There has been talk of a mental health epidemic in the United States since the 1990s, especially among young people. Mass shootings last month in Uwalde, Texas and Buffalo, New York, by 18-year-old gunmen have raised fears that something went wrong. But the problem is not new. American psychiatrists have been studying the incidence of functional mental illnesses, such as depressive disorders and schizophrenia, since the 1840s. These studies show that the proportion of people suffering from such diseases to a mentally healthy population is constantly growing.
Ten years ago, based on the Healthy Minds annual survey of students, 1 in 5 students was involved in mental illness. Between 2013 and 2021, according to Healthy Minds, the proportion of American students affected by depression increased by 135%. During the same period, the share of students suffering from psychiatric illness doubled to more than 40%. “America’s youth,” journalist Neil Freiman wrote in April, “is in the midst of a growing mental health crisis, and public health experts are vying to identify the root causes before it gets worse.”
They are right to compete. Functional mental illness threatens the existence of society and is behind its social, economic and political illnesses.
Functional mental illness is not curable. It can only be operated with lithium or prozac. The effectiveness of such management depends on the rationality of the patient, but a symptom of the disease is irrationality. Epidemic levels of mental illness, even if taken in a 2007 incidence measurement among adults aged 18 to 54 as 20%, mean that 1 in 5 American adults is likely to be irrational at any given time. That is, their judgments would be erroneous and subjective, reflecting their psychological state rather than objective reality. If we take into account the current rates among students or tomorrow’s elite, we can expect that economic, military, political or social assessments from 2 out of 5 American decision-makers will soon become unreliable.
By definition, functional mental illness is a disease of unknown biological origin. The steady, systematic increase in morbidity since the 1840s is proof that its origins are not biological. Yet, against all logic, mental health research focuses exclusively on biology and does not provide a broader explanatory network. Evidence points to a historical and cultural explanation for the increase in morbidity. In particular, this suggests that functional mental illness is a characteristic disease of prosperous and secure liberal democracies.
The more society is committed to the value of equality and the more choices it offers for individual self-determination, the higher the levels of functional mental illness. These percentages increase in parallel with the increase in available professional, geographical, religious, gender and lifestyle choices. This explains why, since the 1970s, the United States has led the world as the country most affected by functional mental illness, even though other prosperous liberal democracies are not far behind. Before the 1970s, the first place went to the United Kingdom, which lost that ranking along with its empire and, as a result, dramatically reduced the number of elections the nation offered to its members. Conversely, the rates of functional mental illness in societies that are insecure, poor, non-egalitarian, or authoritarian are remarkably low. For decades, the World Psychiatric Association has pondered the “eternal puzzle” of relative immunity to such diseases in Southeast Asia.
Equality inevitably makes self-determination a matter of choice, and the formation of personal identity – necessary for mental health – becomes a personal responsibility, a burden that some people cannot bear. Therefore, in democracies, a relatively high percentage of functional mental illnesses should be expected, manifested centrally in self-dissatisfaction and therefore in social maladaptation. But while high levels of mental illness are an old problem, rising levels in recent decades are not just about equality. They are also related to what happened to Western values, especially in the United States, after the collapse of the Soviet Union.
The disappearance of the common adversary of the West has made the individual identities of the West more confusing and unsatisfactory. After losing track of what they, as a society, were up against, millions of Westerners lost their sense of what they were, rejecting common ground, such as personal responsibility, which had previously been at the core of itself in the West. Soviet-style virtues and vices began to be seen as characteristics of groups, significant social groups were genetically determined, all personal discomfort was attributed to society, and the burden of responsibility shifted from the individual shoulders.
This change transforms the understanding of justice from one based on individual action to one based on collective, biologically determined dispositions. This has encouraged social maladaptation, because people who believe they are worthy naturally feel uncomfortable in a society that is not decent. At the same time, he caught huge numbers in vicious but inevitable genetically determined identities. While solving the problem for some, this change in values accelerated the increase in the rate of mental illness.
The tragedies in Uwalde and Buffalo underscore the urgency of tackling the mental health crisis. Understanding the reasons for this will help us do so.
Ms. Greenfeld is a University Professor and Professor of Sociology, Political Science and Anthropology at Boston University and author of Reason, Modernity, Madness: The Impact of Culture on Human Experience.
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