Mainstream Mental Health Is Hazardous for Your Mental Health


In recent years, it’s become fashionable to talk about mental health in more mainstream ways. Superstars like Jim Carrey, Carrie Fisher and Catherine Zeta-Jones have come out with personal stories of struggle, overcoming, and messages of hope and healing for the general public; most of their speeches and stories have even included endorsements of one form of treatment or another, one of which is almost always medication.

Robin Williams’ suicide, along with that of other high-profile people, has in some ways forced the mainstream to allow discussion about it, however selective (“depression” is fine, “schizophrenia” is still taboo, and any “personality disorder” is still “toxic”).

Now it’s “okay” to have depression. It’s “cool” to be anxious. It’s “normal” to “need” to cancel plans last minute or back out of commitments or not follow up or leave people hanging in the name of your personal “mental health.” Ultimately, mental health going mainstream, to rousing cheers and declarations of “small steps toward victory,” has led to a larger demand for the expansion of services since, as I wrote about last month, there isn’t anything in our culture, education system, or work lives that even acknowledges the importance of relational skills, let alone trains us on how to truly be there for each other.

The lip service that “we need each other,” the valid concern about the loneliness epidemic, the repetition from more and more people that “humans need connection” has not actually translated into anything that would concretely remedy that. Instead, it’s now mainstream to talk about your depression, encourage others to “be brave” and go to a therapist, suggest medication to others who may be struggling, too.

What has gone mainstream is the paradigm that mental illness is a real thing, that diagnosis is necessary to get treatment, and that the treatment is lifelong medication, years of talk therapy or, “in many cases, a helpful combination of both,” as the rhetoric goes. The cultural conversation about mental illness is not about mental health; it’s PR for the psychiatry and psychology industries, who are looking for ever more market share even as they dupe millions into believing they are real sciences.

Mainstream “mental-health advocates” endorse the biomedical model and the chemical imbalance theory as they sound the alarm for “underserved” communities, particularly poor, rural, and/or BIPOC communities. Their criticisms of the system amount to #therapysowhite or #therapysoableist or #therapysostraight—that is, members of marginalized groups cannot find therapists that look or think or feel like they do. That there is no mental-health parity in health insurance coverage. That medications are too expensive. That individual talk therapy has become a “middle-class white woman” thing when it should be available to all.

The mainstream conversation about mental health does not touch informed consent beyond individuals who talk about medication including the obligatory “I’m not a doctor, I do not offer medical advice” disclaimer. It does not allow for sustained conversations about “side” effects of medication; when someone does suggest that psych meds might not be the panacea industry would have us believe, they are instantly shut down and their valid concerns are labeled “medication shaming.” The range of conversation around medication in the mainstream is so narrow that it does not allow for nuanced discussion about what informed consent of the consumer means, that we are so far from it with almost any treatment on offer in the mental-health industry and how dangerous such lack is.

The mainstream conversation has not gotten beyond the listicles of “What Not to Say to Someone with Depression” or the debates about what personal designations are appropriate: “we say person with depression not depressed person because you are not your disease.” The mainstream permits talking about our feelings…so long as we do not actually ever feel them.

And what has all this clamoring for more services, more coverage, more “safe spaces” and trigger/content warnings, etc., gotten us? Less isolation and more connection? A stronger sense of true belonging and what we have to offer our communities? The experience of (rather than the intellectual assent to) actual community? Not even a little bit.

We Americans, especially white Americans, still think intensely painful levels of loneliness and isolation are totally normal. Almost 20% of my generation (the Millennials) say that have no close friends—and articles that cite what should be an alarming statistic give “resources” like the suicide hotline as remedies. That is unconscionable.

Not only are suicide hotlines not confidential, even as they claim they are. Not only are they often more alienating for people who call them. Not only do they excuse the pain they inflict on many people with claims that they help more people than they hurt—as if the people they hurt don’t matter.

But how in the world is directing people who report having no close friends to strangers on a phone who, by the way, have the power to send other strangers with guns to your house even if you do not disclose anything about your location an appropriate response? Even after several years of (selective) discussion about mental health in the mainstream, this is the best we can do?

