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 the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.”
A few questions regarding this statement:
“Abilities:” The abilities to do what?
Normal stresses of life: In what economic, political, and socio-cultural setting is the normalcy of “life” measured?
Work productively: Who and what does individual productivity serve? Since when did well-being become reliant on productivity?
It seems like the answers to all questions unite in the narrative that in today’s society productivity defines well-being. The abilities to produce in a capitalist economy have somehow been codified as determinants of well-being and happiness.
Political scientists have a term called “biopolitics” that precisely explains our current relationship with mental health. Popularized by Michel Foucault, biopolitics refers to the form of governance that regulates populations by exerting political power on all processes of human life, such as birth, death, disease, and health, to achieve efficient economic controls.
This form of economic and political governance breeds a ludicrous cycle of how we approach mental health. First, mental health is forced into an arranged marriage with economic productivity. Then systemic “-isms”, be it 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 accumulate as people confront the burden of doing more but getting less within institutional inequalities. Mental health conditions prevail. Identity-based disparities in mental health outcomes also ensue. Now we proclaim, “you have a disease and without treatment you cannot get back to your maximal level of productivity.”
Biopolitics has wrapped its invisible hands around the throat of our mental health.
The “not-producing-therefore-not-well” mentality was not baked into the American psyche overnight by a single institution or power. Intentionally or unintentionally, overtly or subtly, all sorts of institutions under biopolitical governance partake in the regulation of mental health. Mental health is defined in a way that can serve maximal economic efficiency. Politics and public policies categorize populations in a way that allows certain groups to be given more resources and institutional advantages than others and ultimately create systemic disparities in mental health outcomes. Medicine treats mental health in a way that sustains the pathologization needed to oil the machines of the pharma industry.
I would like to reiterate that examining mental health through the lens of biopolitics is not to invalidate medical science or negate the value of understanding the biological mechanisms of mental conditions, but to expand the discourse through which we understand, discuss, and address mental health. Physiological symptoms undoubtedly demand evidence-based treatment, but effective mental healthcare cannot stop at addressing individual symptoms without adequately confronting the social ecosystem that engineers our mental health. We need a candid recognition of the economic and political reality we live in that govern our functions and well-being.
What if we reimagined 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 change of rhetoric demands all aspects of politics and governance to take on the responsibility of managing population mental health. Mental health policies must go beyond medicine for mental illness itself and incorporate political action on poverty, housing, healthcare access, education, and other aspects of resource reallocation to counter the structural -isms that shape population mental health.
Addressing the causal mechanisms of population mental health thus becomes an inevitably complicated and interdisciplinary enterprise.
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, sociologist, anthropologists, your wisdoms about the multifaceted nature of human experiences are invaluable to challenging out understanding of life and health.
Political agents, you shoulder the responsibility to create policies that deconstruct the boundaries of race, gender, ethnicities, sexual orientation, and able-bodiedness in people’s access to resources.
Medical practitioner and researchers, you have the power to push the boundaries of our holistic understanding of mental health through cross-disciplinary innovation and collaboration;
Media and technology developers, your decision on whether the information and technologies you create serve to drive profit at the expense of population health and equity has tremendous weight.
Lastly, to any individual who is reading this, while it may not always fee like a simple deed, we have the responsibility to pursue our happiness and well-being. We are in an arduous battle to demand structural equity on all fronts of mental healthcare, so in the meantime please be kind to yourself, be kind to your kind, be kind to your body.
Mary Lihong Peng is a second-year Master of Public Health candidate and Horstmann scholar at Yale University.