr=1 754w, https://images.theconversation.com/files/552962/original/file-20231010-19-c6innt.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1196&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/552962/original/file-20231010-19-c6innt.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1196&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Amnesty International is trying to draw attention to the islanders’ situation on social media.</span>
<span class="attribution"><a class="source" href="https://twitter.com/amnestyindo/status/1708679798720180432">X</a></span>
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<p>Nothing came of the agreement with PT MEG, until 2023. Earlier in 2023, representatives of PT MEG visited houses of notable locals in Rempang and indicated their intention to survey the land. According to one such local businessperson and community leader, the company did not inform him about what they intended to build. However, in a neighbouring village, some people say they were told about a survey for a glass factory, and in yet another, there was apparently talk of a hotel. </p>
<p>Now, in October 2023, the official business and government plans have revealed a much larger development than was suggested in 2004. The “Rempang ecocity” will be an industrial, service, and tourism area, as envisioned in the National Strategic Programme (PSN) of 2023. It is a joint venture between <a href="https://bpbatam.go.id/en/profile/background/">BP Batam</a> (which incorporates the free trade zone and Free Port Management Agency) and PT MEG. <a href="https://futuresoutheastasia.com/rempang-eco-city/">The project aims to attract investment</a> of about 381 trillion Indonesian Rupiah (Rp) by 2080, creating jobs for 30,000 workers. This equates to around US$24.8 billion or £20 billion. </p>
<p>Crucially, there is a major international investor: the <a href="https://www.aljazeera.com/news/2023/9/27/how-a-china-deal-put-the-homes-of-thousands-of-indonesians-at-risk">world’s largest manufacturer of glass and solar panels</a>, China’s <a href="https://www.xinyiglass.com/en/">Xinyi Glass</a>. And the “glass factory” is no ordinary enterprise. It is a mega-investment from Xinyi which has reportedly pledged US$11.6 billion for the factory over several decades. In return, it seems, they have been promised Rempang’s land. </p>
<p>In <a href="https://www.tandfonline.com/doi/abs/10.1080/03066150.2020.1764542">my previous research</a> I called a similar zone of special economic interest in India, “hydra-like”. That’s because these sought after zones change shape, name and purpose according to what’s profitable at a particular point in time. And what’s profitable in Indonesia, and the world today, is the transition to green energy. Therefore, the showpiece of the Rempang ecocity proposal is the mega solar panel manufacturing facility that will probably supply the world with solar panels in the near future.</p>
<p>In the existing vision of the ecocity, there will be <a href="https://futuresoutheastasia.com/rempang-eco-city/">several zones</a> for industries, commercial and residential purposes, tourism, solar farms, and wildlife and nature. Rempang currently sustains farmers, fishers, seaweed processors and exporters, traders and shopkeepers, seafood kelongs, ten primary schools, three junior high schools, a senior school, hospitals, tourist guest houses and more. But it seems there is no place for this community in the futuristic vision of “green” Rempang. </p>
<h2>A project of strategic importance</h2>
<p>The proposed solar panel manufacturing facility, and the Rempang ecocity, may be a portent of a globalised production boom that the government of Indonesia, and its partner countries like China, envision for this region. This economic vision intends to draw on Indonesia’s <a href="https://theconversation.com/jobless-youth-raise-risk-of-indonesias-demographic-bonus-turning-into-disaster-50402">young and cheap labour</a>, its land and natural resources like silica, <a href="https://www.ft.com/content/aae97af3-02ac-4723-a6fd-dbb0e5de55ff">nickel and cobalt</a>, and its willingness for regulatory flexibility. </p>
<p>It is this flexibility that made the government declare the proposed Rempang ecocity as a <a href="https://www.eco-business.com/opinion/why-has-batams-rempang-eco-city-national-project-become-a-controversy/#:%7E:text=Rempang%27s%20Eco%2DCity%20was%20upgraded,US%2425%20billion">Project of National Strategic Importance</a>, allowing it <a href="https://iopscience.iop.org/article/10.1088/1755-1315/886/1/012071/pdf">to bypass social and environmental impact assessments, and acquire land quickly</a>.</p>
<p>The strategic importance of the Rempang project has not been lost on my contacts in Rempang. One of them speculated that the <a href="https://www.nytimes.com/interactive/2023/05/16/headway/indonesia-nusantara-jakarta.html">government’s plans</a> to build a <a href="https://theconversation.com/a-tale-of-two-cities-why-indonesia-is-planning-a-new-capital-on-borneo-and-abandoning-jakarta-podcast-181134#:%7E:text=Indonesia%20plans%20to%20move%20its,island%20of%20Borneo%20called%20Nusantara.">new capital city on Borneo</a> could be a motive for closer relations with China. They wondered whether the money for the new capital Nusantara would come from China, and whether that was why their land in Rempang had been “gifted” to the Chinese.</p>
<p>Another said: “Did they ask us? No. They only value investment. Not people.” Still others draw links with China’s <a href="https://theconversation.com/uk/topics/china-belt-road-initiative-44606">Belt and Road Initiative</a>, which has invested heavily in Indonesian infrastructure.</p>
<p>Not far from Rempang is one such investment: the series of bridges that will connect two of the largest islands in Riau province: the Batam-Bintan bridge project spread over <a href="https://batamterminal.com/7-km-batam-bintan-bridge-project/">7 kilometres</a>. Funded by the China-led <a href="https://www.aiib.org/en/projects/details/2022/special-fund/Indonesia-Support-for-Indonesia-Batam-Bintan-Bridge-Project.html">Asia Infrastructure Investment Bank</a>, the bridge will make it even easier to manufacture on Indonesia’s westernmost islands and carry this produce by road and sea to Singapore and the rest of the world.</p>
<p>The Rempang project may also be part of a looming trade war between China, the US and the EU. In 2022, China manufactured <a href="https://www.npr.org/2023/05/17/1173250926/solar-power-eu-germany-china">three quarters of the world’s solar panels</a> and produced 97% of the silicon wafers that go into them. So far, the bulk of this production has been in Inner Mongolia and Xinjiang, which have a poor human rights record towards minorities like Uyghurs. Concerns around forced labour and Uyghur “re-education” camps, have <a href="https://www.theguardian.com/world/2021/jun/25/us-bans-target-chinese-solar-panel-industry-over-xinjiang-forced-labor-concerns">attracted sanctions from the west</a>.</p>
<p>This has come with protectionist policies towards <a href="https://www.unpri.org/download?ac=17824">emerging solar industries in the EU and America</a>. That is, to encourage national renewables manufacturing and create much needed green jobs, western governments are ready to generously subsidise manufacturers, while heavily taxing imports from competitors like China. <a href="https://www.carbonbrief.org/media-reaction-us-inflation-reduction-act-and-the-global-clean-energy-arms-race/">This international trade tussle</a> begs the question: does mass solar industrial manufacturing in a third country allow China to bypass sanctions and retain its domination of global solar panel manufacturing?</p>
<h2>Sand: a critical resource in the renewables push</h2>
<p>We know that the <a href="https://www.iea.org/topics/critical-minerals">green transition will require critical minerals</a> like cobalt, lithium and nickel to produce electric vehicles, solar cells and wind turbines. Indonesia has some of the world’s <a href="https://www.energymonitor.ai/extractive-industries/the-top-ten-critical-minerals-powerhouses-of-the-energy-transition/?cf-view">largest deposits of nickel and cobalt</a>, making it extremely attractive for countries and companies involved in the renewables push. </p>
<p>Rempang is not known for critical mineral or metal deposits. Yet, apart from its strategic location in the South China Sea, overlooking Singapore, Rempang is sitting on a crucial resource in the renewables transition: sand. Rempang, and its surrounding islands are abundant in silica and quartz sand, which is the <a href="https://interestingengineering.com/innovation/from-sand-to-solar-panels-unveiling-the-journey-of-solar-panel-manufacturing">base material for the manufacture of glass, and solar panels</a>.</p>
<p>Mass mining of sand is considered a <a href="https://www.theguardian.com/cities/2017/feb/27/sand-mining-global-environmental-crisis-never-heard">global environmental crisis that often goes unreported</a>. The world over, a push for infrastructure and urbanisation is founded on massive supplies of cement and concrete, which are made from sand. By 2060, the world is expected to require <a href="https://theweek.com/news/science-health/960931/why-is-the-world-running-out-of-sand#">4.6 billion tonnes of sand</a>. The hunger for solar panels is part of this global sand rush.</p>
<p>Indonesia is at the heart of the sand trade. For years, it has supplied sand to Singapore. Official figures suggest that between 1997-2002 alone, Singapore imported 150 million tonnes of sand from Indonesia. Between 1999-2019, Singapore has shipped in <a href="https://www.straitstimes.com/asia/se-asia/indonesia-scraps-two-decade-ban-on-sea-sand-exports">517 million tonnes of sand </a> from neighbours like Malaysia, Indonesia and Cambodia. </p>
<p>Riau Islands are directly affected, with several islands shrinking significantly in area due to legal and illegal sand export to Singapore. <a href="https://www.asiasentinel.com/p/indonesia-resume-sand-exports-raising-fears">About a quarter of Singapore</a>, including iconic spaces like Marina Bay Sands and the luxury beach and resort area of Sentosa <a href="https://www.channelnewsasia.com/singapore/sentosa-history-50-years-golden-jubilee-2547546">are built on reclaimed land</a> with imported sand. The losers in this process of <a href="https://academic.oup.com/edited-volume/44609/chapter-abstract/393367359?redirectedFrom=fulltext">land-making</a> have been fishworkers, and others dependent on coastal land and waters, including my contacts in the Riau Islands. Fishworkers I have met speak of muddied waters, islands disappearing and drastic reduction in fish and seaweed at the peak of the sand trade.</p>
<p>In 2003, facing irreversible environmental harm, including rising seawater owing to reduced sand and mangrove plant buffers, Indonesia banned the sand trade. Yet, the <a href="https://www.ft.com/content/5359d629-365c-4cd5-94dd-49eb168be1a2">illegal trade in sand went on</a>. In 2023, <a href="https://www.straitstimes.com/asia/se-asia/indonesia-scraps-two-decade-ban-on-sea-sand-exports">sand is back on the government’s agenda</a> as a legally <a href="https://www.greenpeace.org/southeastasia/press/58968/sea-sand-export-returns-after-a-20-year-ban/">tradeable commodity</a>. Rempang is very likely to face the repercussions of renewed sand mining.</p>
<h2>Compensation: a drop in the ocean</h2>
<p>The ecocity and solar panel project are a priority for the government of Indonesia. Ministers have now been deployed to the site to convince locals to support the project, and to hear them out. This includes the investment minister, <a href="https://en.tempo.co/read/1773595/minister-bahlil-visits-rempang-island-to-find-best-solution-without-violence">Bahlil Lahadalia</a>.</p>
<p>At the same time, residents were handed an eviction date of September 28, 2023. Representatives of <a href="https://bpbatam.go.id/en/">BP Batam</a> told them to sign consent forms by mid-September or risk losing the compensation on offer. Finally, villagers were made aware of the terms of compensation: a 45-square metre house, on 500 square metres of land. The house and land is estimated to cost around Rp120 million, or £6,257.</p>
<p>Residents rejected the compensation, with some instead demanding a 70-sq metre house, 1,000sq metres of land, and Rp200 million in cash. As a political commentator indicated <a href="https://kbanews.com/english-edition/land-and-cultural-conflict-in-rempang-balancing-progress-and-heritage/">in the local press</a>, if the government were to meet this higher demand, it would cost them Rp1.04 trillion for compensating all residents. When the proposed investment in the ecocity is Rp381 trillion, what is a compensation amount of a little under 0.3% of the total cost? </p>
<p>While the government is finally in talks with people at Rempang, and as compensation is being discussed, some people have already signed relocation papers. Some say they have been under intense pressure to do so. </p>
<p>This, however, is not the narrative being pushed by BP Batam which is now trying to win a PR war. In its latest press release <a href="https://bpbatam.go.id/en/progres-rempang-eco-city-25-kk-sudah-tempati-hunian-sementara/">it claimed</a> “most residents at some point have voluntarily accepted the shift”. It quoted the head of BP Batam, Muhammad Rudi, as saying, “there is no coercion or intervention,” and that the choice to be relocated was being made “purely from the hearts of the people” who support the ecocity project.</p>
<p>But others are holding out, convinced that “the Melayu cannot be bought”, or moved from their land. The idea that the local Melayu community is not for sale was repeated by many of my contacts. The powerful slogan was also printed on posters that have gone up in Rempang villages in the gathering movement against the glass factory and ecocity.</p>
