They are turning citizens into patients
The mental health industry is busy trying to make us feel ill.
Last week an American health panel concluded that anxiety levels are so high among citizens that all under-65s should be screened for symptoms.
This recommendation – which would in effect turn American citizens into patients or potential patients- comes at a time when public life has become increasingly medicalised. The argument for the screening of all adults under 65 for mental health symptoms was justified on the ground that America faces extraordinarily high levels of stress since the start of the Covid 19 pandemic. The health panel, called the U.S. Preventive Services Task Force, stated that its guidance aimed to help prevent mental health disorders from going undetected and untreated for years or even decades.
The task force made a similar recommendation for children and teenagers earlier this year.
The call to standardise screening for mental health symptoms represents a major expansion in public health intervention. The drive to expand the remit of the mental health industry is underpinned by the assertion that mental illness is the new norm. Just about all of us are now portrayed as potential patients in need of mental health services.
Nor are alarmist warnings about anxiety confined to the US. A report in The Times noted that ‘we’re just as bad in this country’. This report refers to a ‘global plague of anxiety’, which suggests that Covid Pandemic has led to new, even more insidious threat to public health.
It is important to note that during the past 30 years, the mental health lobby has constantly claimed that levels of anxiety are rising and that the problem of mental illness is getting worse.
Scaremongering about anxiety by the mental health industry is integral to the project of medicalisation. This is a project that turns the normal problem of existence into a threat to mental health. Yet anxiety and feeling anxious is not an illness but a normal response to the uncertainties posed by the future. The Oxford English Dictionary defines anxiety as;
‘Worry over the future or about something with an uncertain outcome; uneasy concern about a person, situation, etc.; a troubled state of mind arising from such worry or concern.
Throughout the modern era, we have all felt anxious when confronted with uncertainty. Anxiety about how someone responds to a marriage proposal or about the outcome of an exam or a job interview are normal responses to what used to be seen as the problems of existence. Feeling anxious, and even really anxious is not mental health problem. It may not feel pleasant, but left to our own resources, the vast majority of people manage to get on with life while feeling anxious.
Unfortunately, there are powerful forces that wish to turn anxiety into a medical problem. Their alarmist message has the unintended, and in some case intended effect of suggesting that we cannot deal with anxiety without the support of mental health professions.
Alarmist messaging about anxiety serves as invitation to infirmity. Mass screening for anxiety is one way of inviting people to feel ill. Another way is to encourage people to dwell on their anxiety. An illustration of this orientation towards anxiety-obsessing was provided by The Guardian during the Covid pandemic. Its headline read, ‘Tell us: are you anxious about the end of lockdown?’ It continued:
‘The Guardian is looking to speak to people who are apprehensive about the prospect of lockdown ending
Are you stressed or anxious about the prospect of lockdown ending and things returning to normal? Have you found yourself thriving in the pandemic and are therefore reluctant to return to activities or obligations you find challenging or stressful?
The Guardian is looking to speak to people who are anxious or uneasy about lockdown ending. What are your concerns for the coming weeks and months? Are you making a conscious effort to re-acclimatise to business as usual?
Reading this article, it is difficult to avoid the impression that objective of the project of connecting with people ‘who are anxious or uneasy about the lockdown ending’ is to ‘raise awareness’ about the coming plague of mental illness.
Turning the Lockdown into a mental health problem
Throughout the Lockdown the mental health industry constantly warned us with catastrophic stories about the threat that the pandemic represented to our psychological well-being. Time and again the public was told that massive resources would have to be mobilised to avert a mental health crisis. As we headed towards the final months of the Pandemic lockdown, it appeared as if the mental-health industry was determined to ensure that we approached the post-pandemic as vulnerable, anxious patients rather than as citizens impatient to embrace freedom!
During the past year they have been busy telling us not to be in too much of a hurry to leave behind our lockdown lifestyle because we face a variety of post-pandemic related disorders.
Steven Taylor, a professor and clinical psychiatrist at the University of British Columbia warned that “there will be people who develop chronic mental-health problems” caused or exacerbated by the pandemic. Taylor, like numerous other mental-health professionals was busy inventing hitherto unknown psychological disorders. He anticipated a surge of “prolonged grieving disorder,” a condition that apparently affects about 10 per cent of bereaved people.
