‘Mental health’ – what does it mean to you?

Mental Health Awareness Week, running from 8th to 14th May 2017, provides an opportunity to reflect on what the increasingly commonplace term ‘mental health’ means to us...

Due to the polysemic nature of the concept of ‘mental health’, its definition has imprecise borders. The World Health Organisation suggests, “mental health is a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”.

What is immediately apparent, is both the cultural and political location of such a definition and its dependence on inherently subjective phenomena. For example, what is a “normal stress of life” and what does coping with it look like? And if “a state of well-being” is broadly understood as “being comfortable, healthy, or happy”, does this potentially render other aspects of ourselves and our experiences (namely the uncomfortable, unhealthy and unhappy ones) less culturally desirable, acceptable or easy to talk about, without fear of stigma, shame or blame?

Taken literally, ‘mental health’ means a “mind free from illness”. In the UK the biomedical model, which understands ‘mental illness’ as a biological or genetic ‘disorder’, ‘disease’, ‘abnormality’, or ‘chemical imbalance’ of the brain, still dominates. Clinical psychiatry in particular diagnoses ‘symptoms’ of ‘illness’ which are then, more often than not, ‘treated’ with medication. However, the danger of assuming psychological distress has its root cause in biological factors alone is that it lays the ‘problem’ firmly within the individual (often without taking into account their behaviour and communication patterns, attachment styles, spirituality, past, present or traumatic experiences and not least, their own meaning for their experiences). Yet, as Jenner et al. note in Schizophrenia: A Disease or some ways of being human? (1993):

“What we call ‘illness’ may represent the complex and variable reaction to an equally complex global situation of a given person.”

What such a quote reflects is the entirely phenomenological nature of human experience, in that every person will react uniquely to their own ‘global situation’ which will encompass their inner emotional, physical, psychological, spiritual realms but also be influenced by their outer relationships, environment, education, socio-economic status and so on.

Those such as R.D Laing, Richard Bentall and Professor Peter Kinderman (British Psychological Society President) also highlight that the cultural response to people’s experiences of distress may be as much ‘the problem’ as the experience itself. The idea there is something fundamentally ‘wrong’ with a person’s biological makeup which needs to be sedated, suppressed or eradicated with medication may represent a broader cultural and existential fear of ‘madness’, distress, unhappiness and anxiety and the desire for a ‘fix’ or ‘cure’.

Not least, we must acknowledge that behind dominant biomedical conceptualisations of ‘mental health’ and ‘mental illness’ operates an enormously powerful pharmaceutical industry, profiting hugely from the maintenance of such paradigms.

Therefore, therapists and mental health professionals might ask themselves:

• If and to what extent do I ascribe to the biomedical conceptualisation of ‘mental illness’? Or do I regard people’s distress as an inherent part of the human condition (or something else)?
• Is the concept of ‘mental health’ a reductionist paradigm at odds with holistic psychotherapeutic approaches which attempt to take into account the existential complexities, contradictions and ‘wholeness’ of a person? And if so do I/we have a professional duty to actively challenge such concepts?
• How do I use language and how does this shape or reflect my own perspectives (i.e. ‘Patient’ or ‘person’? ‘Disorder’ or ‘distress’? ‘Pathology’ or ‘survival mechanism’?)
• How far am I able to ‘bracket’ or ‘un-know’ in order to try to understand someone else’s experiences from their frame of reference? Or am I inclined to interpret, label or diagnose, in order to make my own sense of their experience - if so, why?

Mental Health Awareness Week aims to promote “good mental health” which is undoubtedly a worthy cause. However while focusing on ‘good mental health’ it is important not to lose sight of the myriad other possibilities for making sense of and responding to the full, kaleidoscopic spectrum of human experience.