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<p>Rumours and threats that the resistance at Rempang will lead to the cancellation of the project are beginning to be circulated. These have been <a href="https://inp.polri.go.id/2023/09/20/minister-luhut-confident-in-xinyi-groups-rempang-investment-amid-conflicts/">denied</a> at the highest levels but protests have forced the government to postpone the eviction date, even as they remain determined to start solar panel production at Rempang by <a href="https://www.bloomberg.com/news/articles/2023-09-27/indonesia-to-build-25-billion-project-rocked-by-violent-clashes?leadSource=uverify%20wall">2024</a>. The government has also been compelled to <a href="https://voi.id/en/economy/314059">negotiate with protestors</a> regarding compensation, and has shifted the site of relocation from Galang Island to <a href="https://www.thejakartapost.com/front-row/2023/10/02/visit-to-tanjung-banon-indicates-eco-city-development-is-near.html">Tanjung Banon</a>, a district in the south-eastern corner of Rempang.</p>
<p>There is also talk of a phased relocation and a reduced project area. Some in the government have suggested that shifting within the same island, and fishing just a few kilometres past their old homes, can hardly even be called relocation. But for those who continue to resist the project, their only true home is where they currently live, and where their histories lie. Having had to reckon with relocation, residents are asking fundamental questions like: where will our children study? And, will the solar panel factory displace <a href="https://voi.id/en/news/311679">Melayu ancestral graves</a>?</p>
<p>After fighting alone for their rights for months, the people of Rempang finally have assistance from civil society groups and legal aid organisations. In August 2023, a civil society activist from Jakarta told me “there are too many resource and land conflicts in Indonesia. Something or other is always happening on our 17,500 islands. It is hard to keep up, and be involved in everything”.</p>
<p>But from September, <a href="https://en.tempo.co/read/1775087/civil-coalition-opens-legal-aid-post-in-rempang">prominent civil society groups</a> are assisting the residents of Rempang with a strategy for pushing back. Legal aid has been offered to them relating to their land rights as long-term residents – some of whom trace their connection to Rempang at least to the <a href="https://www.foei.org/rempang-island-indonesia-solidarity/">early 1800s</a>.</p>
<h2>The green transition’s collateral damage?</h2>
<p>My contacts at Rempang had been contemptuous of the suggested shift to Galang Island, and are not impressed by the alternate, smaller site at Tanjung Banon either. One said: “How can you take people from 16 villages, and put them in one small island? There will be conflict over land, and fishing. We are all fishers.” Adding to this incredulity is the idea that the government could even consider moving them to Galang — an island they know as the “Vietnamese refugee island”.</p>
<p>Galang housed boat people from Vietnam, Cambodia, and Laos under the auspices of the <a href="https://refugeecamps.net/GalangCamp.html">UNHCR between 1975-1996</a>. These were refugees in limbo, as they sought clearance of paperwork to emigrate to richer countries like the US and Australia. More recently, Galang housed the area’s main <a href="https://www.thejakartapost.com/indonesia/2022/12/22/galang-island-covid-emergency-hospital-closes.html">COVID emergency hospital</a>. People I am speaking to are understandably furious at being seen as “residue” by their own government – successors to a land that housed refugees and the sick and dying that needed to be isolated from the rest of society.</p>
<p>It is easy to understand the fury of those being left behind, or even trodden on, in the global march for greener energy. These local populations are, sometimes literally, at the coalface of the transition, yet their needs – and sometimes even their human rights – are deemed of little importance. </p>
<p>It is often Chinese investment, which makes the <a href="https://time.com/6313609/indonesia-rempang-eco-city-protests-china/">headlines</a>. But my ongoing research makes it clear that local people as residue is at the heart of this area’s longstanding development model. Indeed, as my <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/dech.12742">writing on the global south</a> more broadly shows, colonial and postcolonial development, and continuing north-south structural inequalities are built on the idea of the residual, racialised, inferior “other”. </p>
<p>The transition to green energy is reinforcing these long-held hierarchies. Events in Rempang are just the tip of the iceberg, as the poorer areas of the south become suppliers in the world’s energy needs.</p>
<p>Batam, and its neighbouring islands in Riau, were first conceptualised as an oil trading and logistics zone by US companies and fossil fuel contractors in the late 1960s. The US had aligned with the military <a href="https://theconversation.com/backgrounder-what-we-know-about-indonesias-1965-anti-communist-purge-66338">General Suharto</a>, against left-leaning nationalist President Sukarno in the fraught Cold War context. With US support, Suharto’s dictatorial New Order ruled Indonesia from 1968-98. </p>
<p>The US was the biggest oil producer in Indonesia at this time, with <a href="https://www.caltex.com/id/en/about-us/who-we-are/our-journey.html">Caltex</a>, a joint venture between Texaco and Chevron, producing <a href="https://oilandgascourses.org/the-amazing-chevron-pacific-indonesia/">a million barrels of oil per day</a> at its peak. Batam, as a regional logistics – and then a manufacturing and services – hub, is a creation of the Suharto-era. It was a major outlet for the crude oil trade from Batam to Singapore, and further afield. It was also an inlet for refined oil, with western oil companies and their enablers in Indonesia hiving off profits at the expense of a decimated environment, and a <a href="https://monthlyreview.org/2022/12/01/mining-capital-and-the-indonesian-state/">dispossessed local population</a>.</p>
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Read more:
<a href="https://theconversation.com/a-tale-of-two-cities-why-indonesia-is-planning-a-new-capital-on-borneo-and-abandoning-jakarta-podcast-181134">A tale of two cities: why Indonesia is planning a new capital on Borneo – and abandoning Jakarta. Podcast</a>
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<p>Meanwhile, people on the small islands around Batam receive between four and six hours of electricity a day from the public utility provider. They experience a sense of déjà vu, as their government starts yet another ambitious project with foreign companies. Once more, their resources are to be ploughed into a money-spinning investment. They will be residue, to be signed off the land. Except this time, in the hotbed of Rempang, they have decided to fight back.</p>
<p>As the world looks to up its green energy consumption, with attendant demands on resources like sand, land and water, we will do well to consider the likely winners and losers in this process. There is a lot of talk on climate and energy justice in international circles right now. The idea of a green energy transition that can be “<a href="https://climatepromise.undp.org/news-and-stories/what-just-transition-and-why-it-important">just</a>” is absent from the volatile spaces of Rempang.</p>
<p>Faced with losing everything they call their own, the people of Rempang are not waiting for justice to be delivered to them. They are fighting for it on the ground. It might be the only way they will be heard, and counted, in the global green energy transition.</p>
<p><em>The Conversation approached the Indonesian government and the Artha Graha group for comments but none were received by time of publication.</em></p>
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<p><em>For you: more from our <a href="https://theconversation.com/uk/topics/insights-series-71218?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insights series</a>:</em></p>
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<li><p><em><a href="https://theconversation.com/my-home-city-was-destroyed-by-war-but-i-will-not-lose-hope-how-modern-warfare-turns-neighbourhoods-into-battlefields-211627">‘My home city was destroyed by war but I will not lose hope’ – how modern warfare turns neighbourhoods into battlefields</a></em></p></li>
<li><p><em><a href="https://theconversation.com/beatrix-potters-famous-tales-are-rooted-in-stories-told-by-enslaved-africans-but-she-was-very-quiet-about-their-origins-202274">Beatrix Potter’s famous tales are rooted in stories told by enslaved Africans – but she was very quiet about their origins
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<p>_To hear about new Insights articles, join the hundreds of thousands of people who value The Conversation’s evidence-based news. <a href="https://theconversation.com/uk/newsletters/the-daily-newsletter-2?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK"><strong>Subscribe to our newsletter</strong></a>.</p><img src="https://counter.theconversation.com/content/214755/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nikita Sud receives funding from the Oxford University Press supported John Fell Fund at Oxford University. Grant reference: 0012658.</span></em></p>The international quest for green energy is reliant on ‘sacrificial zones’ in developing countries.Nikita Sud, Professor of the Politics of Development, University of OxfordLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2154732023-10-11T13:25:40Z2023-10-11T13:25:40ZIsrael-Gaza conflict: how could it change the Middle East’s political landscape? Expert Q&A<p><em>The surprise attack by Hamas launched on Israel on October 7 has already led to thousands of deaths in both Israel and Gaza, and sparked concerns that the conflict could escalate across the Middle East. An expert in the politics and relations of this region, Simon Mabon, explains how all the key players are likely to view this dramatic escalation in violence.</em></p>
<p><strong>Just before the attack by Hamas, Benjamin Netanyahu and Mohammed bin Salman had talked of progress on a “<a href="https://news.un.org/en/story/2023/09/1141302">historic peace deal</a>” between Israel and Saudi Arabia. Is such an agreement dead in the water now?</strong></p>
<p>Not necessarily. The US-led “<a href="https://www.theguardian.com/world/2020/sep/15/uae-bahrain-and-israel-sign-historic-accords-at-white-house-event-formal-relations-trump-netanyahu">Abraham accords</a>”, signed in September 2020, changed the dynamic of what was possible in the Middle East. While Egypt and Jordan had previously established diplomatic relations with Israel (in 1979 and 1994 respectively), the accords signalled that a wider “<a href="https://www.aljazeera.com/news/2023/9/15/map-which-mena-countries-have-diplomatic-ties-with-israel">normalisation</a>” of relations between Israel and the Arab states was in process – and by virtue of this, that Saudi Arabia, which has never recognised Israel as a state, would also normalise relations at some point.</p>
<p>Speaking to Saudi friends, they had envisaged a revival of the 2002 <a href="https://en.wikipedia.org/wiki/Arab_Peace_Initiative">Arab Peace Initiative</a>, which was driven by Saudi Arabia. Getting Israel to buy into that would have been the win that Mohammed bin Salman (MBS), Saudi’s crown prince and prime minister, needed to make normalisation happen. Of course, following the shocking attack by Hamas on Israeli civilians, there won’t be any kind of peace initiative for now.</p>
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Read more:
<a href="https://theconversation.com/israel-hamas-war-updates-on-the-conversations-coverage-of-the-conflict-215285">Israel-Hamas war: updates on The Conversation's coverage of the conflict</a>
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<p>Saudi Arabia has not publicly condemned the attacks, but has been <a href="https://www.arabnews.com/node/2386901/middle-east">vocal in its calls for de-escalation</a>, joining a growing chorus of international voices expressing concern at what comes next. In contrast, the United Arab Emirates (UAE) has <a href="https://www.newarab.com/news/how-did-arab-states-react-hamas-attack-israel">criticised Hamas</a> for the murder of Israeli civilians. But Israel knows it’s a diplomatic game. In the longer term, the shifting political and economic landscape in the Middle East still points to a desire to establish relations with Israel, and to realign regional politics in such a way that Israel, Saudi Arabia and other Gulf states are broadly on the same side of history.</p>
<p><strong>Was the attack on Israel an attempt to disrupt this process?</strong></p>
<p>The main driver of the attack on Israel by <a href="https://theconversation.com/hamas-what-you-need-to-know-about-the-group-that-attacked-israel-215288">Hamas</a>, the elected governing authority in Gaza since 2007, is the 16-year land, sea and air blockade of this Palestinian territory. In Gaza, more than 2 million people live in an area a quarter of the size of London with limited access to electricity and water.</p>
<p>But the timing of the attack certainly carries wider significance. It came during the <a href="https://theconversation.com/hamas-assault-echoes-1973-arab-israeli-war-a-shock-attack-and-questions-of-political-intelligence-culpability-215228">50th anniversary of the 1973 war</a>, when Egyptian and Syrian armies invaded Israel, which I think is symbolically important. And the backdrop of Saudi Arabia’s move to normalise relations with Israel is also significant, because Hamas – and potentially others in the region – will see it as a bonus if the conflict serves to disrupt that dynamic.</p>
<p><strong>When MBS said that “<a href="https://www.theguardian.com/world/2023/sep/21/saudi-arabia-getting-closer-to-normalising-relations-with-israel-crown-prince-says">solving the Palestinian issue</a>” was key to the normalisation process, what did he mean?</strong></p>
<p>There’s a cynical answer to this, which is that Saudi’s leader was looking to use rhetoric to cultivate some support, and to reassure those people (in Saudi and elsewhere) who are concerned about the process of normalisation. To be clear, that’s the bigger prize for MBS – not the articulation or realisation of a Palestinian state.</p>
