In a 2024 forum headed by James K. Kirkbride of University College London, the authors assert that social determinants of mental health are factors that can be changed. The current work, published in World Psychiatry, argues that changes to these systems of power could provide significant prevention of mental illness in populations affected by oppressive social determinants.
Social determinants of health are the factors that individuals face over the life course such as income, employment, socioeconomic status, food security, housing, social support, discrimination, and access to care. These determinants, influenced by policy, laws, location, and neighborhoods, are not random occurrences. They are created and upheld by social institutions and power structures that repeatedly recreate poor conditions for oppressed groups. The authors write:
“We stand at a threshold moment not only in understanding the potential causal role of modifiable social determinants in the onset (or exacerbation) of mental health problems, but also in defining our response to them through effective prevention strategies that reduce inequities in the burden of psychiatric morbidity experienced between and within different populations.”
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Do you think the orders in healing are being created? First, to know how data is collected and aggregated, and still one can become aware of Being ONE! Though something happens when one voice becomes sublimated into the group while learning civility and rights. Secondly, how one goes about creating and making their language a visual language through the Arts when the Sciences focus on the objectivity of the experiments? For somewhere in the first meetings with psychologists, psychiatrists and self, the powers inherent to knowledge creation seemingly are captured, given or freely traded without due diligence. For me, one of the craziest therapeutic sessions occurred when the session began with the music being given to us to sing, “Send in the Clowns” in the State Hospital. Fortunately, there were no walls on the Hospital at that time and I slipped away for an hour to deliver the music to the local pub. And yet, in hindsight, as I learned more, there are reasons for each step of how and why we begin to think differently in compassionate ways.
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Three Gucci little piggies went to market wearing plastic shoes and highly colourfully painted electrically animated faces which look like they were fixed into shape when they were babies. One little piggie went to a restaurant and ate roast beef. One went to a rally to hear a hate speech. The other planned your futures on a spread sheet. And then these little piggies went home. And that marks the boundary of cartoon life and real life every day, because the line between cartoon and real life is blurred when you’re caked in make up and when you take it off you see what you’ve got. Not quite a clotted nexus of twitching flesh with a mouth that looks like the back end of a horse but certainly a spiritless dead thing with facial expression stupid as a fish is staring back at you. And you turned the intelligence and sweetness of cow and lambs and sheep into this fish face of emptiness and confusion staring back at you. People like you are the best argument for pescatarians over veganism, although cannibals who eat only vampires are immune. I am nature’s hyena so watch out. I’m nature’s hyena but spit out linguistic versions of dancing Mary Poppins’ with her nickers in a twist and electric light kickboxing Pope Francis’ who also has his nickers in a twist which might be explained by an awkwardly placed fist.
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But who will make these changes? Government’s role is to manage the class war. Its only the organised working class that can reduce inequality.
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As long as Western philosophy and mindset cling solely to their own frameworks, progress will be limited—especially given how interconnected we all are, whether physically, socially, or virtually. The challenge here is how to create a universal approach to mental health at least in language. But this raises a complex issue: people inevitably compare their mental states across cultures and eras, revealing that what one culture considers a mental illness may be viewed differently elsewhere.
If we start comparing mental health globally, we might realize that many conditions labeled as illnesses in one society may not be seen the same way in another. So how do we medicalize such a condition? However, acknowledging this would mean confronting the fact that some societies, despite being economically disadvantaged, might experience less “psychological” distress than wealthier ones. This is the core barrier: understanding that what contributes to our wealth may also contribute to our suffering.
Ultimately, the solution doesn’t require complex problem-solving but rather an open-minded psychiatry industry willing to revisit its assumptions and accepts their historical gaslighting. It’s time to review the books and rethink the foundations of mental health.
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Personally I wouldn’t ask psychiatry to investigate the cross-cultural picture: I’d ask people like you to do it, because you are sincerely interested in the facts, and have touched upon something important. I feel cross-cultural studies of all kinds, especially in physical and psychological health and cultural outcomes, is the field that will allow space for a self-critique of Western medicine and whatever the proper word is for the gaggle of confusion we would stupidly call ‘the mind sciences’, e.g. psychiatry and psychology. But the cross-cultural data is out there on mental health: unfortunately the researchers, looking through such a narrow lens, don’t relate it sufficiently to the broader social and cultural health which is what you and I would want to include, so if you had the energy of your own interest and passion, I think you would find the total picture yourself and then this understanding would act through you. If psychiatry did it, which probably they would never do if you ask me because psychiatry is an economic grift rather then a truth-seeking enterprise, then they would probably hide what they found anyway out of self-interest, or spin it in a way that still made their profession seem legitimate or credible or useful. Because a true understanding of the cross-cultural picture I feel makes clear that the Western process of industrialization and civilization corresponds to a destruction of what we call our mental health and also our social morality and health and our intelligence and understanding, intelligence defined not as intellectual accumulation but the basic clarity and subtlety of perception and expression.
