Observing population mental health, I detect a concerning social drift whose negative impact not only affects individuals but also the provision of mental health services. Despite advancements in available therapies and treatments, it is disconcerting to note the emergence or intensification of the following phenomena, which I will detail below:
Inverse care law
This is a phenomenon that affects mental health services (both public and private) and involves the fact that those individuals most affected by more severe disorders receive less attention. This is due to a high demand for care from individuals with complaints that don’t even constitute a disorder or those with milder disorders.
Pathologization of normal human life
Normal situations of psychological and physiological distress are treated as disorders. Moreover, there is evidence that psychiatry and psychology do not contribute to the resolution of the majority of these situations.
New diagnoses
The creation and immediate acceptance of new diagnostic categories and dimensions, lacking sufficient scientific basis, lead to some individuals disowning responsibility for their behavior. They acquire a “diagnostic label” that portrays them as “sufferers” of a supposed disorder. However, in many of these cases, the problem behaviors presented are unrelated to the clinical realm.
Individualism and hedonism
As vital ideals in the Western world, individualism and hedonism create a distortion—an unrealistic and detrimental view of human nature and condition. Humans are social beings; our existence cannot be conceived in isolation, and it cannot be lived without experiencing suffering and learning certain lessons derived from that suffering and frustration. A sense of purpose, transcendence, and spirituality are essential for good mental health and cannot be replaced by hedonism or the pursuit of pleasures, no matter how successful or satisfying it may be.
Infantilization
Increasingly prominent is the infantilization of the current adult population, marked by a general trend of not taking responsibility for one’s own existence and behavior. The responsibility for one’s own life path has been replaced by a tendency towards victimization. Instead of developing identities based on positive aspects of the individual, one now seeks to define oneself in terms of reasons for feeling discriminated against or unrecognized. There is a failure to truly take control of the change one needs, and instead, demands are made for compensation and rights due to the perceived grievance.
All of this leads to mentally fragile individuals and entire generations whose coexistence is disrupted, and living together becomes nearly impossible.
"The sense of purpose, transcendence, and spirituality are essential aspects for good mental health and cannot be replaced by hedonism or the pursuit of pleasures, no matter how successful or satisfying they may be."
In summary, there has been an emerging social demand to address a variety of diverse problems in the Western population, for which there is no evidence that psychiatric or psychological care is effective or can alleviate or partially resolve them.
Helping those in greatest need
While it is true that certain things have improved in recent years, such as increased openness to discussing some mental disorders and the normalization of seeking psychological therapy or seeing a psychiatrist, there still exists a trivialization of the suffering of the most severely ill. Nuances that truly make them deserving of care are often overlooked.
For example, a psychotic depression cannot be considered equally serious as a mere mild reactive depression, and not all cases on the autism spectrum can be deemed incapacitating. However, some are profoundly debilitating!
By making diagnostic criteria so lenient and diagnostic categories so inclusive, there may be a reduction in the stigma for milder cases, but severe cases within each diagnostic dimension can become not only equally socially fragmented but even more lacking in available services for them.
Innovative quality care
Another factor to consider with some concern is that, while psychiatric practices have significantly professionalized, specialized, and humanized, there is a general absence of ambition among mental health professionals to innovate and develop intervention strategies that genuinely enhance patient care. It seems as if there were no longer barriers to accessing care, that services should naturally be brought closer to the patient, and that our centers should be equipped with everything necessary so that coercion becomes the exception and is only applied as a last resort.
Mental health education
There is a need to advance in the destigmatization of true mental disorders, and this can only be achieved through extensive education of the population. Increased knowledge about anxiety disorders, depression, obsessive-compulsive disorders, psychoses, bipolar disorder, eating disorders, somatizations, autism, post-traumatic stress, and other well-established pathologies, with clear historical references, is essential. Many effective interventions for the treatment or improvement of these conditions have already been developed and achieved, and raising awareness through education is crucial in overcoming the associated stigma.