Even after piles of evidence that the common (read: only) treatments recommended work only half the time, or work no better than placebo and have hideous side effects, mainstream mental-health advocacy has nothing better to offer than bracelets with semicolons on them and articles instructing readers on how to talk to your friend about “getting help” for their anxiety.

It continues to tout a stigmatizing and dangerous theory of “mental illness” in the name of “advocacy,” including caveats and excuses for why “some people” “need” involuntary treatment/their rights violated “for their own good.” Loneliness continues to rise. People continue for years to “just get through another day” without finding their purpose or their people.

The worst part about all this is that it normalizes suffering that could otherwise be alleviated. Hear me: I am not saying that all human suffering can be alleviated. Pretending that it can be is part of the violence of the mental-health industry. But the suffering caused by systemic injustices and structural oppression—racism, sexism, ableism, capitalism, etc.—could be alleviated by dismantling those systems.

Instead, the mental-health industry commits even more violence by blaming structural injustice and its attending (and totally predictable) suffering on the individual experiencing the damage of those systems and suffering for it. Mainstream mental-health conversation does not make mention of any of that, at least not in any sustained way that might make a difference.

It encourages people to “be open” about their depression, reminding them that they are not alone and that there is “no shame” in seeking therapy or taking meds. “We take medications for all the other organs in our body when stuff goes wrong—why should the brain be any different?” they say, without any acknowledgement that the brain is fundamentally different than “all the other organs,”(including the heart, which is also deceptively complicated).

The brain is the organ we know the least about; the more neuroscientists study it, the less they know. That alone should be enough reason to pause before dumping meds into it, but it isn’t enough for mainstream mental-health advocates.

Mainstream mental-health advocacy stops at “you are not alone.” What could be used to unite, connect, and organize people is instead a bumper-sticker slogan used to direct people to individual services, which reinforce their aloneness.

All of this is intentional; if “mental-illness” sufferers were to embody and act on what it truly means that they are not alone, they could take down the system. They could topple it by mass boycott. They could create their own systems that actually meet their self-defined needs and that render the current ones obsolete. They could truly connect with each other without the smokescreens of diagnosis, mediated interactions or the malaise of false pathologies and the shame that comes with them.

But they are being kept apart by the way our culture talks about mental health, champions “how far we’ve come” and continues to “treat” “mental illness” in exactly the same alienating, invasive, individualistic, and annihilating ways it always has.

Except now it’s worse because the damage isn’t as obvious and the mental-health community has been thrown a bone: “You all get to talk openly about it now. Some of the diagnoses anyway. Not the scary ones like schizophrenia or borderline. Those are violent and toxic, obviously. But hey, baby steps, right? Maybe someday you’ll be able to make jewelry and get viral tattoos about them, too!”

It is a classic misdirection, and it is not progress at all. It is expanding the market for the “services” and “treatments” that further the need for more “services” and “treatments,” leaving the suffering and isolation and alienation completely untouched.

I’m not saying we should or even can fix the mainstream conversation about mental illness (or about anything else, for that matter). But I’ve begun to see some alternative mental-health conversations starting to pick up some of the subtler versions of the mainstream conversations and I don’t want the non-mainstream folks getting co-opted.

One example is folks who claim to be alternative or radical (and thus safe for people who have been abused by the mainstream system) congratulating the “progress” mainstream culture has made in including mental health in the conversation. This muddies the waters and forms a confusing tie between material trying to be alternative and material that is firmly in the mainstream. At this point, trying to meet in the middle would likely dilute alternative discussions.

Another more worrying example of the blurring of the line between alternative and mainstream mental-health approaches is the slide toward “exceptionalism,” mostly found in professionals who claim to be alternative or radical (and who Mad in America has had on webinars and other presentations). It’s one thing for the head of the American Psychiatric Association to endorse medication. It’s quite another for someone who alternative outlets endorse as non-mainstream to do so. As in, “Well, sometimes medications are necessary” or “Involuntary hospitalization is last resort.”

Why do even “radical” professionals feel the need to reserve the right to chemically restrain or violate another human’s rights? Do they really think that these treatments that damage, harm, and terrify people are ever necessary?

I might be able to get on board with that if the argument were to include the clear acknowledgement that our current economic, social, political, and legal/criminal systems are what are causing the harm and that we as a society are wholly addicted to them. As long as we as a society insist on keeping our current systems and structures the way they are, then the “treatments” and “services” like involuntary commitment, forced medication, and impotent talk therapy are “necessary” for the system to survive and perpetuate itself.

