“Mental Health Is Political,” a guest essay by Professor Danielle Carr in the New York Times (9.20.2022), asks “What if the cure for our current mental health crisis is not more mental health care?” She argues that what has been called an “’epidemic’ of mental illness” medicalizes what is primarily a social and political problem – that is it makes it a medical problem to be dealt with through treatment rather than a larger social problem to be addressed through changes in social policy and resource allocation.
“Pointing out the medicalization of social and political problems does not mean denying that such problems produce real biological conditions; it means asking serious questions about what is causing those conditions.” The vitally important social determinants of health framework tells us “that effective long-term solutions for many medicalized problems require nonmedical – this is to say, political – means.”
“And here is the core of the problem: Medicalizing mental health doesn’t work very well if your goal is to address the underlying cause of population-level increases in mental and emotional distress. It does, however, work really well if you’re trying to come up with a solution that everybody in power can agree on, so that the people in power can show they’re doing something about the problem.”
Many psychiatric symptoms are caused by chronic stress. “There is increasingly strong evidence for the idea that chronic elevation of stress hormones has downstream effects on the neural architecture of the brain’s cognitive and emotional circuits.” Increased stress in a population helps to explain the mental health crisis.
To address that crisis thus means changing the social conditions that cause widespread stress in a population. “Solving the mental health crisis, then, will require fighting for people to have secure access to infrastructure that buffers them from chronic stress: housing, food security, education, child care, job security, [living wages], the right to organize for more humane workplaces and substantive action on the imminent climate apocalypse.”
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