<p>In the context of Israel-Palestine and the “<a href="https://theconversation.com/israel-palestine-the-legacy-of-oslo-and-the-future-of-a-two-state-solution-podcast-214107">two-state solution</a>”, peace is a mirage – an illusion held up by people seeking to solidify their positions of influence in Israel, Palestine and beyond. If you look at the facts on the ground, there is no two-state solution in process; Palestine is not even recognised as a state by a <a href="https://en.wikipedia.org/wiki/International_recognition_of_the_State_of_Palestine#:%7E:text=Among%20the%20G20%2C%20nine%20countries,the%20United%20States">large number of countries</a>. It has been described as a political football kicked around by political elites seeking to use it for their own advantage, with the Palestinian people being the ones suffering for decades.</p>
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Read more:
<a href="https://theconversation.com/inside-the-oslo-accords-a-new-podcast-series-marks-30-years-since-israel-palestine-secret-peace-negotiations-212985">Inside the Oslo accords: a new podcast series marks 30 years since Israel-Palestine secret peace negotiations</a>
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<p>If we look at the Abraham accords, the positive spin for Palestinians was that there might be scope for states engaging Israel to put pressure on them, to try and force some kind of resolution. But we’re over three years into these accords and nothing has happened.</p>
<p><strong>What’s been Saudi Arabia’s gameplan?</strong></p>
<p>MBS wants to position Saudi as the driving force of regional affairs – and to ensure that he has the economic power to bring about his “<a href="https://theconversation.com/what-will-saudi-arabias-vision-2030-mean-for-its-citizens-58466">Vision 2030</a>” transformation of the kingdom away from a reliance on oil. But to do that, he needs to address regional security concerns. He’s started doing that with Iran, and has already been doing it tacitly with Israel for a number of years.</p>
<p>There is back-channel dialogue, a lot of collaboration under the table, but recently this has become more open. And it’s not hugely popular among some Saudis and other Arab publics, who continue to see the Palestinian cause as important. So, you have a disjunct between elite leaders in the region, who regard Israel as “just another member” of this club of states, and their people, who view the occupation of Palestinian territories as a key element of the Arab portfolio.</p>
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<p><strong>What does Israel want from the normalisation process?</strong></p>
<p>Recognition. Saudi Arabia is the last major Arab player not to recognise Israel other than Qatar, which will not recognise Israel because of its politics and long history of supporting members of Hamas and political Islamist organisations who stand against Israel. And Saudi is hugely symbolic – it’s the leader of the Sunni Muslim world and the location of the two holy mosques of Mecca and Medina.</p>
<p>For Saudi Arabia to normalise relations with Israel would bring an end, formally, to the Arab-Israeli wars that dominated the 20th century in the Middle East. It would hammer home that the new dividing line (a geopolitical line that, in reality, has been playing out over the past 20 years) is between the Arab states plus Israel, and Iran – although there has been an effort to try to reintegrate Iran into the region as well, culminating in a <a href="https://www.justsecurity.org/85870/saudi-arabia-and-iran-the-politics-of-detente/">China-led normalisation agreement</a> with Saudi earlier this year.</p>
<p><strong>How does Iran feel about current events?</strong></p>
<p>The attack carried out on Israel was a hugely sophisticated, multi-pronged military operation, beyond anything that we’ve seen from Hamas before. That suggests some type of strategic involvement from “others” – but there’s been <a href="https://www.theguardian.com/world/2023/oct/09/no-evidence-yet-of-iran-link-to-hamas-attack-says-israeli-military">no evidence presented</a> that Iran was involved.</p>
<p>Iran is often viewed as an irrational actor, trying to destabilise things – but that misreads the nature of the Islamic Republic and its foreign policy objectives. Firstly, its leaders are pragmatic – they want the republic to survive. Since its inception in 1979, it has faced a huge number of threats to its survival – and right now, it’s got a <a href="https://theconversation.com/iran-hijab-protests-challenge-legitimacy-of-islamic-republic-191958">very serious one internally</a>. So, while there may be an argument to say that a “rally round the flag” type of event might shift focus away from this domestic unrest, I think the stakes are so high that it wouldn’t want to risk openly engaging in conflict with Israel right now.</p>
<p>Iran just doesn’t have the financial resources. It needs the normalisation of relations with states such as Saudi Arabia and, by extension, the US, to have a cash injection to revive its oil and gas industry, which is in a state of disrepair. It needs a huge cash stimulus to get back on its feet. </p>
<p>However, there is an ideological dimension to the Islamic Republic which we shouldn’t ignore. It has positioned itself against the state of Israel for decades, and this is tied into its very essence. In this, Iran is at the vanguard of what it calls the “<a href="https://en.wikipedia.org/wiki/Axis_of_Resistance#:%7E:text=The%20term%20Axis%20of%20Resistance,military%20alliance%20between%20Iran%2C%20militant">axis of resistance</a>” – a loose alliance of Iran, Hezbollah, Hamas and, previously, Syria.</p>
<p><strong>Do the other Gulf states have much influence on how this will play out?</strong></p>
<p>The UAE is <a href="https://www.reuters.com/world/middle-east/uae-after-israel-gaza-conflict-says-it-does-not-mix-trade-with-politics-2023-10-10/">invested economically in the West Bank</a>, as is Qatar. The UAE has taken a similar line to Saudi Arabia on the attack, calling it “a serious and grave escalation”. There’s a bit of competition between them in terms of exerting influence in the West Bank, but broadly they’re on the same path, given that UAE was involved in the Abraham accords and Saudi has been talking about normalisation.</p>
<p>History has shown us that there has sometimes been a willingness to disregard controversial issues in the region. For example, when the US embassy was moved from Tel Aviv to Jerusalem, <a href="https://www.aljazeera.com/news/2018/5/14/world-leaders-react-to-us-embassy-relocation-to-jerusalem">most states remained quiet</a> despite it being a hugely symbolic switch. But, of course, the attack on Israel is at an altogether different level of political sensitivity.</p>
<p>Qatar is trying to play a mediatory role in terms of <a href="https://www.reuters.com/world/middle-east/qatar-leads-talks-swap-hamas-held-hostages-palestinians-israeli-jails-2023-10-09/">potential prisoner swaps</a>. It has a growing history of trying to engage in diplomatic initiatives, having been involved in <a href="https://www.files.ethz.ch/isn/160109/da1df25567ebd34af26d634892934b03.pdf">Lebanon in the mid-2000s</a> and has been involved in <a href="https://www.voanews.com/a/qatar-expects-us-taliban-talks-to-have-successful-outcome-very-soon-/4812426.html">dialogue between the US and the Taliban</a>. But despite this diplomatic dimension to Qatari foreign policy, it hasn’t demonstrated that it’s able to exert much influence over Israel.</p>
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<p><strong>Where does this leave the Palestinian people?</strong></p>
<p>The Palestinian people are increasingly isolated – caught up in the contours of geopolitical machinations, abandoned by those who should be supporting them. While countries have some dialogue with Palestinian groups such as <a href="https://en.wikipedia.org/wiki/Fatah">Fatah</a> in the West Bank, these groups are so weak and have so little legitimacy that it doesn’t really matter what they say. With such huge power disparities, there is limited inclination for the Israelis to engage in peace – even less so since the Hamas attack – and limited capacity for the Palestinians to engage in peace. </p>
<p>In the wake of the attack, Gazans have been <a href="https://www.timesofisrael.com/idf-instructs-gazans-on-evacuation-routes-while-many-find-shelter-in-unrwa-schools/">instructed by Israel to flee their city</a> – but given there is a blockade and you have to have permission from the Israelis to leave through Israeli-controlled checkpoints, there is <a href="https://news.sky.com/story/hamas-israel-war-we-are-being-completely-strangled-aid-workers-report-from-inside-gazas-worst-ever-humanitarian-crisis-12981768">nowhere for them to go</a>. Gaza is effectively the largest open-air prison in the world, with infrastructure that has been devastated by the 16 years of blockade. The ongoing <a href="https://www.reuters.com/world/middle-east/hamas-threatens-kill-captives-if-israel-strikes-civilians-2023-10-09/">Israeli air strikes</a> are further destroying its hospitals, schools, shops and homes.</p>
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Read more:
<a href="https://theconversation.com/the-gaza-strip-why-the-history-of-the-densely-populated-enclave-is-key-to-understanding-the-current-conflict-215306">The Gaza Strip − why the history of the densely populated enclave is key to understanding the current conflict</a>
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<p>Hamas as a political entity is not particularly popular, because it hasn’t been able to achieve its goals. But as a militant group, it has cultivated legitimacy in certain constituencies. However, the morally repugnant act of killing civilians will, I think, prove to be a major strategic mistake for the organisation. Israel’s response to the Hamas attack is being <a href="https://www.theguardian.com/world/2023/oct/10/hamas-attack-israel-us-opinion-divided">widely positioned</a> as part of the “global war on terror”, positioning Hamas alongside groups such as al-Qaeda and Daesh as Israel’s prime minister, Benjamin Netanyahu, seeks to cultivate global support for his actions.</p>
<p>Meanwhile, the <a href="https://www.britannica.com/topic/Palestinian-Authority">Palestinian Authority</a> (PA), which is the broad umbrella organisation that regulates life in the West Bank and Gaza, is impotent, unable to exert any influence on Israel or the world stage. There’s a real frustration among Palestinian people with the PA, who will not come out and condemn Hamas because that would mean condemning resistance against an occupation that has caused such devastation in the years after the <a href="https://www.bbc.co.uk/news/world-middle-east-39960461">1967 war</a>.</p>
<p>The attack has emboldened extremist voices on all sides, from Hamas militants in Gaza to the right-wing settler communities in Israel. The consequences of extremist voices gaining prominence, and the violence that follows, will be devastating.</p><img src="https://counter.theconversation.com/content/215473/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Simon Mabon receives funding from Carnegie Corporation of New York and The Henry Luce Foundation. He is a Senior Fellow with the Foreign Policy Centre. </span></em></p>Is the much-heralded Israel-Saudi peace deal now dead? And how is Iran likely to respond? An expert in Middle Eastern politics explainsSimon Mabon, Professor of International Relations, Lancaster UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2143232023-09-29T16:43:11Z2023-09-29T16:43:11ZSelf-driving buses that go wherever you want? How the UK is trying to revolutionise public transport<figure><img src="https://images.theconversation.com/files/551206/original/file-20230929-23-z1vo5d.jpg?ixlib=rb-1.1.0&rect=14%2C164%2C3015%2C1730&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Scotland’s CAVForth self-driving bus service began in May 2023, serving a 14-mile route that crosses the Forth Road Bridge on the outskirts of Edinburgh.</span> <span class="attribution"><span class="source">Stagecoachbus.com</span></span></figcaption></figure><p>Futurology is littered with predictions that failed to materialise, not least in the field of transport technology. In Edwardian times, when public transport was largely powered by horse or steam, a number of new concepts emerged which were hailed as the “future of public transport”.</p>
<p>In 1910, the <a href="https://collection.sciencemuseumgroup.org.uk/objects/co27065/brennans-gyroscopic-mono-rail-car-model-gyroscopic-mono-railcar">Brennan Monorail</a> was a gyroscopically stabilised, diesel-powered monorail train that ran on a circular test track at the White City in London. One of the early passengers on this <a href="https://www.midnight-trains.com/post/on-board-louis-brennans-gyroscopic-monorail">50-person prototype</a> was then-home secretary Winston Churchill, who insisted on driving the train himself. The new technology <a href="https://www.newscientist.com/article/mg19225780-125-histories-the-spinning-top-railway/">reportedly</a> “proved as interesting to the statesman as a new toy would to a child” – and Churchill is said to have told its Irish-Australian creator <a href="https://www.irishtimes.com/life-and-style/people/louis-brennan-the-inventive-life-of-the-monorail-man-from-mayo-1.1757782">Louis Brennan</a>: “Sir, your invention promises to revolutionise the railway systems of the world.”</p>
<p>Buoyed by such designs, engineering writers of the time looked forward to a future of us all whizzing around the country on new forms of hi-tech transport. But there were concerns too: in one popular <a href="https://en.wikipedia.org/wiki/Harmsworth_Popular_Science">1912 encyclopaedia</a>, an artist’s impression of a monorail train crossing a gorge via an unfeasibly skimpy bridge was accompanied by the warning:</p>
<blockquote>
<p>When [note, not ‘if’] the monorail comes into general use, the feeling of insecurity – quite unnecessary but nevertheless inevitable – will be felt the strongest where there are single-rail bridges.</p>
</blockquote>
<p>In fact, despite Churchill’s support, the Brennan Monorail never got further than the test track. In both its target markets – cheaply built branch lines and the military – a far simpler technology easily outdid it on grounds of practicality, flexibility and cost: the motorised bus and truck.</p>
