Mental health seem to be increasingly in the news much more so than twenty or thirty years ago when they were seen merely as pathologies.

When it was discovered that many diseases were caused by bacteria and viruses there were public health initiatives which decreased their incidence by focusing on sanitation - clean water, food and hospitals. These have been very successful - so successful that we take them for granted now.

Mental health is, on the face of it, very different from this. There is no pathogen for example. Despite this, is it still possible to draw an analogy here? I mean can we think of mental health being amenable to the same thinking: That there could be public health initiatives that drives down the incidence of mental illness in body public?

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    I understand, I think, that you are talking about true initiatives; something proactive. This might work in smaller and medium communities, but it is bound to stir things up. E.g. In a model like Maslow's Hierarchy of Needs, food and shelter must be provided first. If a person, for instance, has been homeless for a long time they will need shelter and stability before treatment will work.
    – Gordon
    Jan 28, 2018 at 2:35
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    Btw there may be pathogens involved. Here is an article about cat ownership and schizophrenia. :) (T. Gondii) m.huffpost.com/us/entry/7538240 I read somewhere that this theory is now in doubt. I am not really sure of the current status of the research.
    – Gordon
    Jan 28, 2018 at 14:02
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    There are not pathogens, but there are precipitating traumas and structural predispositions. One can look at legalizing abortion as a public health measure for mental health issues. The liberal argument, somewhat validated by statistics on political instability and demographics, has often been that criminality decreases when there are fewer unwanted male children reaching their mid-teens. The Freakanomics people trace the bulk of the reason for our most recent crime trend -- the peak of crime in the 90's having fallen to historic lows -- to the timing of Roe vs Wade.
    – user9166
    Jan 28, 2018 at 22:55

2 Answers 2


I am writing from a U.S. perspective. This actually goes back a long time. The Jimmy Carter Administration tried to introduce a public health model, here: "Rather, the change of terms was based on the application of a public health model that emphasized the role of the environment, social services, and prevention rather than the traditional psychiatric focus on the diagnosis and treatment of severe and persistent mental disorders." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690151/#!po=8.46774

During the Reagan administration, Carter's legislation was repealed and a system of block grants was instituted, many public psychiatric residential facilities were closed down; many of these people migrated to the streets and public libraries, so we had librarians acting as "psychiatric nurses". It was a complicated issue because the public long-term residential facilities for the mentally ill were not that great, many people were simply tranquillized and put to bed; so the Reagan Administration was not completely wrong, but they just shifted the problem as I mentioned above to the streets and to inner-city libraries. At any rate, deinstitutionalization was already under way when Reagan took office, timeline: https://www.motherjones.com/politics/2013/04/timeline-mental-health-america/

Karl Mannheim had some good ideas after WWII. (1950) His book is interesting: Freedom, Power and Democratic Action. There is an old review of this book by Commentary magazine on the web.

Of course times were good and no one listened to Karl Mannheim after the war, certainly not in the United States. No one wanted to plan for a better society.

What do we call these things we have in the U.S., mass shootings? This started to my memory with Charles Whitman at U. Texas (1966). Elton John has a song, "Ticking" (1974). "It may be that lyricist Bernie Taupin was inspired by the Whitman shooting, albeit indirectly." (Songfacts)

Might things get better if we let things get worse? Oddly, yes. Maybe we will finally wake up as the madness increases. As it stands now the short attention span of the public and the media acts to push the latest violent incident under the rug.

In the meantime, who wants to take a bullet from one of these shooters? How does nihilism factor into this? We know today that many of us, not all of us but many of us, are postmodern individual monads without community. No religion and no replacement for religion. No overarching narrative. Loneliness. We can't seem to get on the same page. The only narrative we have is Star Wars and I lost interest at part II, whatever it was. I forgot Batman. He must be mentioned. Of course some philosophers think it's a good thing that we don't have a meta-narrative, because it is a form of dominance, an exercise of power over the masses.

Foucault wrote about mental illness and power. Erich Fromm had some ideas. Even Konrad Lorenz in his later works spoke about where man was headed. I must also mention Allen Wheelis, "The Way We Are", 2006. Many others. The problem is with society, and to fix things means to stir up society. For the time being some people can hide away in gated communities, and enjoy the benefits of "security". I think they are fooling themselves.

I do think what the OP suggests regarding mental health would work in small and medium communities as long as they were given money and allowed to do their own planning. However, in the long run we must face up to what this quote suggests:

"It is no measure of health to be well adjusted to a profoundly sick society." Jiddu Krishnamurti


Physical diseases can have physico-chemical causations. Could such causations not explain at least some of the conditions, such certain forms of depression, that are widely regarded as mental illnesses ? A person's depression might be due to chemical imbalance in respect of dopamine, serotonin or norepinephrine.

If this is so, the absence of bacteria or viruses to explain mental illness doesn't relegate mental illness to a pseudo-condition or prevent a genuine parallel and continuity between physical and mental health.

The status of mental health - or mental illness - as a genuinely scientifically recognisable condition has classically been challenged by Thomas S. Szasz, M.D., 'The Myth of Mental Illness' (1961) and 'The Manufacture of Madness' (1970). Old texts, I know, but still pertinent.

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