Mental Well-Being – How do You Know You’re Well, Mentally?

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Mental Well-Being:

I wonder, how do YOU know your mental well-being is, well, well and that the whole you is functioning in ways that tell you you’re being the best you you can be, mentally speaking?

Good question, and one I think it would be helpful if MORE people asked.

Men check their testicles, women their breasts; the NHS checks everyone, (at least those people over a certain age) for whether there’s blood showing in their bowel movements – to catch bowel cancer.  Men over 60+, well,  we’re screened to ensure our aortic artery isn’t showing signs of furring up; and further, women have cervical screening (at least from age 25 – 64) and mammograms;  and so on.

Problem is, those things I’ve mentioned in the paragraph above are all medical conditions, and therefore something we know CAN be screened for and it helps if you believe they can.

Mental ill health however, is somewhat less screenable; ALTHOUGH there are weighty tomes, like the DSM-V (US) – the classification manual which enables health professionals, at least in the US, to diagnose and recognise and treat mental ill health when it’s sat opposite them. DSM – V is, in full, ‘The Diagnostic and Statistical Manual (of Mental Disorders) volume 5 (V – Roman Numerals).

And, not to be outdone, the rest of the world has ‘The ICD-10 Classification of Mental and Behavioural Disorders’, published by the WHO (World Health Organisation) which has recently decided that Gaming Addiction is a disease, that can be classified as such, and therefore, can, presumably be treated.

ICD, if you are really interested, stands for, in full, ‘International (Statistical) Classification of Diseases (and Related Health Problems)’.

Don’t you just love acronyms? That was rhetorical, by the way. Although there’s nothing to stop you adding a comment if you want to, at the end.

Public Health:

Some, such as Katherine Johnson, have argued that the public health agenda has moved over the last several years such that there is nowadays an “… increasing apprehension for ‘global health’ such that public health concerns are no longer seen as constrained by national boundaries …” (Johnson, 2012, p269), and that we are becoming more concerned about inequalities in health (McFarlane, et al 2008, in Johnson, ibid). And as Johnson goes on to suggest, this move to equalise resources and opportunities has, under the tenets of the WHO (World Health Organisation) also moved to include ‘mental health’ – ‘no health without mental health’ (ibid).

Which,  laudable though it is, means that, say, such as when The Lancet launched its ‘Movement for Global Mental Health’ (MGMH) (ibid), it was based upon a ‘medical framework’ (ibid) utilising diagnosis and ‘appropriate’ interventions in the field of mental health disorder, as opposed to the community psychology approach of collective action as a means of promoting good mental health and well-being.

Little is done by MGMH to ameliorate the effects of globalisation and the continued growth of neo-liberalism: instead the focus is upon ways to “…find cost effective methods to alleviate the ‘global burden of disease’…” (Johnson, 2012 ibid p, 270) since large parts of the world are low to middle income states and countries  and without sufficient income of their own for ‘scaling up services for mental disorders’ (Lancet Global Mental Health Group, 2007, p.87 in Johnson 2012, ibid).

It is quite clever of states and nation states – mostly in the west, I will emphasise, to place the burden for this growth in the rate and nature of the perceived ‘disease’ of mental ill health on those who suffer from the disease.

This reframes illness – both physical and mental – as pertaining to the individual; in terms of the root causes of that illness, and in doing this, seeks ways to blame the individual, or their community, or their environment with a view to firmly denying that the real cause of much of what we consider illness, particularly mental ‘illness’, is actually to be found in the socio-economic models that bind the citizenry to the state, and over which we have no control, unfortunately.

Carl Walker puts this argument quite succinctly in a paper in “Community Psychology & the Socio-Economics of Mental Distress” (2012) when he quotes Lemke (2001) who suggests ‘… The neoliberal rationality of government consists of a number of ideologically coherent political precepts drawn together by a fundamental belief in the superiority of the free market over intervention by the apparatuses of the state. Collectively these precepts are predicated on a reconfiguration of the social as individual and a series of discursive moves to to responsibilize  individuals and families such that social risks like illness, unemployment and poverty are transformed into problems of self-care…’(Lemke, 2001, in Walker, Johnson & Cunningham, Eds, 2012, p11).

So, if you struggle with psychological or physical ill-health, the blame rests firmly with you – along with your poverty, lack of education, housing, employment and so on.

This is a theme I will return to in my next blog-post, along with the role that big Pharma now plays in ensuring that the medication that is unnecessarily prescribed for psychological issues, leads to those self same issues, for which more drugs of the same or similar kinds, with the same or similar outcomes,  are then further prescribed, and so it goes, ad infinitum...

Refs:

Walker, C; Johnson, K & Cunningham, L Eds (2012): “Community Psychology & the Socio-economics of Mental Distress – International Perspectives”   Palgrave MacMillan, Basingstoke, UK

Lemke, T (2001)’The birth of bio-politics’ Michel Foucault’s lecture at The College de France on neo-liberal governmentality.  Economy and Society, 30(2), 190 – 207.201

Paul

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