<p>More than a century on, we are in a new era of transport technology disruption. In recent years, across the world, we have seen the emergence of the <a href="https://www.thetimes.co.uk/article/flying-electric-taxis-are-hailed-as-the-future-2v6jllgfc">flying taxi</a> and <a href="https://www.forbes.com/sites/jamesmorris/2022/11/29/is-it-finally-time-for-high-speed-hyperloop-transportation/">hyperloop train</a> prototypes, <a href="https://www.latimes.com/politics/story/2021-08-10/hydrogen-highway-or-highway-to-nowhere">hydrogen highways</a> and <a href="https://www.weforum.org/agenda/2022/09/trackless-trams-help-revitalize-suburbs/">trackless trams</a>, as well as countless driverless <a href="https://www.theverge.com/2012/12/23/3797260/self-driving-cars-automated-vehicles">car</a>, <a href="https://theconversation.com/driverless-cars-what-weve-learned-from-experiments-in-san-francisco-and-phoenix-199319">taxi</a> and <a href="https://fortune.com/2017/01/14/vegas-self-driving-bus/">bus</a> pilots. At the same time, our most popular forms of public transport – the train and bus – are creaking under the strain of <a href="https://www.local.gov.uk/about/news/thousands-bus-routes-risk-amid-funding-uncertainty">government funding cuts</a>, <a href="https://news.sky.com/story/resolving-rail-disputes-would-have-cost-less-than-strikes-admits-minister-12789405">union disputes</a> and <a href="https://www.railpro.co.uk/railpro-magazine/april-22/staffing-strategies-must-be-fixed-to-secure-future-for-uk-rail">technological upheaval</a>.</p>
<p>Is this the dawning of a much-needed revolution in mass transit, led by a new breed of clean-powered, demand-responsive, driverless vehicles? Or for all the people young and old, rural and urban-based, who rely on public transport for their everyday needs, will these grand designs turn out to be little more than modern versions of the Brennan Monorail flop?</p>
<h2>Slow death of the bus</h2>
<p>A key factor influencing today’s public transport strategies is the commitment to limit planetary warming to 1.5°C by reaching net zero emissions – a strategy the UK prime minister, Rishi Sunak, <a href="https://www.bbc.co.uk/news/uk-politics-66857551">recently appeared to row back on</a>. One global projection by the C40 network suggests public transport use in cities needs to <a href="https://www.c40.org/news/public-transport-cities-decade-1-5c-target/">double by 2030</a> to meet these targets.</p>
<p>But there are, of course, many other benefits of good public transport: from <a href="https://www.unep.org/explore-topics/resource-efficiency/what-we-do/cities/sustainable-transport-and-air-pollution">improving air quality</a> and <a href="https://www.urbantransportgroup.org/resources/social-inclusion#:%7E:text=Transport%20has%20a%20vital%20role,to%20fully%20participate%20in%20society.">social inclusion</a> to encouraging <a href="https://www.newstatesman.com/spotlight/economic-growth/regional-development/2022/07/transport-is-the-core-of-levelling-up">regional economic development</a> (aka levelling up) and <a href="https://oecd-opsi.org/innovations/pink-passes/">widening workforce participation</a>.</p>
<p>In the UK, trains continue to hog the headlines, amid the rumoured <a href="https://www.bbc.co.uk/news/business-66909732">cancellation of the northern section of the HS2 route</a>, the general <a href="https://www.theguardian.com/commentisfree/2022/oct/22/north-rail-system-franchises-london">lack of rail investment in the north</a>, ongoing <a href="https://www.theguardian.com/uk-news/rail-strikes">industrial action</a> over pay and staffing levels – and even the agonising <a href="https://www.theguardian.com/uk-news/2023/sep/26/no-one-knew-anything-rail-passengers-11-hour-london-to-edinburgh-odyssey">11-hour ordeal</a> endured by rail passengers when their London to Edinburgh service was cancelled mid-route. Meanwhile, the long, slow <a href="https://www.theguardian.com/commentisfree/2023/aug/06/bus-neglect-national-failure-public-policy-motorists">collapse of the UK’s local bus services</a> has gone largely unnoticed – other than by the people who have lost this critical mode of travel.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/550306/original/file-20230926-15-nvzbgk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="BBC graphic of bus cuts" src="https://images.theconversation.com/files/550306/original/file-20230926-15-nvzbgk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/550306/original/file-20230926-15-nvzbgk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=935&fit=crop&dpr=1 600w, https://images.theconversation.com/files/550306/original/file-20230926-15-nvzbgk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=935&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/550306/original/file-20230926-15-nvzbgk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=935&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/550306/original/file-20230926-15-nvzbgk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1176&fit=crop&dpr=1 754w, https://images.theconversation.com/files/550306/original/file-20230926-15-nvzbgk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1176&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/550306/original/file-20230926-15-nvzbgk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1176&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Changes in bus use in English counties.</span>
<span class="attribution"><a class="source" href="https://www.bbc.co.uk/news/uk-64651414">Department for Transport/BBC</a></span>
</figcaption>
</figure>
<p>In March 2023, the House of Commons Transport Committee <a href="https://committees.parliament.uk/publications/34612/documents/190548/default/">reported</a> that England’s long-term decline in bus use outside London – a 15% drop between 2010-11 and 2018-19 – had deteriorated by a further 15% despite the government’s temporary <a href="https://www.gov.uk/guidance/2-bus-fare-cap">£2 cap on fares</a> (rising to £2.50 in November 2023). The situation is <a href="https://www.transport.gov.scot/publication/scottish-transport-statistics-no-38-2019-edition/chapter-2-bus-and-coach-travel/#:%7E:text=380%20million%20journeys%20were%20made,cards%20in%20Scotland%20in%202019.">similar in Scotland</a>, where bus use has declined 22% since 2007-08.</p>
<p>In parallel with this decline, <a href="https://www.bbc.co.uk/news/business-64557250">services and routes have been cut</a>. Government bus grants have become increasingly selective, resulting in entire bus networks vanishing in a number of areas, and being left “<a href="https://www.msn.com/en-gb/money/other/local-bus-services-hanging-by-a-thread-mps-warn/ar-AA19fI5V?ocid=msedgntp&cvid=e1abcf8487c34436b238e8eb141cacb9&ei=34">hanging by a thread</a>” in others.</p>
<p>This isn’t just in smaller towns and rural areas. Many larger settlements have also been affected, such as Stoke-on-Trent, where bus services have reduced by half since 2012-14. In June 2023, when <a href="https://www.bbc.co.uk/news/articles/c3gz35wgpdyo">further cuts were announced</a>, <a href="https://www.stokesentinel.co.uk/news/stoke-on-trent-news/first-potteries-axes-journeys-cuts-8536993">local media</a> reported the impact on users such as this unhappy traveller:</p>
<blockquote>
<p>I use the bus to get to work and back, and losing the service would mean reducing my hours. It’s getting us down. My husband’s an Avon rep, so he’s on and off the buses all the time. And the 8am bus I get is packed.</p>
</blockquote>
<p>There are exceptions to this downward spiral. Manchester’s mayor, Andy Burnham, recently heralded the launch of the new, <a href="https://www.greatermanchester-ca.gov.uk/news/local-accountability-at-centre-of-new-bus-network-as-operators-appointed-to-run-first-franchised-services-outside-of-london-for-almost-40-years/">“re-regulated” Bee network of buses</a> across Greater Manchester as “symbolic of a need to get more public control and ownership of critical services”. Praising this initiative, the Guardian wrote in its <a href="https://www.theguardian.com/commentisfree/2023/sep/18/the-guardian-view-on-greater-manchesters-bus-revolution-the-public-at-the-wheel?CMP=share_btn_tw">leader column</a>:</p>
<blockquote>
<p>The cutting of bus services on purely commercial grounds has led to greater social and economic isolation, restricting opportunities for the elderly and those without other means of getting around. Publicly regulated buses will at last allow greater accountability in relation to a service that, for many passengers, is fundamental to their daily quality of life.</p>
</blockquote>
<p>But this is not the direction of travel in most parts of the country, where privatised, disconnected bus services remain dominant. A key structural reason for the decline in local bus use is that people’s patterns of travel have become <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1165693/our-changing-travel-how-people_s-travel-choices-are-changing.pdf">much more dispersed and complex</a> – behaviour that is hard to accommodate with a conventional, fixed-route public transport system such as the bus.</p>
<hr>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
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<p>In fact, the strongest recent growth in local travel – seemingly exacerbated by the pandemic – has not been along major corridors to city centres, but in <a href="https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=5f45c81567467d0a5f56899774153461b85b1e4e">suburban and rural areas</a>. Not only are people <a href="https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/employmentandemployeetypes/articles/characteristicsofhomeworkersgreatbritain/september2022tojanuary2023">working in different ways</a> but our economy is increasingly <a href="https://commonslibrary.parliament.uk/research-briefings/sn02786/#:%7E:text=The%20service%20industries%20include%20the,employment%20in%20January%E2%80%93March%202023.">service</a> and <a href="https://www.capitaleconomics.com/newsroom/uk-economy-returns-growth-driven-consumer-spending">consumer-focused</a>, and travel patterns have altered significantly as a result. The major areas of travel growth are now for <a href="http://www.demand.ac.uk/wp-content/uploads/2018/04/FutureTravel_report_final.pdf">social and leisure-related purposes</a> – and again, traditional fixed-route bus services struggle to accommodate these types of trip, while it is so much easier to simply use a car.</p>
<p>The advent of certain digital technologies – in particular, <a href="https://www.route-one.net/features/cashless-is-king-the-shifting-landscape-of-ticketing/">cashless ticketing</a> and <a href="https://www.theguardian.com/public-leaders-network/2016/sep/15/top-10-transport-apps-smarter-travel">journey planning apps</a> – may make using public transport more desirable for those comfortable with such technology. But they don’t change the core service. A smart app is just a high-tech insult if buses don’t run when and where you want to go.</p>
<h2>The emergence of trackless trams</h2>
<p>In 2011, a small but radical new service was established to connect passengers using Heathrow Airport’s Terminal 5 with their parked cars. These <a href="https://www.heathrow.com/transport-and-directions/heathrow-parking/heathrow-pod-parking-terminal-5">Heathrow Pods</a> consisted of driverless, four-seater vehicles available on demand, taking passengers straight to their destination along special elevated, segregated roadways. Users were promised they would “never have to wait more than 30 seconds for one to become available”.</p>
<p>While admittedly covering a very limited area, this radical alternative to the traditional fixed-route, scheduled model of public transport <a href="https://www.dailystar.co.uk/travel/travel-news/mans-video-futuristic-heathrow-airport-28010349">continues to garner praise</a> since reopening after a hiatus during the pandemic. In the wake of the Heathrow Pods’ introduction, it had been expected that similar tracked, autonomous transport systems would develop elsewhere – but that hasn’t come about.</p>
<p>Rather, they could be seen as a small-vehicle precursor to the <a href="https://citymonitor.ai/transport/trackless-trams-may-be-the-best-alternative-to-light-rail">trackless tram systems</a> that have subsequently emerged around the world. A combination of <a href="https://en.wikipedia.org/wiki/Global_Positioning_System">GPS</a> and <a href="https://www.mrlcg.com/latest-media/lidar-in-cars-how-lidar-technology-is-making-self-driving-cars-a-reality-299493/">Lidar (light detection and ranging</a>) guidance technologies are enabling battery-powered electric vehicles to fulfil the function of trams without the need for disruptive and costly track and overhead line infrastructure – making high-quality tram-style services viable beyond a handful of “global elite” cities.</p>
<p>The Chinese <a href="https://www.researchgate.net/figure/The-Trackless-Tram-System-developed-by-CRRC-and-demonstrated-in-Zhuzhou-China-Source_fig1_330069521">pioneered this form of public transport</a> with the automated rapid transit (ART) vehicles, which <a href="https://theconversation.com/why-trackless-trams-are-ready-to-replace-light-rail-103690">first entered service in the eastern city of Zhuzhou</a> in 2018, then rapidly spread to other Chinese cities. Initially manually driven, these trackless trams are now moving to autonomous operation. In Zhuzhou, a four-carriage model was introduced in 2021 which can carry 320 passengers at a maximum speed of just over 40mph, running on batteries charged at each station stop.</p>
<p>And the concept is spreading beyond China: in 2022, a trial was announced for a five-mile route <a href="https://www.stirling.wa.gov.au/your-city/news/2022/march/exciting-new-phase-in-trackless-tram-feasibility">in the city of Stirling</a>, Western Australia. In the UK, however, there is less inclination to <a href="https://eandt.theiet.org/content/articles/2022/10/uk-and-us-seek-to-undermine-chinas-growing-technological-influence/">depend on Chinese-controlled technology</a>. And of course, trams – trackless or otherwise – don’t solve the issue of people wanting services that take them beyond a fixed route.</p>