But I don’t know how we can say that such barbarism is “necessary” for the individual, especially when we haven’t tried true community, offering education on relationship building and connection and true advocacy, which should look more like taking down harmful systems and less like listicles and charm bracelets.

Listicles and charm bracelets are harmful because they misdirect from the real issues. They cause people to believe progress is being made when it really isn’t. They reinforce, or at least are totally silent about, stigmatizing and inaccurate theories about “mental illness.” They give people a false sense of belonging that does not compel them to take consistent, sustained action on behalf of others and they forestall solidarity by channeling any energy available for that toward yet more consumerism, connection lite, and resolve to “just get by” rather than fight for real change.

It may be possible to change the mainstream conversation—after all, I remember the times when mental health was unmentionable in public, and I’m not that old. But I don’t know that that’s how best to use our energy anyway.

The choice between trying to change systems or creating new ones is, of course, as old as damaging systems and there are good arguments from every angle. What I hope I’ve done here is clarify the problem of mainstream mental-health talk so that the discussion about changing systems or creating new ones can take these issues into account, as well as to call out the slippery slopes I see appearing in various places by people that claim to be, and may generally want to be, truly alternative.

This is not about “us versus them” but about preserving the line between what we truly need and what the system needs, because there can be no real unity between them.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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  1. Another cutting piece of writing by Megan! Her words tend to make me very emotional. Her generation will shape our future, and so few of them have any certainty yet about what direction to go in.

    She recognizes how much of the messaging we are getting amounts to PR and marketing. Manipulative tools of the large corporate interests. The problem I see is that there is almost NO messaging out there right now that is not of this type. In other words, I find the “progressive” messages meant for the young just as disingenuous as the ones that seem to be promoting “the system” being maintained by their parents or grandparents.

    At this point, all really viable alternative viewpoints, or messages, are almost completely suppressed. Many people who decry the “medical model” still think the brain must have a lot to do with mental and emotional functioning!

    So, what I see is that “the system” has provided us with an entire game, complete with opposing views that seem very contentious but that always leads us back inevitably to … the same system. Megan recognizes that we seem to be confronted with a choice between changing (“reforming”) the existing system and creating a new system. She sees that the need for a brand new approach to almost every aspect of life is required, yet most of us are too embedded in the current system to think in those terms.

    I have my own vision of how things could play out.

    It starts with the realization that we have all participated in creating the current system, that it is an insane system, and that we therefore all must have some degree of a sanity problem, need to take responsibility for that, and stop shopping around for an Oppressor that we can blame for everything that goes wrong.

    Next, a relatively small group of people who realize the above will get together and learn what needs to be done and what has to be done to create a new system, and will quietly go about creating one. The system, when it notices this, will dismiss this work or its people as having its own characteristics – dishonest and criminal. Therefore, recruiting new members into this smaller group will be very difficult to do.

    But, assuming they can get enough people and keep their show on the road, their creations will begin to become more noticeable. Probably at first this will be most apparent as attempts to “clean up” the system, or for calls to restore basic rights and freedoms. Revelations of long-standing systemic wrongdoing may occur. And it will start to become more obvious that this group has a “leg up” for some reason. Popular support will begin to shift to the point that it cannot be hidden by false or wild stories.

    I don’t expect the clamor that can be created by the real crazy people will ever go away. But the rest of us will get better and better at ignoring it, like a few of us do now. Eventually “the system” will become a sideshow, to be amused by or pitied. And it will lose its political power.

    I think it is important to realize that a lot of this madness traces back to the compulsive need for political power. As more people turn sane and learn how to use power properly, Earth could become a formidable force for good in the universe. It actually has that potential.

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  2. Since I don’t use medications or see therapists, I get to watch MH professionals go into contortions if I get annoyed enough to tell them that (A.) I’m schizophrenic and that (B.) I don’t use meds at all, but take mega-nutrients and watch what I eat and drink while paying attention to whatever drugs I might be offered (no stimulants or alcohol, please). I think that sometimes they’re wondering if I might suddenly go on a rampage.

