It’s just a disease.

The erasure of systemic socioeconomic problems in the mental health and suicide discourse. by Luís Lowden da Silva

“mental illness: any of a broad range of medical conditions (such as major depression, schizophrenia, obsessive-compulsive disorder, or panic disorder) that are marked primarily by sufficient disorganization of personality, mind, or emotions to impair normal psychological functioning and cause marked distress or disability and that are typically associated with a disruption in normal thinking, feeling, mood, behaviour, interpersonal interactions, or daily functioning.”

The Merriam-Webster dictionary.

Warning: this article discusses themes of mental health and suicide that might be disturbing or upsetting for some. In 1968, the second edition of the Diagnostic and Statistical Manual of Mental Disorders was released. Among its collection of 182 alleged disorders, one can find homosexuality. Although it has been removed in the subsequent editions, room for questioning remains: who can determine what is “normal thinking” and “daily functioning”? How much does the ruling ideology determine what we consider unhealthy behaviour, and how much is psychology helping in upholding the status quo? The right to decline treatment is typically reserved to anyone who is suffering from any illness of the body. However, during the process of diagnosing mental conditions, we sometimes also rule people to be unfit to decide whether or not to receive treatment. The line between medical attention and imprisonment becomes then blurred. Sectioning is the practice of keeping people in a hospital regardless of their will due to concerns about their mental health. While most certainly understandable in many cases in which people pose a risk to themselves or others, it results in the de facto criminalization of certain kinds of neurodivergence. It is no longer possible to pretend that these definitions are purely medical ones; the psychiatrists that write them must, in the process of doing so, define what is a normal thinking and functioning process, things that are informed by whichever ideologies they sympathize with. The expression “disruption in daily functioning” is too quite loaded. Is it not healthy to have daily functioning disrupted by the death of a loved one? Is despair in hopeless circumstances not a rational response? By describing humans as merely broken parts in a machine that needs to be fixed, we rarely ever have to question if the machine is suitable for a fulfilling human life. By diagnosing someone with depression, anxiety, or some other imbalance of brain chemistry, it becomes unnecessary to ever think about how this imbalance actually came to be. Through masking every mental health issue as a purely

The Diagnostic and Statistical Manual ofMental Disorders, first edition.

Source: https://www.psychologymania.com

biochemical condition in a particular individual we avoid ever having to face the ways in which our current world is unsuitable for human life. It is fundamental to repoliticize mental illness if we wish to rid ourselves of conditions that favour its development. It is also patronizing, even, to determine that certain options can never be the choice of a person of sound mind. The question of suicide is certainly controversial. In many cases people who attempted suicide come to later appreciate the fact that they didn’t succeed. But is forcing someone to live against their will not a gross violation of their bodily autonomy? It can be argued that in every occasion where a previously suicidal person overcomes these urges to have helped them end their own life would have been to cause the death of someone who is in the present content with life. However, this possibility rests on a fundamental assumption: that whatever is causing the distress in this person’s life can be changed. The recognition of the necessity of this condition is why we are typically more receptive to the concept of euthanasia than that of suicide. People with terminal and painful physical conditions are an undeniable example of that situation. But what about people with what some doctors call “Shit Life Syndrome”? SLS is the condition that plagues people left behind by the economy with no real hope to ever change their material conditions. This is a serious problem, as Sarah O’Connor describes it in her Financial Times article regarding the degradation of the quality of life of the inhabitants of Blackpool:

“The term isn’t meant to sound dismissive. People with SLS really do have mental or physical health problems, doctors say. But they believe the causes are a tangled mix of economic, social and emotional problems that they — with 10- to 15-minute slots per patient — feel powerless to fix.”

— Sara O’Connor, Financial Times, https://www.ft.com/ blackpool

What is the fundamental difference between someone who is miserable because of their socioeconomic situation and one who is so because of a medical condition, if both are equally unable to change what ails them? Is there anything besides the guilt that comes from building a society that creates the conditions in which the rational choice for some people is to end their own lives? The question of mental health is intimately intertwined with the socioeconomic conditions of a population. By pretending that suicide can only be the choice of a madman and that madmen come to be only through isolated issues of neurological pathologies, we wash our hands of the responsibility to build a world in which everyone actually wants to live in.