<p>Meeting the modern, disparate mobility needs of an entire population doesn’t just require new types of vehicle or clever booking apps. We need a new vision of what public transport could be – and in different corners of the UK, there are places starting to offer this.</p>
<h2>The UK’s self-driving public transport prototypes</h2>
<p>Scotland’s <a href="https://www.cavforth.com/">CAVForth self-driving bus service</a>, which came into public service in May 2023, is described on its website as “the world’s most ambitious and complex autonomous bus system”. Serving a <a href="https://www.cnet.com/tech/i-rode-the-worlds-first-autonomous-public-bus-service/">14-mile route</a> that crosses the Forth Road Bridge on the outskirts of Edinburgh, the buses drive themselves along ordinary roads, obey traffic lights, and mix with pedestrians and cyclists. The main reaction of passengers seems to be that they are unaware the buses are not manually driven, as one early user <a href="https://www.cnet.com/tech/i-rode-the-worlds-first-autonomous-public-bus-service/">wrote in CNet</a>:</p>
<blockquote>
<p>Though the bus is fully autonomous, you’d be forgiven for not really recognising it as such. You’ll find a regular steering wheel upfront, and behind it, a driver who’ll no doubt look as though they’re operating the vehicle as usual. UK law dictates that even fully autonomous vehicles must still have an ‘operator’ present who can take manual control, should the need arise.</p>
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<figcaption><span class="caption">Stagecoach video showing passengers on board the CAVForth self-driving bus service.</span></figcaption>
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<p>Using a combination of three sets of Lidar technology and a “suite of cameras and radar”, the autonomous system can currently manage 90% of the route, <a href="https://www.itpro.com/technology/meet-the-cavforth-project-the-worlds-first-autonomous-bus#:%7E:text=The%20five%2Dbus%20fleet%20began,will%20expand%20northwards%20to%20Dunfermline.">according to ITPro</a>, with the human driver “handling the exit from the depot and a few other locations”. The route is projected to expand further north, to the city of Dunfermline, in 2024.</p>
<p>Because the driver is a <a href="https://theconversation.com/free-public-transport-doesnt-add-up-unless-you-get-rid-of-the-drivers-97129">big part of bus running costs</a>, if buses can eventually be autonomous then the challenging costs of providing late-night services or thinly used routes will be reduced – meaning that services could be improved. But the IT-led potential extends much further than a driverless bus.</p>
<p>In south-east England, <a href="https://www.mi-link.uk/">Mi-Link</a> – billed as “the UK’s first fully electric autonomous bus service” – is a move towards something more radical. As well as being electric-powered, this self-driving bus service – which launched in January 2023 and now <a href="https://www.bbc.co.uk/news/uk-england-oxfordshire-65888336">runs on public roads to Didcot Parkway railway station</a> in south Oxfordshire – is linked to a real-time journey planning app which helps travellers plan their journey whether they are walking, cycling or taking the bus to the Milton Park trading estate. It keeps users updated according to their individual travel preferences through the likes of WhatsApp and Messenger.</p>
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<figcaption><span class="caption">First Bus video launching the Mi-Link self-driving electric bus service in Oxfordshire.</span></figcaption>
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<p>The integration of autonomous technology with a smart journey planning system feels critical if public transport is to prosper by attracting traditional car users. App-linked self-driving taxi fleets may well prove another key part of this future, and there are already entirely driverless public taxi fleets such as Waymo and Cruise in <a href="https://www.bing.com/videos/search?q=driverless+cars+san+francisco&docid=603485803253406102&mid=FACAC36B1FADD54CBAAFFACAC36B1FADD54CBAAF&view=detail&FORM=VIRE">San Francisco</a>, and the <a href="https://uk.pcmag.com/news/145977/visiting-chinas-capital-city-dont-be-surprised-if-your-taxi-has-no-driver">Robotaxi</a> in China. On the whole, these appear to be <a href="https://theconversation.com/driverless-cars-what-weve-learned-from-experiments-in-san-francisco-and-phoenix-199319">technically successful</a>, if highly subsidised and dependent on powerful 5G networks to operate. However, their emergence has been <a href="https://www.bbc.co.uk/news/technology-66611513">met with resistance</a> both about perceived lack of safety and <a href="https://www.ft.com/content/f312c9ff-633d-480e-8887-4b5ad3f0ae5e">luddite-esque fears</a> of potential job losses.</p>
<p>But for one of the best clues to what local public transport could look like in the future, we should again look closer to home, to a UK city that has long been renowned – and sometimes mocked – for its futuristic visions.</p>
<h2>The future according to Milton Keynes</h2>
<p>After its foundation in 1967, the ambitious <a href="https://www.tcpa.org.uk/areas-of-work/garden-cities-and-new-towns/new-towns/">new town</a> of Milton Keynes in Buckinghamshire soon began attracting an international reputation for anticipating future social, economic and cultural trends. Along the way, it was also derided as a <a href="https://inews.co.uk/news/uk/milton-keynes-turns-50-embracing-roundabouts-city-wants-lead-culture-tech-42699">city of roundabouts</a> and <a href="https://en.wikipedia.org/wiki/Concrete_Cows">concrete cows</a>, with one architecture critic <a href="https://www.theguardian.com/books/2010/oct/23/ruins-britain-owen-hatherley-review">calling it</a> “the doomed apotheosis of the fossil-fuel society”.</p>
<p>Today, its designers’ desire to accommodate extremely high levels of car use can be viewed as an environmentally irresponsible planning stance. But despite its detractors, Milton Keynes has proved extremely successful both economically and socially, and today has a growing reputation for being at the forefront of a <a href="https://www.milton-keynes.gov.uk/news/2023/major-boost-advanced-rapid-transport-mk">more climate-friendly era of transport innovation</a>.</p>
<p>Recently, its planners have grappled with the need for a new type of public transport – something that is “demand responsive” in the way of a taxi, but without taxi-level fares.</p>
<p>Demand-responsive transport (DRT) services have been attempted by public authorities over the years – but <a href="https://oro.open.ac.uk/19345/1/">largely without success</a>. A <a href="https://www.sciencedirect.com/referencework/9780081026724/international-encyclopedia-of-transportation">global assessment</a> in 2021 concluded that when a new DRT service is set up, revenue from the low number of passengers could not cover the running costs, particularly those of the driver and back-office systems.</p>
<p>One early example was the <a href="http://news.bbc.co.uk/1/hi/england/2399505.stm">Corlink DRT service</a> in north Cornwall, which launched in 2002 to link rural communities with towns. The subsidy cost of over £28 per passenger trip was financially unsustainable and when special government support for the project ended, the service was withdrawn.</p>
<p>The Taxibus service to Bicester rail station, which launched around the same time, ran flexible routes off-peak and, by late 2003, was carrying 50,000 passengers a year. But even then, the service was eventually withdrawn as commercially unviable.</p>
<p>Twenty years on, however, Milton Keynes has addressed <a href="https://oro.open.ac.uk/85542/1/Corrected%20proofs%20TCP%20DRT%20article.pdf">the cost problem</a>, at least, with its DRT service, <a href="https://getaroundmk.org.uk/on-board/mk-connect">MK Connect</a>. Facing the familiar situation of decreased funding to support the rising cost of uneconomic bus services, the city council opted not to implement cuts. Instead, it replaced its subsidised routes with a new demand-responsive service in partnership with the international tech company <a href="https://ridewithvia.com/about?lang=en-gb">Via Transportation</a>. Introduced in 2021, MK Connect still requires a subsidy, but <a href="https://oro.open.ac.uk/85542/">half that of the conventional bus services</a> it replaced.</p>
<p>The service is booked by users like an Uber taxi, logging their pick-up and drop-off addresses through a smartphone app, web portal or by phoning the contact centre. The app directs users to a nearby pick-up point, and they are dropped near their destination. Other passengers may be picked up and dropped off along the way.</p>
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<p>The vehicles are small: as well as the fleet of eight-seater vans (many of which are electric), some cars are used. They generally arrive within 30 minutes of a booking being made, though the wait can be longer at busy times and in more rural areas. Fares are similar to that of traditional buses (payment is cashless), and the service covers the whole Milton Keynes city area – with far better coverage and operating times than the limited bus routes the service replaced.</p>
<p>An important feature is that the app will not allow someone to book on MK Connect if they could use a commercial bus route for their trip instead. In these cases, travellers are informed where to catch the conventional bus and when it will arrive. This ensures that MK Connect does not adversely affect existing viable bus routes, while improving the city’s public transport as a whole. Equally, if people cannot use existing buses due to a disability or other reason, they can register this and will always be accommodated on MK Connect.</p>
<p>The service is widely used, with some 40,000 trips being made each month (almost half a million each year) – a level of use that means its finances stack up. MK Connect has enabled trips to be made that previously were difficult or impossible using conventional buses, including for a man with sight loss who is the <a href="https://www.youtube.com/watch?v=oQYnJ41CmTY">subject of a widely shared video</a>.</p>
<p>One of us – Stephen – has used MK Connect on a number of occasions, and offers this mixed review of his experiences of the service:</p>
<blockquote>
<p>I booked a trip to get to the barbers for a haircut. You can only book an hour or so beforehand, but I found a service that would get me there on time, which picked me up from the end of our road (the app guided me to the exact pick-up point). One other person joined us on the way and another was dropped off en route, but I got to my drop-off point in time for a three-minute walk across to the barbers. Coming back was less smooth, though. Initially, I was refused a booking – no vehicles were available. I waited a few minutes and tried again. This time I got a vehicle, after a 50-minute wait …</p>
</blockquote>
<p>This mixed experience reflects the feedback that has been given in various <a href="https://oro.open.ac.uk/85542/1/Corrected%20proofs%20TCP%20DRT%20article.pdf">passenger surveys</a>. MK Connect is designed to serve modern, dispersed patterns of travel demands but is by no means perfect – some people find it harder to use than the buses it replaced, and there are problems with the vehicles being full at busy times, meaning prospective passengers are refused a booking or not accommodated for a long time. The booking system is also not yet reliable enough when a person has to get to an appointment or college lecture on time, say, or to connect with a specific train.</p>
<p>However, generally speaking, regular users appear to be getting used to the new system and its quirks. The real benefit to them, of course, is that this DRT service allows them to make trips that would be much more difficult, or impossible, using traditional route buses.</p>
<p>Another recently launched DRT, <a href="https://www.intelligenttransport.com/transport-articles/132018/transport-accessibility-hertslynx-drt-hertfordshire/">HertsLynx</a>, aims to serve the rural fringes of Hertfordshire using four electric-powered, 16-seater minibuses in an operating zone centred around the market town of Buntingford and surrounding villages. Passengers are able to travel between 250 virtual bus stops, as well as nearby towns including Stevenage, Hitchin, Letchworth and Baldock – although travel to these towns is limited to fixed points (hospitals, train and bus stations, and high streets).</p>
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<p>HertsLynx now makes 2,600 passenger trips a month and, like MK Connect, booking is by app, online or phone. With only four buses, it has hit a similar issue to MK Connect of being unable to take some trip requests when vehicles are fully in use, as noted in this <a href="https://busandtrainuser.com/2023/07/30/the-drt-renowned-for-its-success/">recent review</a>.</p>
<p>These two prototype services suggest a good model is emerging for local public transport, but that it needs refining. DRT services can best serve more dispersed trips, while conventional buses work well when a regular, predictable arrival time is needed and in situations of high demand. A good mix of the two is what is needed and Milton Keynes and HertsLynx, while heading that way, haven’t yet achieved it. Adding a in a <a href="https://www.manchestereveningnews.co.uk/news/greater-manchester-news/its-a-new-dawn-for-27759901">Manchester-style regulation structure</a> might well do that. </p>
<h2>The future of local public transport?</h2>
<p>As the Brennan Monorail flop illustrated more than a century ago, predicting the future is a dangerous thing. But there is clearly potential to <a href="https://theconversation.com/four-visions-for-the-future-of-public-transport-125443">rethink public transport systems</a> all over the world, in a way that makes a real difference to the planet and quality of daily life – by improving mobility while reducing costs, air pollution and congestion levels.</p>
