The rising trend of deteriorating mental health today is almost being normalized because life is not fair. Technology is moving too fast. Our bodies aren't equipped to handle social media. These are the usual talking points. Could there be a more structural systemic cause? We are discouraged from even asking that question. It's just brain chemistry. Blaming the system means questioning the system and that not only reduces profit but is also very dangerous to its very existence.
Capitalism functions on your worth being tied to your work. You’re only as valuable as your labor, even at the cost of your mental or physical health. This is accompanied by the alienation, exhaustion, stress, and loneliness that are brought on by living under capitalism every day. The more capitalism celebrates individualism, the more asking for help and seeking community support reduces. The hegemonic power of the capitalist system has convinced us that, as Crossley (2015) puts it, 'the status quo is natural and inevitable, beneficial for all, and thus, inducing them to identify with it.' Your suffering then becomes your own doing. Individuals are blamed for their own plight.
Several studies have shown a direct correlation between poverty and mental illness. Researchers who compared rates of mental illness in countries with higher income inequality such as the United States to countries with lower income inequality such as Japan, found a more than a threefold difference in rates of mental illness and a stronger tendency towards drug use in less egalitarian countries (Wilkinson & Pickett, 2011).
Then there is the problem of unemployment, especially for working-class people, which has also been found to directly affect mental health (Hari, 2019). The way that capitalism operates denies the functionality of social relationships that are essential for positive mental health. Baran and Sweezy (1966) argue that, under capitalism, social interactions become frivolous and superficial. This breeds loneliness. Combating solidarity and collectivism is integral to the survival of capitalism. Competition is necessary. It is one of the economic and intellectual foundations on which the market runs. Thus, competition leads to further isolation.
Neoliberal capitalism also encourages consumerism and when people adopt materialistic values, they are more likely to have symptoms of anxiety and depression with poorer relationships and lower self-esteem (James, 2008). Capitalism compliments other forms of systemic oppression and ensures their sustenance, be it racism, patriarchy, queerphobia, etc. This can be seen through poverty and mass incarceration of minority populations in particular (Nkansah-Amankra et al., 2013).
Neoliberal policies particularly seek to disenfranchise minority populations which often results in very poor overall health and an alarmingly high rate of suicides within these communities. This often goes along with blaming the minority groups for their poverty, with racist undertones, hence justifying the creation of a disposable group of people that is needed in order to continue the accumulation of power and profit for the rich (Pulido, 2016).
Neoliberal capitalism not only affects your mental well-being but also dictates how mental disorders are diagnosed and treated. Under a system run by profit, it is not surprising that the psychiatry being practiced today is largely guided by and under the influence of pro-profit hospitals and the pharmaceutical industry (Davies, 2017). The shift to neoliberalism was accompanied by the shift to a biological approach in psychiatry. There came a widespread shift in what was considered ‘normal’ and what wasn’t. These distinctions of normality are inherently biased because they are based on the assumptions of market principles as rationality (Cohen, 2017; Esposito & Perez, 2014). Distress came to be medicalized.
In fact, Cohen in his book 'Psychiatric Hegemony' details that the changes made in DSM-III (as well as subsequent DSMs) reflect the emergence of neoliberal obsessions with efficiency, productivity, and consumption. The language used in the manual is far from neutral and reflects the dominant ideological rhetoric, which here is the emergence of neoliberalism. Whereas the DSM-I and the DSM-II make hardly any reference to work, school, or home, the DSM-III significantly expands such language, a tendency that is expected to continue as neoliberalism advances. Despite the fact that the manuals are almost comparable in length, there was a significant rise in the usage of the "work" and "school" phrasings between the DSM-IV-TR (in 2000) and the DSM-5 (in 2013).
This also meant that the pharmaceutical business began to push biological psychiatry by supporting public health campaigns, funding individual psychiatrists who supported the biological approach, and funding practically all clinical studies into psychiatric medication (Davies, 2017). Treating psychiatric disease with medicine is also more cost-efficient, as a doctor may now treat three to four people in a one-hour session, which is why profit-driven health insurance companies prefer it. These changes were not only profit-driven but also reinforced the existing neoliberal social order.
We also see an increase in the number of symptoms that constitute mental illness, leading to the medicalisation of normal responses to the stressors of life under neoliberal capitalism, leading to the furthering of ruling class values (Cohen, 2017; Moncrieff, 2001). Furthermore, the diagnosis of a mental illness is frequently based on a person's inability to perform well at work, school, or at home, implying that failure within the neoliberal system is a personal ailment that needs to be treated rather than a fault with the social order itself.
This is not a comprehensive description of the number of ways that neoliberal capitalism contributes to mental and physical suffering. It is far from it. However, it is essential to address these disturbing trends of increased mental illness, suicide, increasing deaths, and alcoholism by changing the way we practice, recognizing the current social order, and addressing its real-life implications with the patients.
Psychology as a field must shift focus to training clinicians on structural competence, which explains how social, economic, and political issues contribute to health disparities (Metzl & Hansen, 2018). This helps clinicians deal with their own individual biases and help them learn how to advocate for their patients through community-based advocacy projects. We should also put greater emphasis on looking at and understanding the socio-economic causes of mental health problems while reducing looking at work and productivity only as markers of recovery and focusing on other goals.
There are only a few possible alternatives to the practice of psychology today. But what is essential to conclude is that the current practice does not benefit the masses. It is for the few, with its priorities mirroring the priorities of the capitalist system. A change is more than necessary, to adhere to the principles of psychology as a field, to help people live their lives with as little distress as possible.
References
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American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). doi:10.1176/appi.books.9780890423349.
Baran, P. A., & Sweezy, P. M. (1966). Monopoly capital: An essay on the American economic and social order. New York: Monthly Review Press.
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Crossley, N. (2005) Key Concepts in Critical Social Theory. London: Sage.
Davies, W. (2015) The Happiness Industry: How the Government and Big Business Sold Us Well-Being . London: Verso.
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Pulido L. F. (2016). Environmental racism, and racial capitalism. Capitalism Nature Socialism 27(3):1–16. doi: 10.1080/10455752.2016.1213013
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Zeira A. (2022). Mental Health Challenges Related to Neoliberal Capitalism in the United States. Community mental health journal, 58(2), 205–212. https://doi.org/10.1007/s10597-021-00840-7
By-Ayishah Wafiyath Midhat
BA Hons. (Psychology)
[Edited by- Ritika Das
Art Curated by: Jahanvi Sharma]
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