In terms of cross-cultural studies, Robert Whittaker does a meta-analysis and wrote a book both of the same name, ‘Anatomy of an Epidemic’, which included cross-cultural studies on mental health and also historical studies, comparing the data and research on psychiatry at different points of American and European history. This has the same kind of rewards, I feel, as cross-cultural studies, and indeed historical comparisons are really cross-cultural studies, because it was a different world in 1950s America compared to donald trump america. Also, there was an amazing book called Madness and Modernism by Louis Sass which traced the features of psychosis and compared them with the features of modernist art and literature, and found compelling similarities that lead him to also consider the cross-cultural picture, and he was a psychiatrist as well as someone clearly interested and academically proficient in the humanities. He had an appendix where he looked at the cross-cultural picture, but you can go further still.
I would recommend comparing the process of shamanism and shamanic initiation we see in many indigenous cultures across the world, perhaps the majority, for example native American cultures, cultures around the Hindu Kush (Pakistan, Afghanistan, Tajikistan), in African cultures, and probably to be found in some form or another in all traditional, organic tribal cultures, to see how the phenomena we call ‘psychosis’ emerges and is treated in a completely different way, and also look at the work of Professor Goff who induced non-ordinary experiences through psychadelics and then breathwork, and who helped people through psychosis seeing it as a healing process, calling it ‘spiritual crisis’ or ‘spiritual emergency’ or ‘spiritual emergence’, and then you can see how really the process we call psychosis and the process of shamanic visions and experiences and also the process of psychadelic experiences all tap in to the same non-ordinary dynamics of consciousness, because then you really connect all the dots that the Western hegemon most urgently needs to understand, even though to understand it would be to self-destruct. Because we all need the Western hegemon to self-destruct. Otherwise, it’s toast for life on Earth.
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What you say makes a tremendous amount of sense. I could share my own experiences and thoughts, but my experience now on the Internet is that it’s almost always misinterpreted and starts a debate about which nobody’s sure what the question is. So I will just say that personally, I look to Yoda, Master Oogway, Mr miyagi and Alan Watts for my sanity. That and the physical beauty of the world which still inspires me!
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This forum asserts that social determinants of mental health can and must be changed. But their recommendations are the same old psychological/ psychiatric programs pushed and capitalized on by the same old vested interests.
If access to services was the solution then the problem of mental health would have been solved by now. When are the experts going to propose workable solutions for education, employment and income? If we stand at the threshold of preventing mental health problems and apply these “solutions,” we are going to miss it.
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Where is a discussion of stimulant psychosis? Since my son suddenly became a paranoid schizophrenic and cannot take care of himself even after getting an MBA degree and buying a house, thanks to methamphetamine, I have noticed that many homeless people seem to be just as crazy as he is. Do policy makers know about this problem? It is certainly not common knowledge.
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It is common knowledge to those not so busy stuffing their face at the trough that they can spend a moment or two acquiring a basic understanding of the reality around them. Is it the job of policy makers to understand the social and psychological terrain they are making policy over which they govern? Obviously it should be, but does any policy maker take it as their duty to understand the terrain they govern, and DOES ANY VOTER IN PRACTICE SEE THIS TAKE PLACE, DOES IT EVER TAKE PLACE, and DO YOU ACTUALLY EXPECT AND DEMAND THIS OFF YOUR POLITICIANS, AND DOES ANYONE? They THINK they do, but which policy maker do you actually think, in US history, has bothered become acquainted by with the terrain to the extent that they notice that homeless people go as nuts as a non-homeless person when they take ADHD drugs??? If you think your elected politicians are that interested in the social and psychological reality they govern, then you are objectively mad.
Does any Donald Trump voter in the whole of America actually expect him to be an expert in the social and psychological terrain he is governing? Are goobers doing backflips off of cliff edges? If we can’t answer these basic questions in life, we may as well do a backflip off a cliff edge. But we in the UK wouldn’t talk of goobers. We’d talk of pillocks, berks, wollies and prats, but you catch my drift.
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