Society's Mental Illness

What is the problem with the mental health care system today? I think it's a spiritual one. People do not understand, often are unwilling to consider, that we are biological beings, not only in terms of our body but in terms of our being. People don't want to admit that we are inextricably linked to our bodies. Most people would rather imagine we are somehow attached to the physical body. Most of us prefer to see the human spirit as a passenger riding in the body's shell. We would rather imagine that we are something bigger and more robust than, really something more important and superior to, the physical body. Admittedly some of this thinking arises because we don't yet understand very well how we could manifest from the body's functions. This gap of understanding, this gap in our knowledge, seems to be narrowing as science increases what we know about the brain.

When we can accept that we are the creation of our body (mostly our brain), our perspective on many social and cultural difficulties will change radically. When we accept that the function of our brain determines who we are, we will be much more interested in how our nervous system and our brain can malfunction.

Today we give a sort of lip service to the idea that our brain causes us sometimes to behave and think in abnormal ways. Of course we used medications to affect our brain so that we can improve our mood and sometimes our behaviors. But behind this usage of medicines continues an undercurrent of magical thinking regarding who we are and how we function. So most people today still think that how a person functions in the world -- really who he is in the world -- is a function of his character, more specifically his God-given character. And we regard character as something we each are responsible for despite our vague sense that even how we are able to exercise that responsibility can be influenced by how our brain and body is functioning. Alcohol intoxication is an obvious example.

When we accept as a society that how people function reflects how their brains are working we will make a priority of examining people's brains when we find people functioning in ways we recognize as dysfunctional. Then when someone does something harmful to themselves or to others we won't need to accumulate a dossier of their misbehaviors before we consider they might have a brain condition. We will examine brain function whenever someone misbehaves.

Now this sort of viewpoint freaks no small number of people out, because it can be viewed as an invasion of privacy and an erosion of personal freedoms. Further, for those people who regard the best society to be one filled with individuals operating in their own self-interest with little or no oversight by their communities -- a sort of libertarian perspective -- attributing these behaviors to the brain's functioning imposes on society an obligation to manage each person's brain function. After all, if the brain's dysfunction prevents a person from managing themselves (including keeping their brain healthy), then that task has to fall upon others.

"What," you say, "you mean I have to pay my taxes to take care of other people's mental dysfunctions?" Of course today this already occurs to some extent but how it occurs can quite arguably be described as inefficient and even sometimes abusive. For instance, many people with mental health problems reside in the penal system where their mental health care is often minimal. That many of these people end up returning to their communities with their mental health problems unmanaged means that, as is the case for ordinary criminals, the mentally ill prisoner really has no enduring rehabilitation.

This arrangement, which is our current social response to the significantly mentally ill, means that nothing fundamentally changes for these people when society's intercession ends. Today, society's arrangements for the newly-released probationer do little to change the risks to the larger population; recidivism rates approach three cases in four. And if anything it is worse for people with significant mental illness when they return to society. Today such "state-of-the-art" medical care for the mentally ill exacts a heavy price on how our society appears and functions.

Changing this situation requires us to see ourselves in a new way where our mental functioning is viewed as a product of brain activity. Rather than relying upon our wishful religious traditions to guide us when a person misbehaves, in every case we need to consider, then look for, evidence of brain dysfunction.

There is a reason this hasn't already occurred, and it has two facets. One is that it requires us to see ourselves in a new way, a way distinct from tradition. Second, it means we need to learn a great deal more about how the most complex organ in the body, the brain, works. That requires resources -- people, equipment, money -- to advance the science. To the extent this work rubs up against the beliefs of tax paying citizens, it is likely to be hindered. Arguably that is happening now and it is likely to happen even more as the science advances. Religions that are offended by this science are faced with a challenge at least as great as the one they see coming from evolution. Truly they are faced with obsolescence unless their viewpoint and message adapts to modern understandings.

While this adjustment of religious thinking and advancement of science proceeds, we will have to live with the consequences of our current policies toward the mentally ill. Unfortunately, that will mean no small number of lives shattered. This is our situation today.