<p>This revolution is being driven by a range of organisations, spanning powerful technology companies and IT startups as well as the existing public transport industry and both national and local policymakers. Central to a more diversified public transport future is easily accessed information and payment systems that allow users to customise different services for their own travel needs. Personalised apps on mobile devices to book and pay for public transport services will become increasingly important.</p>
<p>If you combine digital planning and payment systems, autonomous driving and a DRT service redesign, then a radically better form of public transport starts to emerge. Without the need for a driver, fixed-route buses could be smaller but run more frequently. Combined with DRT services to cover more dispersed trips, the potentially transformative, “small vehicle-small infrastructure” vision of public transport systems comes into place.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/driverless-public-transport-will-change-our-approach-to-city-planning-and-living-35520">Driverless public transport will change our approach to city planning – and living</a>
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<p>The result could be that, rather than people needing to adjust their behaviour to the schedules and routes of a bus or metro, they can travel directly, whenever they want, on services operating 24/7 – overcoming the poor quality of infrequent evening, night and Sunday public transport services experienced today.</p>
<p>All that said, the future may still not end up quite as automated as <a href="https://blogs.worldbank.org/digital-development/automated-transport-could-propel-development-forward-can-we-turn-vision-reality">some technologists predict</a>. Driverless vehicles overseen by control centres cost an awful lot to set up and run, and this may limit the use of driverless bus and taxi systems to where use is high enough to make the sums add up – in other words, major cities. For a good while yet, public transport vehicles in most medium-sized UK towns, as well as rural areas, are likely to remain manually driven.</p>
<p>Rather than trying to jump straight to an IT-driverless ideal, a phased introduction of upgradable, adaptable system designs makes more sense. In this way, the spectre of the Brennan Monorail should remain a useful reminder that not all technological advances will change our world for the better, and there is a real danger that second-best fixes could impede potentially transformative change. This is a journey that has only just started – and it’s going to be a bumpy ride.</p>
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<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Amid bus route cuts and rail strikes, can the answer to our future public transport needs be found in the hi-tech prototypes being trialled around the UK?Stephen Potter, Professor of Transport Strategy, The Open UniversityMatthew Cook, Professor of Innovation, The Open UniversityMiguel Valdez, Lecturer in Technology and Innovation Management, The Open UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2132832023-09-21T15:54:12Z2023-09-21T15:54:12ZRupert Murdoch and the rise and fall of the press barons: how much power do newspapers still have?<p>Global media tycoon Rupert Murdoch has <a href="https://www.nytimes.com/2023/09/21/business/media/rupert-murdoch-fox-retire.html">announced his retirement</a> as chairman of Fox and News Corp, <a href="https://theconversation.com/the-sky-takeover-and-the-next-generation-of-the-murdoch-dynasty-97889">making way for his son Lachlan</a>. He has been demonised as a puppet master who would pull the strings of politicians behind the scenes, as a man with too much power. But what influence did he and his fellow media moguls really wield?</p>
<p>The day after the 1992 UK general election, Murdoch’s tabloid <a href="https://www.sciencedirect.com/science/article/abs/pii/S0049089X15001854">The Sun claimed credit</a> for the Tory victory with the notorious headline “It Was The Sun What Won it”. <a href="https://www.theguardian.com/media/2012/apr/25/rupert-murdoch-sun-wot-won-it-tasteless">Murdoch subsequently denied</a> he had such influence.</p>
<p>But in 1995, and with another general election on the horizon, Labour leader Tony Blair certainly thought it was worth courting the media mogul. Blair, along with his chief press secretary Alistair Campbell, <a href="https://www.penguin.co.uk/books/389153/diaries-volume-one-by-alastair-campbell/9780099493457">travelled to Hayman Island</a>, Australia, to address a News Corp. conference. Two years later The Sun turned its back on the Conservatives and backed New Labour, which emerged victorious from that year’s general election. </p>
<p>Commentators have argued that Murdoch’s US media empire, notably Fox News, gave Donald Trump significant public support in his quest for presidential power. Although Murdoch now seems to have gone cold on Trump, <a href="https://www.theguardian.com/books/2023/sep/19/rupert-murdoch-dominion-suit-trump-fox-michael-wolff-book">his latest biography</a> quotes the tycoon’s ex-wife Jerry Hall as telling him: “You helped make him president.”</p>
<p>More than a century ago, commentators were worrying about the power of the “press barons”. The archetype of this malign figure was Lord Northcliffe, who as <a href="https://www.gutenberg.org/ebooks/59794">Winston Churchill put it</a>, “felt himself to be possessed of formidable power” after helping to unseat a prime minister and install the next one. According to Churchill, “armed with the solemn prestige of The Times in one hand and the ubiquity of the Daily Mail in the other”, during the first world war Northcliffe “aspired to exercise a commanding influence on events”.</p>
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<img alt="" src="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
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<p>Of course, the media landscape has changed dramatically since then. Indeed, it has even been transformed in the years since The Sun’s political interventions of the 1990s. Today’s press barons have had to come to terms with a digital revolution which has uprooted the traditional business model of newspapers: readership has declined and advertising revenues have collapsed, hoovered up by tech giants such as Google and Meta. Local newspapers have borne the brunt of the financial damage caused by this and by collapsing print sales, but national newspapers have struggled too.</p>
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<img alt="Four frontpages from The Sun newspaper" src="https://images.theconversation.com/files/549421/original/file-20230920-31-4aptm3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/549421/original/file-20230920-31-4aptm3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=751&fit=crop&dpr=1 600w, https://images.theconversation.com/files/549421/original/file-20230920-31-4aptm3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=751&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/549421/original/file-20230920-31-4aptm3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=751&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/549421/original/file-20230920-31-4aptm3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=944&fit=crop&dpr=1 754w, https://images.theconversation.com/files/549421/original/file-20230920-31-4aptm3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=944&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/549421/original/file-20230920-31-4aptm3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=944&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Front pages of The Sun backing - and mocking - different political leaders.</span>
<span class="attribution"><span class="source">wikipedia</span></span>
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<p>One good example is the Telegraph Media Group: bought by the Barclay Brothers for £665m in 2004, but valued at just £200m by 2019. The group is now <a href="https://www.theneweuropean.co.uk/the-telegraph-proves-a-difficult-sale/">up for sale again</a>.</p>
<p>Meanwhile “alt truthers”, like Russell Brand, amass huge followings on social media while railing against a “media elite” that seems to include most of the traditional newspaper press. </p>
<p>As the 2024 election looms, it is timely to consider how the power and influence of newspapers – and newspaper owners – has waxed and waned, and to ask what this history might tell us about the state of the press and public life in the UK today.</p>
<h2>A ‘free press’ is born</h2>
<p>By the middle of the 19th century, the British newspaper industry was one of the most diverse and sophisticated in the world. Campaigners had, over the previous decades, successfully lobbied to see the dismantling of government restrictions and taxes on the press. Britain now had a “free press”, with no prior censorship of what could be printed and an essentially free market with little state regulation. Campaigners hoped this would usher in a period of democratic political expression in print. The free market would supposedly give everyone a voice, allowing a multiplicity of viewpoints to be published each day.</p>
<p>For a fleeting moment, this seemed to be borne out in an immediate flourishing of new titles. In the six years after the 1855 repeal of the newspaper stamp duty, <a href="https://www.routledge.com/Powers-of-the-Press-Newspapers-Power-and-the-Public-in-Nineteenth-Century/Jones/p/book/9781138276796#:%7E:text=Aled%20Jones%20addresses%20the%20problem,explores%20the%20social%20and%20intellectual">492 new newspapers were established</a>, many of them in provincial towns and cities which had never previously had their own newspapers. The reforming Manchester Liberal MP John Bright applauded the <a href="https://www.bloomsbury.com/uk/dawn-of-the-cheap-press-in-victorian-britain-9781472511546/">“great revolution of opinion on many public questions”</a> that was taking place thanks to “the freedom of the newspaper press”. </p>
<p>However, many of the new titles quickly went to the wall and during the later 19th century a very different type of newspaper industry emerged. A new generation of entrepreneurs realised that they could benefit financially from market opportunities by applying novel technologies and techniques to newspaper production and distribution. </p>
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Read more:
<a href="https://theconversation.com/the-election-wot-the-sun-and-the-rest-of-the-uk-tabloids-never-won-79208">The election wot The Sun (and the rest of the UK tabloids) never won</a>
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<p>Recently constructed national and international telegraph networks allowed them to bring in the latest news from around the country, and around the world, scooping their rivals. Steam engines could be used to power printing presses, allowing them to print vast numbers of newspapers quickly enough to sell them the same day. And steam trains provided a way to get those newspapers to readers across the country using the new rail network. Fleet Street became the centre of a truly national industry. </p>
<p><a href="https://en.wikipedia.org/wiki/Edward_Levy-Lawson,_1st_Baron_Burnham">Edward Levy</a> (later Levy-Lawson) led the way. From 1855 he owned The Daily Telegraph: the name of the paper was itself a reference to the new technologies being deployed in the newspaper industry. </p>
<figure class="align-right ">
<img alt="Full length photo of a balding man with glasses taken in the 1900s." src="https://images.theconversation.com/files/547481/original/file-20230911-28-3n6j88.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/547481/original/file-20230911-28-3n6j88.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=1132&fit=crop&dpr=1 600w, https://images.theconversation.com/files/547481/original/file-20230911-28-3n6j88.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=1132&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/547481/original/file-20230911-28-3n6j88.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=1132&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/547481/original/file-20230911-28-3n6j88.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1423&fit=crop&dpr=1 754w, https://images.theconversation.com/files/547481/original/file-20230911-28-3n6j88.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1423&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/547481/original/file-20230911-28-3n6j88.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1423&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Edward Levy Lawson 1st Baron Burnham. Image taken in the early 1900s.</span>
<span class="attribution"><a class="source" href="https://www.npg.org.uk/collections/search/use-this-image/?agreed=true&email=&form=cc&mkey=mw177321">NPG</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
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<p>Levy-Lawson’s Telegraph combined serious, up-to-date news reporting with American-style journalistic innovations, including lurid crime reporting, plenty of sports coverage and publicity stunts, such as backing H. M. Stanley’s <a href="https://www.joh.cam.ac.uk/library/library_exhibitions/schoolresources/exploration/stanley">1874 expedition across Africa on the Congo River</a>.</p>
<p>The purpose of all this was to sell more newspapers. By 1877, the Telegraph’s circulation approached 250,000 – the highest daily sales figure for any newspaper anywhere in the world. </p>
<p>Levy-Lawson saw newspapers primarily as a business, not as a route to political influence or social advancement. Although he was made Lord Burnham in 1903, the established elite looked down on his commercial origins. That snobbery was reinforced by antisemitic prejudice. The most disgusting public attacks on Levy-Lawson came from Henry Labouchere, editor of a newspaper called Truth, <a href="https://www.jstor.org/stable/20082684">who raved against the influence</a> of “Hebrew barons” on British public life.</p>
<p>Levy-Lawson established a template for a new type of press proprietor who was, first and foremost, a businessman. These entrepreneurs formed public companies to raise the vast sums of capital required to build their newspaper empires. They priced their newspapers aggressively low to attract the largest possible readership. </p>
