As an advocate, I’m always looking for ways to stay motivated and to motivate other people to contribute to social justice. A sense of social responsibility is something that, for me at least, requires cultivation. It’s so easy to look at a person with a mental illness and see a tragic situation that is beyond your control; so easy to look at the ever-increasing numbers on suicide, psychosis, depression and anxiety, and see the inevitable work of bad genes and bad luck at play. The truth is that environmental factors- like family contact and community involvement- play a huge role in the expression of mental illness. Most of us reading this blog already feel responsible for doing something to change or mitigate the factors in our society that particularly aggravate mental illnesses- the alienation, the stigma, the competition, the long hours, etc. The challenge is to spread that sense of responsibility to people who don’t suffer or have immediate family members who suffer from mental illness.
An article I read recently (available here) illustrated to me that many people may actually benefit from the types of norms that can be so harmful to people with mental illnesses because those are the same norms that motivate people to engage in a consumer-driven economy. I’m not arguing that an economically strong society is good-in-itself, or that norms emphasizing individual accomplishment, isolation, and competition are necessary to build a strong economy. What I am saying is that if you believe those things- and a lot of people do- then you should also recognize that people with mental illnesses are forced to make a sacrifice so that you can enjoy the benefits of a strong economy.
The article was reporting on a thirty-year World Health Organization study that came to the hard-to-believe conclusion that treatment for schizophrenia in developing countries is far better than that in developed, western countries. Individuals with schizophrenia in poorer countries were more likely to have jobs, spend fewer days in hospitals, and up to twice as likely to become symptom-free than patients in rich countries. The authors pointed to a number of favorable factors present in developing countries, but the gist is that individuals with schizophrenia in developing countries are able to work, engage in family life, and remain otherwise socially connected in a way that similarly situated individuals in the West cannot.
One of the researchers pointed out that the kind of community-based care available in poorer countries is not compatible with a society organized around autonomy and individual accomplishment. (My cracker-jack hypothesis is that the ideal treatment for any mental illness is not compatible with a society organized around autonomy and individual accomplishment.) However, the premise here is that the US and other western countries are rich because they cultivate those norms of autonomy, independence, and competition. This means that (perhaps unintentionally) developing countries are paying a large opportunity cost in order to have the kinds of communities that provide good treatment environments for schizophrenia. The way I’ve set it up, there is a trade-off between cultivating the types of values that are conducive to economic success and cultivating the types of values that are conducive to ideal treatment for individuals with schizophrenia.
My point is not that we should eschew American ideals and values for a more humane, less materialistic society, although that would be a noble point to make. Rather, it is that those people who are better off for living in a rich country should feel obligated to contribute resources to compensate the people who are worse off for living in a rich country. It’s all too easy to ignore someone else’s problem when you have no control over it. When you realize that you could do something to make it better if you wanted to, and that you benefit from the state of affairs that makes their problem worse in the first place, it should be a little harder for you to look the other way.
4 comments:
It's an amazing thing to live in a country where so many people are capable of having whatever they want whenever they want it and end up blaming those who aren't in their situation when the system wouldn't allow for that to happen anyway.
Great first blog for you! I think it's sad that we can fix so many things, but don't seem to know where to begin to slow down the machine that leads to individualism and isolation. It's like everyone is on the ride and no one knows who is running it or when it stops.
Thanks for this post Ned--I think what troubles me about it is that--and maybe I'm reading you wrong--you seem to set up a false binary, with wealthy/mentally healthy/productive on one side and poor/mentally ill/unproductive on the other. There's lots of mixing of these traits, though. And we don't know how many people with mental illness are made unproductive by it--many of the super successful people I know suffer with mental illness--and I'm not convinced that competition/capitalism/etc is worse for mental health than poverty. Anyhow...just some thoughts...
Thanks for your comments, guys.
Lizzie: I did set up a false binary, but the one I was trying to set up was between a set of norms that are conducive to a strong, consumer-driven economy on the one side and a set of norms that are conducive to providing ideal environments for people with mental illness on the other.
I don't think that the two things are mutually exclusive. However, I set this up in an attempt to instill a sense of responsibility in the people who think you can either have a strong economy or you can have a healthy society. And I'm trying to do that without refuting their economic/sociological theories, wrong as they may be. Perhaps I wasn't explicit enough in the layout, but it's supposed to read:"If you think there's an inevitible tradeoff between GDP and ideal treatment for MH, and you think you benefit from having things tilted towards GDP, then you should at least feel responsible for doing something (contibuting time/$$) to help the people who suffer from having things tilted towards GDP."
I imagine that there are lots of people with mental illness who consider themselves to be in the camp that would rather live in a society with a strong economy- a la US- than in one that had superior treatment outcomes for schizophrenia- like India. My hope is that those people will nevertheless do what they can to bring western countries up to speed on community-based care for individuals with severe mental illness.
Ned, this article really resonated with me after spending a summer watching the awful effects of isolating people with mental illness play out every day in court.
Things are particularly awful here in Vegas because we just don't have any resources in this city and in this state to deal effectively with mental illness and addiction in our communicites. We don't want to spend the money and as a result, a lot of people are suffering and our community is worse for it.
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