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      • Yes, the “mental health professions,” and some mainstream criminal (now FBI convicted) doctors, HATE all those who don’t need or want their “help.” So much so, that they force treated us.

        And now the entire country is looking at forced vaccinations, and at least half the country is not pleased. Gosh, what’s confusing about forced medical treatment, of any kind, should be illegal?

        Absolutely no products or services should be forced upon anyone. If something must be forced upon people, obviously that product or service isn’t good enough to make it in a free market society, which our country used to be.

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  3. Consent is not happening.
    Everyone should be warned about what dangers exist with, 1. the labels, and 2. drugs.
    Say the minimal and wear shades, actually preferably a clown mask.
    And each day get up and say, I made another day without calling.

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  4. Thanks Megan,

    You don’t get many people boasting about being “Schizophrenic”!

    Though I have friend a doctor whose told me he’s not bothered about what “schizophrenics” think about. So long as they feel okay – he’s happy.

    If people are not okay then they can tell him and maybe he can help them.

    He s told me he’s known people who have tried to come off ‘medication’ and weren’t successful. He said they can cut down quite a bit but not come off completely. Because then they can run into problems.

    I told him, that the last little bit needs to be come off very carefully. But I don’t know if this registered!

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  5. It seems like the whole topic of mental health skips the basic human needs to feel included, such as feeling known, cared about, and belonging. People think those things are available to everyone so the therapists help you know how to get them and give you a little bit of them while you have therapy, and they then send you back out into your world, where you fail again. Drugs are something to keep you from feeling or thinking too much. Considering the state of the culture, that’s probably about all the can be done. Where are the good people? Do they vanish a little bit more from each generation to the next?

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  6. Can anyone tell me which phrases cause shame and stigmatization?

    “You are mentally and biologically defective.” -Psychiatry

    “You’re so dangerous you get less rights that criminals and need to be forcibly jailed/drugged.” -Psychiatry

    “You lack insight and are too stupid to know what is good for you.” -Psychiatry

    “You must be off your psych drugs. Get help.” -Common response when someone disagrees with the speaker.

    “You need to take drugs to fix your defective self.” -Common response if someone has accepted your mental health label.

    “Long term studies find psych drugs have no benefits. The drugs cause/increase suicide/violence, disability, death psychotic and depressive symptoms and so on.” -Anti-psychiatry

    “No replicatable study has found people with a psych labels have a chemical, biological or genetic difference between those not labeled. You are in the range of normal.“ -Anti-psychiatry

    Somehow psychiatry has convinced people to mindlessly assume the shame and stigma created by psychiatry is caused by anti-psychatry.

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  7. Megan,

    I love the article, being a former professional(not medical) I identified a tremendous amount with your previous articles as well on what to stop saying at work. Here you have identified so many things that, I , myself have come to realize as well. Being that we came to the same conclusions independently is powerful.

    Something is really really wrong with this casual mental health term and the gentrification of it so that it can be used to funnel others into psychiatry. I noticed this awhile back and it made me really upset, I think i started to put words to it when I read about NAMI’s role in psychiatry when i read Anatomy.

    Its my own thought, that more closely tied communities could naturally overcome the problem but that’s such a huge ask. No one takes responsibility for each other anymore, everyone just accepts that there is nothing they can do when a loved one or friend is harmed. They are taught that you should remain calm and just be there for them, instead of holding others completely and thoroughly accountable for the harms inflicted on them.

    I also think critical introspection has been unwittingly vilified by a lot of people because it can cause anxiety and depression. However, i contend that the anxiety and depression are a nature survival response to an environmental threat, and very healthy in that respect… probably a product of long years of evolution. However, when we are taught to not be critically introspective and just listen to others or take a Drs word for it, we are being trained to be a passenger to the powers that be. This is quite possibly the objective of almost every leader out there, corporate or otherwise. But it also enables psychiatry and all sorts of other harms.

    Sometimes I am curious why I rarely hear others telling friends or loved ones to think critically for themselves, to figure out and learn what is best for them. I assume they are afraid of what that might mean, but that fear is driving the real harm being done. I see trusting each other and committing to each others wellbeing as a paramount paradigm shift in this conversation. There are many other things that ‘could’ occur but I am concerned about the lasting viability of those options without fundamental changes in our communities and expectations of self.

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