“Houston, we have a problem!”

Well, to say that we have a single problem, as things are, can be a temerity, but this time I want to focus on an issue that concerns us and affects us internally, mental health.

Historically, suffering has had a profound meaning and meaning. It was a sign that told us that something worked wrong, put us in front of the environment, looking for the structural origin of our discomfort, and that evolution of the causes of suffering could become the starting point that activated us to fight collectively.

Neoliberalism has revolutionized it. Since 1980 there has been a new interpretation of suffering, totally depoliticizing our discomfort and making it a trade opportunity for the benefit of economic objectives:

– Suffering has been related to individual origins: what needs to be changed is not the system, it is you.

– Individual well-being has been linked to consumerism.

– Attitudes and feelings that seek to question or modify the status quo have been medicalized.

– Suffering has become a business opportunity.

The ideology of mental health for the economy has not only transformed activity in this field, but also the psychological attitude of a whole generation. At least that's what British professor at James Davies University says: "Sedated. How modern capitalism managed the mental health crisis” (2022, Captain Swing).

Can't make sense of the work you do? You have to learn how to develop positive thinking; tori self-help books. Are you unemployed and unable to find a job? You have to change that inadequate mental attitude, work the positive psychology, you can! What do kids spend a bad time in school? The younger you are diagnosed and start taking the corresponding psychopharmaceuticals, the better…

Davies makes an interesting comparison between the debt trend and the consumption of psychopharmaceuticals since 1980. They both grow and rise, but neither do they improve our lives, they say they are a way of hiding the structural problems that our society has.

“The use of psychotropic drugs has become widespread, not because they are the safest, most beneficial and most effective, but because public services do not have the necessary funding. This direction has been imposed by neoliberalism. The approach of very powerful pharmaceutical and psychiatric interests has prevailed; the use of psychopharmaceuticals and the cognitive behavioral approach have placed the problem among our ears”.

Psychotherapy didn't have to be that way. I didn't have to depoliticize and medicalize people's suffering. In fact, in good hands, psychotherapy could be useful for sociopolitical awareness and criticism. But the health of the economy has taken precedence over people's health.

If we do not respond to our basic needs (physical and economic security, affective linkage, personal fulfilment, meaningful work. equal treatment and respect) we will have little welfare. Consumerism is not only not useful in solving this discomfort, it is also harmful because it distances us from what would truly enrich our lives.

When a group understands and becomes aware of the causes of its problems, social and political action is made possible. The medicalized approach, however, dissolves the collective experience, extracting our discomfort of social and shared origin, applying it to dysfunctions that are situated in the individual self. Political tribes become diagnostic tribes because we begin to identify with a group related to a particular mental illness. Our suffering is deactivated politically. The emphasis is placed on the individual self, rather than on social reform, and individualistic therapies accentuate it.

In Davies’ words, “most mental illnesses have psychosocial origins. This does not mean that we can reduce all causes of mental illness to inequality or any other particular social factor. You can't say that our biology doesn't influence our social and psychological lives. It means that social determinants must be central to the interpretation and management of our mental suffering. That is why we must put the world and everything that happens in it at the centre of our work. This requires mentally healthy social policies. We must ensure that all our interventions incorporate a sociological perspective. As Michael Marmota, one of the most illustrious public health professors in the UK, says, "We need to build a society based on the principles of social justice that reduces income and wealth inequalities, and that builds a welfare economy at the heart of the government's strategy, replacing blind economic interests with well-being and health."

James Davies highlights in his book the words of Lithuanian psychiatrist Dainius P?ras (UN special rapporteur on the right to physical and mental health from 2014 to 2020). In fact, when psychologists are asked what's going on, 90 percent say the problem is a lack of resources. Dainius P?ras, however, states that the main problem is not the lack of resources, but the correct reorientation of expenditure to address the social causes of discomfort and to implement effective psychological and social interventions.

According to Fr., the austerity policies implemented since 2008 have accentuated the factors that worsen mental health: social fragmentation, inequalities and social isolation. If governments do not oppose these social determinants of suffering, biomedical and individualistic treatments increase, poor mental health outcomes will worsen.

The UN rapporteur has his recipe for improving things: policies that will address the social roots of suffering, a fairer tax system, more unionization of workers, better social benefits, more community protection and reduction of inequalities and social exclusion. “We must focus on relationships, not on the brain: bringing people together, demedicating discomfort and addressing problematic social and environmental causes.”

Reading the book shows that the problem of mental health is a win-win-win strategy for capital: not only do the conditions that cause discomfort (individualism, consumerism, depoliticization) occur, but they are enriched with medicalized remedies and the collective response with insanity. In the end it is true that the only problem we have is capitalism with all its surnames.

Unai Oñederra