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Inequality and Mental Health
A recent international report in The Guardian noted that mental health problems are far worse in rich nations that are socially unequal and that individual treatment is not the solution. Although poverty can be a trigger for poor mental health, it is inequality that has the most profound and far-reaching effect on individuals and the wider society.
The report, carried out by WHO, argues that radical and broad policy changes are needed to directly counter growing inequality. It goes so far to say that the social and economic prosperity of Europe will depend upon improving mental health and well-being.
“The adverse impact of stress is greater in societies where greater inequality exists and where some people feel worse off than others. We will have to face up to the fact that individual and collective mental health and wellbeing will depend on reducing the gap between rich and poor.”
Although physical health outcomes point to a positive impact on mortality rates as nations become richer, the opposite seem to be true of mental health, where the level of mental distress among communities “needs to be understood less in terms of individual pathology and more a response to inequalities involving relative deprivation across society”.
The report’s author, Lynne Friedli, contends that, to date, there has been an “undue focus on individual solutions” to mental health issues like depression, when what is called for is a social solution. She points to cognitive behavior therapy (CBT) as being the therapy that works for many individuals, that no amount of CBT can address society as a whole, where huge inequalities reflect the kind of society we live in.
I would even go farther than pointing to CBT and by extension all the so-called “evidence-based” individual therapies. I would hold accountable the much proclaimed Diagnostic Statistical Manual and the WHO counterpart, The ICD Classification of Mental and Behavioral Disorders, which focus upon classifying individual symptoms of mental illness. Rather than focus on a credible etiology of mental illnesses, we have seen the institutionalization of these evidence-based protocols, whereby insurance carriers, colleges, and government research centers are all on the same page.
Rather than focusing only upon the individual’s mental diagnosis, the pandemic has revealed the family and community that the individual resides in are also a cause of mental disorders. We will want to enlist sociologists, social anthropologists, political scientists, and economists to help diagnose and prescribe meaningful strategies to further explain these causes and recommend solutions.
But the core issue remains, that we are currently stuck with an antiquated, ineffective, and inflexible therapeutic milieu that serves the mental health industry at the expense of practitioners and the public. The rich will get richer and the inequalities will become greater without major policy changes that include social, cultural, and economic conditions that support family life.
We need to target child poverty and address workplace conditions that have sparked Covid-19 outbreaks, causing the infection to spread throughout one’s family. Rather than stigmatizing and blaming people living in poverty, particularly those displaying mental issues, Friedli thinks we need a “radical rethink” about the kind of society we wish to live in.
What do you think?
This blog is being co-published with PsychResilence.com