Mental illness isn’t caused by capitalism. Would access to care be better under the utopian system the book advocates? Of course— it’s a utopia! Except that the authors don’t actually seem to believe in mental illness as such (or so I gather from a perusal of the “Death Panel” podcast). In it’s failure to accept the tragic reality of organic mental illness, or the desperate need for skilled medical treatment by professionals whose care is based on a combination of extensive training, experience, wisdom, compassion and evidence based medicine (I.e.psychiatrists!) they remind me of the Christian Science promise that illness can be cured by faith.

Putting energy into making Medicare for All a reality makes sense to me, but conjuring a prelapsarian vision of bottomless abundance of care on demand (much of which would presumably not actually be necessary, since capitalism causes illness) just seems quixotic. I wish people with good brains and hearts like these writers would address those hearts and minds to the problems on the street. I dare say it is harder to spend time caring for the seriously ill than to work in the elevated realm of political theory. Also, the painfully familiar anti- psychiatry talk is upsetting to me, both as the mother of an adult with SMI and as someone with a decades long chronic illness myself (and who lived with untreated depression for many years before the advent of SSRIs).

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I haven’t listened to the podcast but the book doesn’t make claims that mental illness is caused by capitalism or that mental illness has no physical basis. In fact, they explicitly challenge the “myth of mental illness” style antipsychiatry arguments. More on this in part 2.

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I also think we should accept that we know very little of how much debilitating mental illness we'd have in a much better society than the present one.

I used to think, for my own part, that surely everything was down to a fucked-up brain. Even though I accepted that external factors might have contributed to my brain getting fucked up once upon a time, I thought okay, NOW it is what it is, this is a MEDICAL problem now. I would get PISSED OFF at people who pushed the social model of disability, psychiatric conditions included, really hard. I'd be like you do you, but don't you try to push that ON ME, because my problem really is medical, it really stems from inside my head, not from society. And I can tell, because hey, it's MY mental illness and MY brain we're talking about!

I was extremely surprised, shocked even (but in a good way), when it turned out that better circumstances made such a MASSIVE difference. That I could improve so much, and go from completely fucked up and mentally ILL to more of a weird and neurodivergent but ultimately okay person.

That's just my individual story. But there's also all this resesarch on poverty and mental illness, stress and mental illness, trauma and mental illness, etc. Ultimately, I think we have NO idea how good things could get on a population level. No, I don't think any kind of (realistically possible) society would make mental illness completely disappear. But neither should we confidently talk about how the frequency will always be the same, even though we could give better care to the unfortunate souls who suffer from it. I think we have no idea, really, how good things could get - what the upper limit is on "population-level mental health".

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This sounds really interesting.

So presently we have all this gatekeeping of treatment, of disability support, etc. And we see over and over how politicians (or, I guess, in the US insurance companies) think there are too many ill and disabled people, too many people getting treatments and/or special support, and it's getting too costly. So they narrow the gates until fewer and fewer people get in, even though that means shutting out people who ARE entitled to treatment and special support according to the laws and the rules.

It seems a common reaction to think that if someone who's entitled to treatment and special support according to the laws and the rules doesn't get it, there must be some MISTAKE that will be corrected if only we point it out to the right people. But it's an inherent part of the system that things work like this!

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