The Western Struggle for Mental Health

Ten years ago, based on an annual study on the healthy minds of college students, 1 in 5 students had a mental illness. Between 2013 and 2021, according to Healthy Minds, the share of American students affected by depression increased by 135%. During the same period, the share of students suffering from any psychiatric illness doubled to more than 40%. “American youth,” journalist Neil Freiman wrote in April, “is in the midst of a mental health crisis, and public health experts are racing to identify the root causes before it gets worse.”

They have the right to race. Functional mental illness threatens the existence of society and lies behind its social, economic and political illnesses.

Functional mental illness has no cure. It can only be operated with, for example, lithium or Prozac. The effectiveness of such treatment depends on the patient’s rationality, but the symptom of the disease is irrationality. Mental disease epidemic rates, even if the 2007 incidence among adults aged 18 to 54 is taken into account as 20%, mean that 1 in 5 American adults is likely to be irrational at any given time. That is, their judgments would be erroneous and subjective, reflecting their mental state rather than objective reality. If we take into account current rates among students, or tomorrow’s elite, we might expect that judgments on economic, military, political, or social issues by 2 out of 5 U.S. decision-makers will soon become unreliable.

By definition, a functional mental illness is a disease of unknown biological origin. The steady, systematic increase in the incidence rate since the 1840s is proof that its origins are not biological. However, contrary to all logic, mental health research focuses exclusively on biology and does not throw a wider network of explanations. Evidence suggests a historical and cultural explanation for the increase in incidence rates. In particular, it suggests that functional mental illness is a characteristic disease of prosperous and secure liberal democracies.

The more society is committed to the value of equality and the more choices it offers for individual self-determination, the higher the rate of functional mental illness. These rates increase in parallel with the increase in available choices of occupations, geographical, religious, gender and lifestyles. This explains why, since the 1970s, the United States has led the world as the country most affected by functional mental illness, even though other prosperous liberal democracies are not far behind. Before the 1970s, the first place belonged to Great Britain, which lost that rank together with its empire and the dramatic reduction in the number of elections that the nation offered to its members as a result. In contrast, rates of functional mental illness in societies that are insecure, poor, unequal, or authoritarian are extremely low. For decades, the World Psychiatric Association has been thinking about the “eternal mystery” of relative immunity to such diseases in Southeast Asian countries.

Equality inevitably makes self-definition a matter of one’s own choice, and the formation of personal identity - necessary for mental health - becomes a personal responsibility, a burden that some people cannot bear. Therefore, in democracies, a relatively high rate of functional mental illness must be expected, which is centrally expressed by self-dissatisfaction and, therefore, social maladaptation. But while high rates of mental illness are an old problem, rising rates in recent decades are not just explained by equality. They are, in addition, linked to what has happened to Western values, especially in the United States, since the collapse of the Soviet Union.

The disappearance of a common adversary of the West has made individual identities in the West even more confusing and dissatisfying. Having lost sight of what they, as a society, were against, millions of Westerners have lost their sense of what they represent, rejecting common points of reference, such as personal responsibility, which previously formed the core of the West’s self. Virtues and vices, in the Soviet style, began to be seen as characteristics of groups, significant social groups were genetically defined, all personal discomfort was attributed to society, and the burden of responsibility was shifted from individual shoulders.

This change has transformed the understanding of justice from one based on individual actions to one based on collective, biologically determined dispositions. This encouraged social maladaptation because people who believed they were decent were naturally uncomfortable in a society that was not decent. At the same time, he captured a huge number of evil, but inevitable genetically determined identities. While solving the problem for some, this change in values ​​has accelerated the rise in the rate of mental illness.

The tragedies in Uvalde and Buffalo emphasize the urgency of resolving the mental health crisis. Understanding its causes will help us do that.

Ms. Greenfeld is a university professor and professor of sociology, political science, and anthropology at Boston University and author of Mind, Modernity, Madness: The Influence of Culture on Human Experience.