Mental health - again!

I know that this is a highly contentious subject but I just cannot understand why it is now proposed that Australian schools should be provided with “mental health and wellbeing counsellors”.

These are children growing up in a fractured world with raging hormones just trying to “fit in”! 

Now don’t get me wrong! I am fully aware of the indisputable fact that there are many mentally distressed people who are in desperate need of help and support. My “beef” is with how this distress is diagnosed, categorised and finally the efficacy of any treatment offered. 

Firstly, let it be known, and widely known, that there is no consensus or definition of “normal”. What is a “normal” human being? There are roughly 7.2 billion people alive today. That means there are roughly 7.2 billion different people going about their lives, doing different things and behaving in different ways. Does this mean there are roughly 7.2 billion different ways of being “normal”?

Please tell me!

Then we come to the diagnosis of “mental illness”. A popular “diagnostic tool” is the HONOS – Health Of Nations Outcome Scale (please check this on line if you doubt me). Now this scale, as with any others used to “diagnose” a patient’s mental health, and there are plenty of them, is purely subjective. It is a “tick a box” exercise. Using this HONOS each question – there are twelve of them – must be rated 0 to 4. More than a previously determined “score” and you are diagnosed as depressed, schizophrenic, psychotic – or whatever and in need of help. 

Ok. When that is done – what now?

The important question now arises - what is the cause of any distress?

The answer? Nobody knows. Simple. There are plenty of, “the inference is”, the assumptions are”, “there is hope that further research will determine”, etc, etc….!

Again let it be known, and widely known, that there are no objective tests, no biological cause – no blood tests, no fMRI tests (functional Magnetic Resonance Imaging), no genetic link, and particularly no causal link between an apparent “symptom” and the distress evident in the presenting patient. The symptoms enumerated in the DSM5 (Diagnostic and Statistical Manual version 5 of the American Psychiatric Association –APA), used world-wide, were agreed by a committee.

The simple fact is that the “etiology” - the cause – of most mental disorders (Huntingdon’s and Alzheimers disease are more or less determined) are not understood enough to accurately distinguish the “mentally ill” from the rest of us.

Now we enter the minefield of the treatment of “mental illness”. The fall back position of psychiatrists and clinical psychologists is to consider a “mental illness” as a biological condition and treat it as such with a perfect cornucopia of psycho-pharmaceutical drugs produced by “big pharma” to their enormous profit. There is limited evidence regarding the efficacy of these drugs compared to other treatments (“Big Pharma” are very reluctant to release any research that does not support their advertising). Furthermore the side effects – heightened risks of metabolic disorders, rapid weight gain, diabetes, sexual disfunction and heart disease for instance – are carefully sidelined.

That some people do derive benefit from these drugs cannot be denied. They do. But these drugs never “cure” – they are a stop-gap offered to often desperate patients by medicos “stumbling in the dark”.  Often a “suck it and see” approach is applied – “Try this one. If that doesn’t work, try this at double the dose”, kind of thing. But then again, many people get better on their own or feel better with a placebo (sugar pill).

So – to get back to my opening statement about treating school children - until we know the CAUSE of the obvious mental distress experienced by some patients, how can anyone determine, with any certainty, what treatment should be offered? 

Finally I will repeat a quote, from the Indian sage Jiddu Krishnamurti (1895-1986), who said, "It is no measure of health to be well adjusted to a profoundly sick society".

There we have it in a nutshell!

Mental health, surveillance, controls and us.

Amended September 21, 2018.
This is another post from some years ago that is, I feel, particularly relevant today with the news that China is using millions of CCTV cameras (with face recognition software) to keep tabs of all citizens. Those who are seen to follow the "Party Line" earn "Social Credits" and are allowed to travel both within and outside China, for example. There are many more social activities that you or I would consider normal that are denied those with a low "Social Credit" score.


Today, when we are deluged with advertising exhorting us to buy this or that product, to follow this or that cause, to do this or that because “you deserve it”, how many of us actually know what we like or even who we are? Certainly advertising is useful – in its place. But when we reach a stage of believing everything we are told – by someone who certainly does not have our best interests in mind – I think we are in trouble. How can anyone know what I need, or want, or should do? They (whoever “they” may be) may generalise and say that statistically most people do this or that or the other thing. But when “they” try to apply their generalisations to me (or you) it becomes an opinion, because they don’t know my (or your) specific attributes and needs.

