A few months ago I received a referral for a new patient with a history of depression who’d made a serious suicide attempt. Perhaps unsure how to describe these episodes, the referring clinician wrote vaguely that the person had a “history of mental health.”
Ordinarily, the word “health” implies an absence of illness. That is no longer how the term “mental health” gets used. The idea of mental illness, or mental disorder — both terms that have been subjected to their own intractable debates — has come to be supplanted by a broader umbrella notion, “mental health,” which somehow, confusingly, gets used to refer to states of both wellness and distress. Some awareness campaigners have even adopted the slogan “
We all have mental health,” which seems on the face of it to be a stigma-busting, solidarity-building mantra. On closer examination, however, it manages a double exclusion. It fails to actually name any mental health
problems — those about which we ought to be raising awareness — and it also makes a claim that is sadly untrue; there are many people who, at least some of the time, do not have mental health. (...)
The term “mental health” is a euphemism, and euphemisms are what we use when we want to obscure something. This language — in contrast to “mental illness” — encourages us to focus on the regulation of more or less transient states, and on the maintenance of something we supposedly all have. “Mental health” conjures phenomena that are, more or less, relatable: anxiety and depression. But who is being excluded as a result? The change in language was supposed to address stigma. But it has simply moved our attention away from the very people who face the most stigma — those with diagnoses of schizophrenia, for example, or symptoms that do not allow ready participation in the mental health curriculum.
This shift also cuts in another direction. An emphasis on health and equilibrium, with accompanying “advice” and “techniques” for self-regulation, has resulted in the term “mental health” undergoing a kind of mission creep: from providing increased awareness of specific difficulties to offering a broad set of prescriptions about how we should live.
by Huw Green, NY Times |
Read more:Image: Tyler Comrie. Photographs from Getty Images[ed. For a good example, see also:
US adults should get routine anxiety screening, panel says (AP): "
U.S. doctors should regularly screen all adults under 65 for anxiety, an influential health guidelines group proposed Tuesday.It’s the first time the U.S. Preventive Services Task Force has recommended anxiety screening in primary care for adults without symptoms. (...). [ed. but...]
finding mental health care can be difficult given shortages of specialists."]
