Politicians want to improve our worsening mental health with big psychiatric initiatives. The problem with this model, says historian of neuroscience Danielle Carr, is that it ignores the social and structural forces causing widespread mental suffering.
Fun fact: mental health issues are less prevalent when you're able to afford a healthy diet, roof over your head, occasional social activities, and aren't constantly stressed about all the bills you have to pay.
Here's my solution:
Currently the US spends roughly $11,912 per capita on healthcare. New Zealand, a comparably developed country, spends $4,393 per capita but their system apparently provides better care.
the US follows New Zealand's example and properly regulates the pharma, insurance and healthcare system, bringing down costs by $7519.
the US now has better (mental-)healthcare
Everyone gets a Universal Basic Income of $626.58(=$7519/12) per month to help pay the most important bills or help pay the rent
First, I'm incredibly fortunate to have a high paying job. Second, that high paying job lets me get good healthcare and quality living standards. Third, my job also pays for my psychologist! So I'm kinda in this extremely fortunate circumstance where I get so much support.
Versus my family. No one in my family makes above 40k. None of them has the perks I have. They all go through some struggles. And no amount of therapy will help them when really, the issue always leads back to finances.
While money doesn't but happiness the absence of money surely makes happiness almost impossible with how much you always have to worry about different stuff...
I'm very thankful to be in a position where I don't have to worry about which supermarket has the cheapest groceries as I know I can afford it if it's 10% more expensive than it needs to be - seeing my mom spending hours going through ad-magazines to figure out where to buy what only to save a handful of euros is something I'm very glad I don't have to do
Affordable healthcare specifically including mental health treatment. Unfortunately, in many countries it's not included under universal healthcare AND it's fully taxed.
mental health issues are less prevalent when you're able to afford a healthy diet, roof over your head, occasional social activities, and aren't constantly stressed about all the bills you have to pay.
Biologist here. You are absolutely correct.
The “mental health” we talk about is 100% the functioning of your physical brain. Your physical brain is partly a function of your genes, inherited from your parents and grandparents stretching back to before the first two cells decided to cooperate. It’s partly epigenetics - if your mother was malnourished or stressed that will carry over onto you and can last until your kids’ generation. It’s partly the embryonic environment - nutrition, drug and alcohol use, physical and emotional stresses of the mother, overall medical health. It’s partly how you were raised - physical and emotional abuse, education opportunities, supportive environment, racism, violence, poverty, acceptance. It is constantly being tuned - if you’re in an honor culture in which physical defense of personal honor is mandatory, you’ll have received rewards for doing so. Those help pre-condition the brain to do that kind of thing again, more easily next time. PTSD, whether you’re a marine from Iraq or a kid from Gaza, will change your brain.
Mental health care including medication and therapy can help these problems, but systemic problems need to be addressed systemically, and we’d be better off if we were able to start to alleviate these issues at their causal level.
Politically controversial though, so good luck getting politicians to tackle some of the root causes, even if it would likely end up saving money and increase productivity.
Minor quibble: that’s money spent by the government and private citizens for healthcare. Anything of that $7.5k that didn’t come from government spending can still be reallocated from our military budget though
Ending the drug war would help psychiatrisy move forward with some excellent meds (psilocybin, MDMA). It would also let a lot of innocent people avoid the six year prison stint I did for growing my own medication.
So, I don't see it as not political. But I also don't see it as not psychiatric.
Have a friend administering psilocin/4-HO-DMT to patients for one of those psychedelic startups in Canada. Thought it was cool because the first serious psychedelic research also began in Canada in the late 40s-50s, Humphrey Osmond even coined the term "psychedelic" while experimenting with them at a mental hospital in Weyburn, Saskatchewan, in a letter addressed to Huxley. They first used them as "psychomemetics" with the understanding they mimicked the symptoms of schizophrenia, to better sympathize with the patients (this was in the days of mental institutions.) They used it for alcoholism as well apparently, Osmond said it would reveal to them how their behavior was affecting other people etc.
Although we desperately need better medications (that are affordable), this covers treatment. What's being pointed out here is that we're not addressing the causes. Legalization certainly helps with one cause, but there's clearly way more contributing to the rise in mental illness which is largely being ignored.
I agree with what you're saying and probably mostly agree with the article.
But the headline pitched it as an either/or thing (not psychiatry but politics!). My comment was meant to highlight the impact politics has had, and continues to have, on psychiatrists being able to use medicines that Western science has been well aware of the potential for in the treatment of mental illness for 50+ years.
There's similarities in regards to body autonomy and Dr/patient autonomy with abortion access and psychiatric medicine that many people are ignorant too because of oppressive policies on the part of the Nixon administration that continue to be the status quo.
Public policy changes to address systemic causes of mental illness are absolutely needed. But pitching it in this sort of binary as the headline does misses the mark imo.
Psychiatrists are the ones doing a lot of the research.
I get your point but I find the research still important for harm reduction even if I don't think these medicines should only be available with a prescription.
In war zones rates of depression and anxiety drop down to statistically zero.
There's no time for ennui, to much shit is going on that you can admit you have no control over and every decision you make could potentially mean life and death for anyone around you.
People find their purpose. It's just that it's usually "survive", and might develop into "revenge".
The movies for which Guy Ritchie remains best known, Lock, Stock, and Two Smoking Barrels and Snatch, both have this bit in which all the chickens to whom he's spent the past hour patiently getting us acquainted all come home to roost at the same time in the same place, and it's marvelous and hilarious.
This reads like the first two (officially released) Fantastic 4 movies. Oh my god! Those heros saved us! That's fine, Susan, but they only had to save you because they caused the bridge to collapse in the first place! Quit praising people for picking up the milk bottle they knocked over, they didn't even clean up the mess!
Politicians want to improve our worsening mental health with big psychiatric initiatives. The problem with this model, says historian of neuroscience Danielle Carr, is that it ignores the social and structural forces causing widespread mental suffering.
I actually think this is true for everybody diagnosed with a "mental illness". Society wants to push you to a psychiatrist as an easy fix. But in reality, there are social and emotional pressures that have caused the patient to become distressed. It could be bullying, or financial worries, or the loss of a relative, or other big worries. Psychiatry invents "diagnoses" so that the true social and environmental pressures get swept under the rug. Because they don't care about you, they just believe that you might turn dangerous (even if you have no history of doing anything wrong), so they'll drug you to reduce what they think is a risk.
Edit: Thinking about it more, maybe we should get rid of the biopsychosocial model that doctors love to talk about. Just have a psychosocial model instead (getting rid of the bio bit, where they drug the patient). Because nearly all of the time, they never prove any biological fault with the patient's brain. And yet they're still happy to drug the patient.