<p>As a result, sales revenue fell well below enormous running costs. They made up the shortfall by raking in money from advertisers attracted by the large circulations and national reach of their papers. The battle was now for scale. Each press baron wanted to control the biggest possible newspaper empire.</p>
<h2>The Napoleon of Fleet Street</h2>
<p>By the late 19th century, a fortune could be made from owning newspapers. Alfred Harmsworth came from a modest background but built up a stable of publications aimed at entertaining, amusing and interesting the enormous new literate public created by Victorian universal primary education and rapid urbanisation.</p>
<p>Harmsworth used a range of eye-catching schemes to publicise his papers, including a competition that awarded the winner a pound a week for the rest of their life. By 1894, his newspapers and periodicals had a <a href="https://www.goodreads.com/book/show/1831895.The_Life_and_Death_of_the_Press_Barons">combined circulation of almost two million</a>, constituting the world’s largest publishing business.</p>
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<img alt="Sepia photo of a gentleman reading a newspaper in 1896." src="https://images.theconversation.com/files/547489/original/file-20230911-17-e89b6a.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/547489/original/file-20230911-17-e89b6a.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=445&fit=crop&dpr=1 600w, https://images.theconversation.com/files/547489/original/file-20230911-17-e89b6a.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=445&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/547489/original/file-20230911-17-e89b6a.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=445&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/547489/original/file-20230911-17-e89b6a.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=560&fit=crop&dpr=1 754w, https://images.theconversation.com/files/547489/original/file-20230911-17-e89b6a.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=560&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/547489/original/file-20230911-17-e89b6a.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=560&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Alfred Harmsworth, 1st Viscount Northcliffe in 1896, the year he launched The Daily Mail.</span>
<span class="attribution"><a class="source" href="https://www.npg.org.uk/collections/search/portrait/mw111194/Alfred-Harmsworth-1st-Viscount-Northcliffe?">NPG</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
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<p>In 1896 Harmsworth launched the Daily Mail, a daily paper selling for a halfpenny. It targeted an aspirational lower-middle-class national readership, made up of women as well as men – an attractive demographic for advertisers. The paper was to contain everything that could be expected from a “serious” daily, presented in a respectable-looking package, but with more life, human interest and entertainment.</p>
<p>Content was condensed into short articles, presented in a punchy, accessible style, aimed at the new breed of office workers and commuters. Harmsworth’s brother Harold (later Lord Rothermere) ran the commercial side of the business on efficient, industrial lines.</p>
<p>In 1905, Harmsworth was made Lord Northcliffe. He chose this title in part because it allowed him, half-jokingly, to initial his correspondence “N”, in the style of Napoleon. He became infamous for his dictatorial, erratic, pedantic, obsessive and abusive management style. He would sometimes appoint two people to the same post and make them compete with one another to keep their job. Employees faced lavish rewards, alternating with frequent threats of dismissal. Fleet Street journalists <a href="https://archive.org/details/greatoutsidersno0000tayl_a3p6">warned prospective job applicants</a> that Northcliffe would “suck out your brains, then sack you”.</p>
<p>Northcliffe cultivated informers in the Daily Mail office to tell him what was going on behind the scenes and to monitor private telephone conversations. He liked his staff to be his “creatures”. A later <a href="https://books.google.co.uk/books/about/Dangerous_Estate.html?id=P_Y2AAAAIAAJ&redir_esc=y">newspaper editor thought</a> that there was “something more than a little nauseating about his relations with many of his chief associates; one wonders how they could stomach the humiliations he imposed and retain their self-respect.” </p>
<p>The political elite, and many journalists, <a href="https://archive.org/details/greatoutsidersno0000tayl_a3p6">looked down on Northcliffe</a> and his popular papers. Lord Salisbury famously dismissed the Mail as being produced “by officeboys for officeboys”. Northcliffe’s former employee, E.T. Raymond, thought that the press baron had “an uncanny way of arriving at the results of thought without thought itself”. Another contemporary described Northcliffe as “brainless, formless, familiar and impudent”. </p>
<p>Northcliffe’s purchase of The Times in 1908 marked an attempt to expand his political influence, but some contemporaries still doubted whether he was very important. <a href="https://www.google.co.uk/books/edition/Journals_and_Letters_of_Reginald_Viscoun/dmRZngEACAAJ?hl=en">Lord Esher remarked</a> that “he evidently loves power, but his education is defective, and he has no idea to what uses power can be put”. Many of Northcliffe’s press crusades seemed harmlessly apolitical, such as his campaigns to promote the consumption of wholemeal bread or to grow better sweet-peas.</p>
<p>However, others worried about the consequences of allowing a small number of very rich men, running enormous corporate conglomerates, to dominate the British newspaper industry. The writer and journalist <a href="https://books.google.co.uk/books/about/The_Influence_of_the_Press.html?id=mG9AAAAAIAAJ&redir_esc=y">R. A. Scott-James</a> lamented in 1913 that “privilege” now dominated public debate, and that the press had become “a vehicle for false notions and antisocial ideas”. </p>
<p>The writer Norman Angell (a former Northcliffe employee who subsequently became a Nobel-prize-winning peace activist) similarly argued that the “modern industrialised Press” had become the most powerful instrument for the “capture of the mind by our industrial aristocracy”. Newspapers, <a href="https://books.google.co.uk/books/about/The_Press_and_the_Organisation_of_Societ.html?id=fjJAAAAAYAAJ&redir_esc=y">Angell claimed</a>, now worked to “exploit human weaknesses” for the purpose of profit, corrupting public debate. </p>
<h2>Press, politics and the first world war</h2>
<p>Concern about the power of press barons grew exponentially during WWI. From 1914, Northcliffe used his newspapers <a href="https://www.dailymail.co.uk/news/article-11063463/Daily-Mail-founder-Alfred-Harmsworths-blistering-denunciation-Lord-Kitchener.html">constantly to critique</a> the Liberal government’s coordination of the war effort. His main targets were Prime Minister Herbert Asquith and the secretary of state for war, Lord Kitchener. In 1915, Northcliffe accused Kitchener, in print, of failing to supply the army with enough high explosive artillery shells. Initially, this made the Mail unpopular. Circulation dropped dramatically and the paper was ceremonially burned on the floor of the London Stock Exchange.</p>
<p>However, as its claims about government mismanagement began to seem justified, the Mail’s popularity recovered. The “shell scandal” contributed to the fall of the Liberal government and the establishment of a reconstituted coalition under Asquith’s leadership.</p>
<p>The ambitious Liberal politician David Lloyd George worked closely with Northcliffe in order to further his own career and Lloyd George was rewarded when he was made Minister of Munitions in the wake of the shell scandal.</p>
<p>But Northcliffe’s criticism of the government continued and Cabinet members worried that German propagandists were exploiting his public attacks on the British war efforts to undermine morale. Northcliffe’s campaigning finally helped precipitate the resignation of Asquith in December 1916. The Daily News (a national newspaper founded in 1846 by none other than Charles Dickens) branded Northcliffe a <a href="https://www.goodreads.com/book/show/6711394-northcliffe">“press dictator”</a> for his role in the prime minister’s downfall. </p>
<p>Northcliffe’s ally Lloyd George took Asquith’s place as prime minister. However, Lloyd George now cannily kept the press baron at arm’s length, giving him relatively minor official jobs that came with little power while making it difficult for him to attack a government with which he was now identified. At the end of the war, <a href="https://archive.org/details/greatoutsidersno0000tayl_a3p6">Lloyd George finally broke openly with Northcliffe</a>, attacking the press baron in a vitriolic speech delivered in the House of Commons. Northcliffe was deluded, Lloyd George suggested, in thinking that as part of his “great task of saving the world” he had the right to dictate the terms of the <a href="https://en.chateauversailles.fr/discover/history/key-dates/treaty-versailles-1919#:%7E:text=After%20four%20years%20of%20devastating,break%20out%20twenty%20years%20later.">1919 peace settlement</a> with Germany. Lloyd George spoke of Northcliffe’s “diseased vanity” and tapped his own forehead meaningfully as he delivered the speech to the assembled MPs.</p>
<p>By this point Northcliffe had become a serious liability to Lloyd George, and was indeed ill, both physically and mentally. His behaviour had become more erratic and aggressive than ever, and his language increasingly foul and paranoid. At one point he was reported to have brandished a revolver at his doctor. </p>
<p>Northcliffe died in 1922 leaving no legitimate heirs, although he had had several mistresses and two secret families. Management of his media empire passed to his brother, Lord Rothermere, who sold The Times and went on to expand in more profitable directions, conducting vicious commercial warfare against his rivals. Rothermere later became a prominent public supporter of Oswald Mosley’s British Union of Fascists and an admirer and personal acquaintance of Hitler.</p>
<h2>The rise of Beaverbrook</h2>
<p>The first world war also saw the rise to prominence of another archetypal press baron, <a href="https://www.britannica.com/biography/Maxwell-Aitken-Beaverbrook">Max Aitken</a>. Like Northcliffe, Aitken came from a humble background. He was born in Ontario, raised in New Brunswick, and made his fortune through somewhat dubious Canadian business dealings. He came to England in 1910, forged new political connections and was elected as a Conservative MP.</p>
<p>By the end of 1916 Aitken had purchased a controlling interest in the Daily Express, the main rival to the Daily Mail. He was involved in the behind-the-scenes political intrigue that toppled Asquith as prime minister and brought Lloyd George to power that year, though his exact role was never made clear. Lloyd George treated Aitken more generously than he had Northcliffe: Aitken was made Lord Beaverbrook and in 1918 was appointed minister of information, taking charge of British wartime propaganda and entering the cabinet.</p>
<p>During the 1920s and 1930s, Beaverbrook turned the Daily Express into the biggest-selling newspaper in the UK. The paper adopted an aspirational, aggressive, populist tone to appeal to a broad audience and maximise advertising revenue. Beaverbrook used the Express to support his political allies, and to attack enemies like the Conservative leader, Stanley Baldwin. </p>
<p>Following the Wall Street Crash, Beaverbrook launched his “Empire Crusade” in the Express, seeking to turn the British empire into a tariff-protected economic union (a little like an English-speaking version of the later European Union). This campaign, also supported by Lord Rothermere of the Daily Mail, constituted a further direct threat to the leadership of Baldwin, now prime minister. </p>
<p>In a speech in parliament, Baldwin famously <a href="https://www.kiplingsociety.co.uk/quotation/quotes_harlot.htm">used words provided by his cousin Rudyard Kipling</a> to castigate Rothermere and Beaverbrook. He argued that by weaponising “direct falsehoods, misrepresentation, half-truths” the press barons aimed at “power without responsibility – the prerogative of the harlot throughout the ages”. </p>
<p>Baldwin eventually defeated Beaverbrook’s crusade, but the press baron continued to prosecute his personal vendetta. In supporting the embattled Edward VIII during the abdication crisis of 1936, Beaverbrook admitted in private that his main aim was to <a href="https://books.google.co.uk/books/about/Walter_Monckton_The_Life_of_Viscount_Mon.html?id=0ssYxgEACAAJ&redir_esc=y">“bugger Baldwin”</a>. </p>
<h2>Conrad Black - the ‘moneylogue’</h2>
<p>Half a century later another wealthy Canadian, Conrad Black, used his fortune to build his own press empire. Black inherited substantial Canadian business holdings from his father, which he refocused on newspaper ownership. During the 1980s and 1990s he built up a vast portfolio of media investments in north America, the UK, Israel and Australia. In Britain, his key possession was the Telegraph Group.</p>
<p>Unlike some other notable press barons, Black revelled in the glamorous lifestyle that his wealth brought him. Newspapers were, for him, partly a status symbol. “The deferences (sic) and preferments” that the UK’s political culture “bestows upon the owners of great newspapers are satisfying,” <a href="https://www.panmacmillan.com/authors/max-hastings/editor/9781447269809#:%7E:text=Editor%3A%20A%20Memoir%20is%20above,Hastings%20is%20a%20brilliant%20reporter.">as he once put it</a>. But his press investments also helped fund his lavish spending. By the early 1990s, The Daily Telegraph was generating substantial profits and supporting Black’s other businesses interests. </p>
<p>Max Hastings, editor of The Daily Telegraph <a href="https://www.panmacmillan.com/authors/max-hastings/editor/9781447269809#:%7E:text=Editor%3A%20A%20Memoir%20is%20above,Hastings%20is%20a%20brilliant%20reporter.">between 1986 and 1995</a>, concluded from his time working for Black that it was, at root, all about the money.</p>
