Let’s break down the World Health Organization’s definition of mental health. Mental health is defined as “a state of well-being in which an individual is aware of his own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his community.”
A few questions about this claim:
“Abilities:” The abilities to do what?
Normal stress of life: In what economic, political and socio-cultural setting is the normality of “life” measured?
Work productively: Who and what does individual productivity serve? Since when does welfare depend on productivity?
The answers to all the questions seem to coalesce into the narrative that in today’s society, productivity determines well-being. Capabilities to produce in a capitalist economy are somehow codified as determinants of well-being and happiness.
Political scientists have a term called “biopolitics” that accurately explains our current relationship with mental health. Popularized by Michel Foucault, biopolitics refers to the form of government that regulates the population by exercising political power over all processes of human life, such as birth, death, disease, and health, in order to achieve effective economic control.
This form of economic and political governance creates a ridiculous cycle in the way we approach mental health. First, mental health is forced into an arranged marriage with economic productivity. Then systemic “-isms,” be they racism, sexism, or discrimination based on sexual orientation, help certain groups while preventing others from reaching a “comfortable” level of wealth. Chronic stress and anxiety build up as people face the burden of doing more for less within institutional inequalities. Mental conditions prevail. Identity-based disparities in mental health outcomes also occur. Now we say, “you have a disease and without treatment you cannot return to your maximum level of productivity.”
Biopolitics has wrapped its invisible hands around the throat of our mental health.
The don’t-produce-therefore-not-good mentality wasn’t built into the American psyche overnight by a single institution or authority. Consciously or unconsciously, overtly or covertly, all institutions under biopolitical governance are involved in the regulation of mental health. Mental health is defined in a way that can serve maximum economic efficiency. Politics and public policies categorize populations in ways that allow certain groups to receive more resources and institutional advantages than others and ultimately create systemic disparities in mental health outcomes. Medicine treats mental health in a way that perpetuates the pathologizing needed to oil the machinery of the pharmaceutical industry.
I would like to reiterate that examining mental health through the lens of biopolitics does not mean invalidating medical science or denying the value of understanding the biological mechanisms of mental states, but rather expanding the discourse through which we understand, discuss and consider mental health. Physiological symptoms undoubtedly require evidence-based treatment, but effective mental health care cannot stop at addressing individual symptoms without adequately confronting the social ecosystem that projects our mental health. We need a sincere recognition of the economic and political reality in which we live that governs our functions and well-being.
What if we reframed mental health not as a dysfunction of the mind, but as the symptoms experienced by the mind in response to the dysfunction of society?
This shift in rhetoric requires all aspects of policy and management to take responsibility for managing population mental health. Mental health policies must go beyond mental illness medicine itself and include political action on poverty, housing, access to health care, education, and other aspects of resource redistribution to challenge the structural isms that shape mental health. of the population.
Thus, addressing the causal mechanisms of population mental health becomes an inevitably complex and interdisciplinary endeavor.
Artists and musicians, you have the power to help people communicate their lived experiences of mental health and mental illness through your creations;
Historians, philosophers, sociologists, anthropologists, your wisdom about the multifaceted nature of human experience is invaluable for challenging the understanding of life and health.
As political agents, you take responsibility for creating policies that deconstruct the boundaries of race, gender, ethnicity, sexual orientation, and ability in people’s access to resources.
Practitioners and researchers, you have the power to push the boundaries of our holistic understanding of mental health through interdisciplinary innovation and collaboration;
Developers of media and technology, your decision about whether the information and technology you create serves to drive profits at the expense of population health and justice carries enormous weight.
Finally, to every person reading this, even though it may not always be worth it as a simple matter, we have a responsibility to pursue our own happiness and well-being. We are in an uphill battle to demand structural justice on all fronts of mental health care, so in the meantime, please be kind to yourself, be kind to yourself, be kind to your body.
Mary Lihong Peng is a second-year Master of Public Health candidate and Horstman Scholar at Yale University.