For its part, The Sunday Times conveyed a mood of panic when it conveyed an alarmist narrative about the tortured life of lockdown teen-agers facing deteriorating mental health.
As far as the Royal College of Psychiatrists were concerned the closure of schools and the lockdown threatened to unleash a mental health crisis amongst young children, that can damage them for life!
As the ending of the Lockdown was in sight, mental health charities were busy inventing new problems to worry about. They claimed that the return to normal life will be anything but normal. Expect ‘heightened levels of stress and anxiety’. One psychiatrist advised beware as ‘lockdown ends to avoid ‘re-entry syndrome’!
Ostensibly, the mental health industry purported to help people re-enter the world after months and months of lockdown. However by turning ‘re-entry’ into a complex psychological operation they signalled society that that their expertise was essential to help people deal with the new normal world. ‘We’re all suffering from cave syndrome – so here’s how to step into light’ is the title of an article in The Telegraph addressing this issue[.
So-called helpful expert advice on re-entry into the post-Covid world simply medicalised the challenge posed by the ending of the lockdown and communicated the warning that without professional support people will struggle to make their way towards the post-Covid world.
Psychiatrists and psychologists have an uncanny talent for making up new syndromes. Re-entry syndrome illustrates how mental health entrepreneurs complicate our life. Of course, most people were anxious about knowing what life would be like on the other side of the lockdown. But people’s natural worry about the post-Lockdown world coexisted with the joy of knowing that they were finally going to get their life back. So why was the mental health industry so devoted to turning a good new story into a cautionary tale about potential mental health problems? Why were these experts telling us that ‘uncertainty and disruption caused by the end of lockdown could negatively affect people with no prior history of mental health issues’?
One reason why mental health entrepreneurs are so obsessively promoting their alarmist narrative is because they have lost sight of distinction between health and illness. The have such a wide definition of well-being and mental health that virtually no one can claim to be free of some kind of psychological affliction.
From its inception, the expansion of the meaning of illness was enthusiastically advocated by the World Health Organisation. It defined health as ‘a state of complete physical, mental and social well-being and not merely the absence of diseases or infirmity’. From this perspective, the absence of sickness does not signify that you are healthy. Very few of us can claim to be a ‘state of complete physical, mental and social well-being’. As very few of us can claim to be healthy, not being well becomes all too normal.
The growing tendency to erode the distinction between health and illness is underpinned by a radical redefinition of what it means to a person. In recent decades the very idea of a person has been re-defined downwards to the point that mental health entrepreneurs can claim that people cannot be expected to make difficult decision about life without professional support. The classification of the normal experience of anxiety into a health problem is symptomatic of a therapeutic worldview that insists that people should not be expected to cope with making the transition from one point of life to another.
The American sociologist Robert Merton developed the concept of ‘self-fulfilling prophecy’ to describe the way that initial assumptions and beliefs about a situation played a significant role in establishing the meaning that those assumptions had for its outcome[. The representation of existential problems as medical ones has an important influence on the way that individuals perceive their health. The relationship between the medicalised narrative of wellbeing and its impact on people is a dialectical one, in that it does not simply frame the way people are supposed to feel and behave – it also constitutes an invitation to being ‘not well’. That is why the sensibility of being ‘not well’ has today become part of many people’s identity.
Following Merton’s analysis, it is evident that if the proposal to screen all adults under 65 for symptoms of identity were implemented, it would lead to an explosion of the number of people afflicted with this condition. Once people are warned that their symptoms can serve as a marker for mental illness, many would perceive themselves as individuals in need of a cure. There are of course real mental health issues that afflict thousands of people. But anxiety is not one of them. Perversely, alarmist messaging about high levels of anxiety distract attention from the real problems and trivialises mental illness.
Whatever their intention, mental health entrepreneurs create more problems than they solve. Through constantly highlighting people’s difficulty with coping with the trials of life they pressurise society to assume that human fragility and vulnerability is the default norm. They instruct people to assume that powerlessness is the defining feature of the human condition. The therapeutic sensibility promoted throughout western culture incites many of us to look for a medical solution to the problems of everyday life. Its most regrettable consequence is that by orienting people to obsess about their internal life it distracts people from engaging creatively with the public issues of the day.