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<p>Whatever the professed convictions of proprietors, most are moneylogues rather than ideologues. Their decisions are driven by commercial imperatives. Stripped of their own rhetoric, the political convictions of most British proprietors throughout history add up to an uncomplicated desire to make the world a safe place for rich men to live in.</p>
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<p>True to form, Black anticipated the coming slump in the newspaper industry and sold off many of his press interests while their value was still high, including the Telegraph Group in 2004. </p>
<p>In 2007, Black was sentenced for fraud in the US and served 37 months in prison. In 2019, US President Donald Trump granted him a <a href="https://www.cbc.ca/news/world/conrad-black-pardon-trump-1.5137985">full pardon</a>. The previous year Black had published a flattering biography: <a href="https://www.nationalreview.com/2018/05/book-excerpt-donald-trump-a-president-like-no-other-conrad-black/">Donald J. Trump: a President Like No Other</a>. Commentators were left to draw their own conclusions.</p>
<h2>Enter the ‘Dirty Digger’</h2>
<p>The preeminent press baron of our time has, of course, been <a href="https://theconversation.com/rupert-murdoch-how-a-22-year-old-zealous-laborite-turned-into-a-tabloid-tsar-204914">Rupert Murdoch</a>, who from the 1960s extended his Australian newspaper empire to the UK (buying The Sun and The News of the World in 1968 and The Times in 1981). From the 1970s he also made inroads into the US newspaper industry.</p>
<p>Murdoch established a reputation for selling newspapers using previously unacceptable levels of sensationalism and sex (Private Eye magazine labelled him the “Dirty Digger”). He later bought into the global film and television industry, building a US$17bn (about £14bn) fortune and establishing a reputation <a href="https://www.vanityfair.com/news/2023/04/rupert-murdoch-cover-story">for meddling in politics</a> around the world.</p>
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Read more:
<a href="https://theconversation.com/rupert-murdoch-how-a-22-year-old-zealous-laborite-turned-into-a-tabloid-tsar-204914">Rupert Murdoch: how a 22-year-old 'zealous Laborite' turned into a tabloid tsar</a>
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<p><a href="https://www.nytimes.com/2008/12/28/books/review/Carr-t.html">Biographer Michael Wolff</a> has suggested that Murdoch does <a href="https://www.penguinrandomhouse.com/books/193219/the-man-who-owns-the-news-by-michael-wolff/">not greatly value</a> his personal wealth or relationships, writing: “Working isn’t the means to an end; it’s the end. It’s one man’s war – a relentless, nasty, inch-by-inch campaign.”</p>
<p>According to Wolff, what Murdoch loves is playing the game of high-stakes business, being in the room where it happens, doing the deal, owning more newspapers, and destroying his rivals. He enjoys gossip and gathering information about those with political power, using it to protect his commercial interests and to support the political agendas of those he favours. Beneficiaries have included Margaret Thatcher, Blair and Trump. </p>
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<p>In running his media concerns, like Northcliffe and Beaverbrook before him, Murdoch is aggressive, interventionist and hands-on. Wolff claims that Murdoch did not want his employees to be partners but would rather they serve him as subordinates, and so surrounds himself with sycophants. He is seemingly willing to accept short-term financial losses to secure long-term market dominance. This approach is rooted in the golden age of the press barons, when the dominant business strategy was to take over or shut down the competition, allowing the victor to rake in windfall profits unopposed.</p>
<p>Perhaps this strategy still makes sense: as the profits made by traditional newspapers dwindle, the remaining rewards might go to the last man standing.</p>
<p>Murdoch’s media empire has endured its periods of commercial crisis. The disastrous failures of journalistic ethics at the News of the World embroiled the newspaper in the phone hacking scandal and the paper was closed down by Murdoch in 2011. In the US in 2023, Fox News settled a lawsuit over on-air accusations concerning the role of voting machines during the US elections of 2020, <a href="https://apnews.com/article/fox-news-dominion-lawsuit-trial-trump-2020-0ac71f75acfacc52ea80b3e747fb0afe">costing the network</a> almost US$800m (£650m). </p>
<p>However, other elements in Murdoch’s empire continue to produce a profit. After an initial near-disaster, Murdoch’s takeover of The Wall Street Journal has proved a financial success. He paid US$5.6bn (about £4.4bn) for it in 2007. Now thanks to a stunningly successful drive for subscribers (3.78m of them, 84% digital-only) the paper is worth around US$10bn (£8bn). In the UK, successful management of the digital transformation has similarly meant that The Times and The Sunday Times have gone from a £70m annual loss in 2009 to a <a href="https://www.theguardian.com/media/2023/apr/28/murdoch-empire-succession-fox-news-settlement">£73m profit in 2022</a>.</p>
<h2>Press barons of the future</h2>
<p>The figure of the press baron has recently found a new fictional archetype in <a href="https://theconversation.com/uk/topics/logan-roy-111726">Logan Roy</a>, the dark heart of HBO’s series Succession. Roy has a number of reasons for wanting to own newspapers and other media outlets. Primarily, he simply needs to acquire more stuff, compulsively buying new titles to build an empire capable of eradicating all challengers. </p>
<p>Like Murdoch, expansion – doing the deal – is for Roy a reward in and of itself. He also loves the influence his media interests bring and wants to dominate those with political power, partly to protect his business, but largely because he craves control. The wealth and the lifestyle that accompany his media empire, in contrast, seem to give him little pleasure. </p>
<p>Succession reflects continuing concerns about who owns the media, how they make their money, and what they want to get out of their media outlets. As the show’s British writer, <a href="https://www.theguardian.com/tv-and-radio/2023/may/27/jesse-armstrong-on-the-roots-of-succession-bum-rush-trump-presidency">Jesse Armstrong</a>, reflected:</p>
<blockquote>
<p>The Sun doesn’t run the UK, nor does Fox entirely set the media agenda in the US, but it was hard not to feel, at the time the show was coming together, the particular impact of one man, of one family, on the lives of so many. </p>
</blockquote>
<p>But does the press still have such influence over politics and public life? The many challenges facing traditional newspapers do seem to threaten their historical role. The UK’s newspaper industry has been <a href="https://www.gov.uk/government/publications/leveson-inquiry-report-into-the-culture-practices-and-ethics-of-the-press">rocked by scandals</a> about phone hacking, professional ethics and behind-the-scenes links between journalists, politicians and the police. </p>
<p>And then there is the declining readership and advertising revenue. In 2019, <a href="https://www.gov.uk/government/publications/the-cairncross-review-a-sustainable-future-for-journalism">a somewhat uninspired official report</a> on the future of British journalism summarised some of the challenges, but offered few meaningful solutions. That was the same year the Telegraph Media Group was valued at just £200m.</p>
<p>London’s Evening Standard is meanwhile facing <a href="https://www.theguardian.com/media/2023/aug/11/evening-standard-reliant-owner-evgeny-lebedev-funding-losses-widen-newspaper">an annual loss of £16m</a>, and relies on loans from its Russian-British proprietor, Evgeny Lebedev, to stay afloat. The same Lebedev who was <a href="https://www.bbc.co.uk/news/uk-politics-61163446">controversially given a peerage</a> in 2020 by then prime minister, Boris Johnson. </p>
<p>Newspapers are also in danger of being dismissed as “mainstream” or “legacy” media: old-fashioned, obsolete and unable to counter the mendacities and conspiracy theories of online “alt truthers”. Recently, following allegations presented in newspapers and on television, the <a href="https://theconversation.com/russell-brand-investigation-what-good-journalists-should-have-to-go-through-to-report-sexual-assault-allegations-213815">comedian Russell Brand</a> immediately sought to discredit “coordinated media attacks” which he claimed served some shadowy hidden agenda.</p>
<p>Meanwhile, as their own profits dwindle and they <a href="https://pressgazette.co.uk/media_business/2023-journalism-news-job-cuts-redundancies/">lay off more journalists</a>, the capacity of newspapers to investigate public lies and misdeeds is drastically reduced. Some worry that the newspapers themselves are having a damaging effect on public debate – apparent, for example, in the polarising and sometimes <a href="https://www.theguardian.com/media/2016/jun/24/mail-sun-uk-brexit-newspapers">inaccurate press coverage</a> and comment that accompanied the Brexit referendum and its aftermath. Fuelling culture wars, rather than mounting an informed defence against them, seems to be a key tactic in staying afloat for some titles.</p>
<p>Yet the reasons why press barons want to own newspapers remain much the same today as they did for Northcliffe, Beaverbrook, and Black: making money, securing a place in the national (or global) economic and social elite, generating political influence, and delivering the thrill of the great corporate deal.</p>
<p>And the old media dynasties endure: in 2022 the 4th Lord Rothermere, great-grandson of the Daily Mail’s co-founder, took the Daily Mail & General Trust group out of public ownership, and <a href="https://www.theguardian.com/business/2022/sep/22/lord-rothermere-take-over-daily-mail-chairman">became its chief executive</a>. </p>
<p>Above all else, traditional newspaper titles retain their appeal to potential owners because, in a crowded marketplace for online news, they can represent a trusted and prestigious brand. The <a href="https://nymag.com/intelligencer/2023/04/how-buzzfeed-news-went-bust.html">fate of Buzzfeed</a> has demonstrated <a href="https://www.theguardian.com/commentisfree/2023/may/16/vice-bankruptcy-buzzfeed-news-dead-digital-age-revenue">the difficulties</a> of creating a viable online presence without such an established base. </p>
<p>Traditional newspapers will continue to scale back print runs over the coming years. Probably, at some point, they will just stop printing newspapers. But some of these companies will live on as profitable online brands. </p>
<p>In a post-Murdoch age, future press barons – digital media emperors – will want to invest in these brands because they offer recognition and respectability, following the early example set by Amazon founder Jeff Bezos, who <a href="https://www.theguardian.com/media/2013/aug/05/washington-post-sold-jeff-bezos-amazon">purchased The Washington Post</a> in 2013. </p>
<p>Potential buyers for the Telegraph Media Group take in <a href="https://www.theguardian.com/media/2023/jun/07/daily-telegraph-and-sunday-telegraph-newspapers-to-be-put-up-for-sale">UK businesses</a>, including <a href="https://news.sky.com/story/daily-mail-proprietor-rothermere-in-talks-with-investors-over-telegraph-bid-12938653">the Mail’s Rothermere</a> and the owner of the <a href="https://news.sky.com/story/hedge-fund-tycoon-marshall-hires-bankers-to-plot-daily-telegraph-raid-12959685">rightwing GB News</a>. But there is also interest from <a href="https://www.telegraph.co.uk/business/2023/07/17/mike-mctighe-appointed-telegraph-chairman-sale-lloyds/">Europe and the US</a>, as well as the <a href="https://news.sky.com/story/yorkshire-post-owner-signals-interest-in-buying-daily-telegraph-12937353">Gulf states</a>. Surprisingly, perhaps, the Barclay family has itself assembled a portfolio of potential Middle Eastern finance to try to buy the business back from Lloyds. </p>
<p>Some of these international players may see the Telegraph Group as offering a respectable voice in the British media landscape and a route to political and popular influence, something that only a traditional newspaper business can provide. And they are no doubt interested in the brand’s asset of <a href="https://www.theguardian.com/media/2023/jul/25/telegraph-media-group-paying-subscribers-chelsea-magazine-company">nearly one million subscribers</a>, many of them digital – data being the be all and end all in today’s market. </p>
<p>Whichever way that sale goes, we are still a long way from the dream of a democratic utopia promoted by 19th-century campaigners for press freedom. They believed that the free market would liberate the press and, by doing so, liberate us all. Sadly, it seems like Logan Roy was closer to the truth when he said to his wannabe successors: “Money wins. Here’s to us.”</p>
<hr>
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<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em>For you: more from our <a href="https://theconversation.com/uk/topics/insights-series-71218?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insights series</a>:</em></p>
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<li><p><em><a href="https://theconversation.com/my-home-city-was-destroyed-by-war-but-i-will-not-lose-hope-how-modern-warfare-turns-neighbourhoods-into-battlefields-211627">‘My home city was destroyed by war but I will not lose hope’ – how modern warfare turns neighbourhoods into battlefields</a></em></p></li>
<li><p><em><a href="https://theconversation.com/beatrix-potters-famous-tales-are-rooted-in-stories-told-by-enslaved-africans-but-she-was-very-quiet-about-their-origins-202274">Beatrix Potter’s famous tales are rooted in stories told by enslaved Africans – but she was very quiet about their origins
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<p class="fine-print"><em><span>Simon Potter does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Newspaper owners used to wield huge political influence – but as Rupert Murdoch steps down for his son Lachlan can the same be said of today’s?Simon Potter, Professor of Modern History, University of BristolLicensed as Creative Commons – attribution, no derivatives.