The thing is that it is so easy to follow what others do. There is comfort in knowing that we conform to what the group or society is doing (whether this is right or wrong). I suppose it is that same sort of comfort afforded to a herd of gazelles about to be attacked by a lion. There is comfort in numbers – an individual gazelle’s chance of being eaten by the lion is in inverse proportion to the size of the herd – a relatively small chance. Many of us may unconsciously try to comply with the same herd instinct. I am not sure that this is, generally, in our best interests. To revert to the example of the gazelles, each gazelle conforms to the characteristics of their kind – all are of a similar colour and size. Human beings, on the other hand, are not all of one colour or one size, and what are are the characteristics of our kind? We have attributes and characteristics derived from ALL animals – we live, survive and seem to thrive in every climatic and environmental condition.

So where does this leave us human beings? We have a propensity to conform – it is so easy to do so. There is no need for us to think for ourselves. Someone (who we presume must know better than us) tells us what to do because it is deemed to be best for us (as individuals). On the other hand it is a human requirement that we each grow and develop in our own individual way for our own individual purposes. We each learn from and react to experiences and circumstances in our own unique way. We are not clones. We each, in our own way on our journey through life, add to the sum of human knowledge. This is as it should be because in this way humanity benefits. There will certainly be ups and downs, positives and negatives in this journey and with the knowledge we gain in this process. But again this is as it should be. How else can we learn?

This gets me back to where I started from – other people telling me (or us) what to do. Rather than being told what to do, there is I believe a (possibly unconscious) covert move to influence us in other ways. Why are there so many surveillance cameras in most major cities? I believe it is because the authorities (whoever they are) want us to believe that we are under constant surveillance by some unseen authority. In this way it is hoped that we “internalise” this sense of being observed and alter our behaviour. This is a form of power whereby physical control is switched from the old concept of chains, to self control through the fear of not knowing for certain whether or not we are being observed. This uncertainty will change the way we think of ourselves as citizens by introducing the element of fear which leads us to “conform” to some vague, undefined, pattern of behaviour.

Ostensibly the surveillance is to identify criminals, and one has to admit it is useful in this regard. However are we to submit to some Government ill defined “greater good”, which limits individual freedoms? By freedoms I do not in any way suggest that we can or should do what we like. Not at all. Paradoxically, because we, as individuals, always hold to the core belief that we are good, any attempt to expose activity to the contrary (i.e. by surveillance cameras) is met with an element of anxiety – no one wants to be shown up to be less than their own idea of who they are. This aside, any constraint on our ability as individuals to express ourselves as we see fit has, I am sure, unforeseen consequences. The fundamental law of life – the law of cause and effect, may be forgotten but can never be avoided. Ethics, morality and values (both personal and cultural) must be adhered to.

Stress and anxiety are known to be precursors of a variety of mental problems as defined by the Psychologists “Bible” – the American Psychiatric Association’s Diagnostic and Statistical Manual  – DSM5. It is possible, even probable, that the elements of stress and anxiety brought about by this background of constant surveillance is instrumental in the, verified, higher incidence of schizophrenia in cities as compared to rural areas.

In high density urban environments we are constantly pulled and pushed by conflicting demands – we need to maintain certain standards of behaviour (on the surface at least) to keep peace with neighbours; we have a desire to maintain living standards and to have certain material goods to satisfy our children and to “keep up with the Jones’”; we are aware that we are constantly being observed by our neighbours for any transgressions. Thus we are forced to conform to standards that are not of our making and which may conflict with our individual values and moral standards. To have added to this the knowledge that we are under constant CCTV surveillance is an additional level of stress.

This does bode well for our peace of mind.

Maybe the Chinese Authorities should recall that some twenty-seven centuries ago the Chinese philosopher Confucius stated that:

"If you govern people by laws, and keep them in order by penalties, they will avoid the penalties yet lose their sense of shame. But if you govern them by your moral excellence, and keep them in order by your dutiful conduct, they will retain their sense of shame, and also live up to this standard."