Rethinking Psychiatry: Call for Transition to Social Rather Than Biological Treatments

Are psychiatric disturbances social in nature rather than biological?

Why does a physicist routinely write about psychiatry? Well, I don’t know for sure, but I guess that, once you have embraced a post-material perspective, you develop a very different sensitivity to some topics that wouldn’t mean much otherwise.

This paper by psychiatrist Helena Hansen, Kevin J. Gutierrez, and Saudi Garcia deeply resonates with me because it looks at mental health from a very different perspective than the traditional biological or mere individual psychological approach by including the historical collective trauma. It sounds so obvious to me that I wonder why we all don't see this. The past and present colonial history, with its oppression, slavery, and economic injustices that was perpetrated for centuries created a huge and widespread generational trauma that is nowadays reflected in mental illness throughout the Native American, Black, and Latinx communities.

It is about going toward a future able to step beyond the stagnant brain-centered materialistic understanding of psychiatric research “shifting the discourse from an in-out (a person’s internal psyche/brain is broken, causing maladaptive emotions and behaviors) to an out-in model (the social and institutional constructs are affecting the person even at the biological level).” It is time to recognize how the social environment influences brain development as well.

I will not try to go into the details here and leave this to more competent people than me.
For the original research article see here.
For a summary see here.

Some quotations are worth of being highlighted.

“U.S. psychiatry is often a source of inequality and iatrogenic harm, operating within a profit-driven health care system that makes mental healthcare inaccessible and low-quality even for the white middle class, while clinically supporting police surveillance and mass incarceration in low-income Black and Brown neighborhoods. Psychiatry anchors a medical-prison-industrial complex in which interlocking health care and criminal-legal systems privilege corporate profit-making, and in which the only place Americans are guaranteed mental health services is in jails and prisons. An estimated ten times more people with serious psychiatric diagnoses are incarcerated in prisons than in the remaining state mental hospitals of the United States, making the carceral system the largest provider of public mental health care in the country.”

“In this essay, we translate insights from Fanon and standpoint theory to recommend that U.S. psychiatry look to movements of socially and politically marginalized people for examples of sociogenic mental health. People who have survived oppression have embodied social-structural knowledge; they have had to resist the toxic ethos of social division and economic extraction. Their techniques redefine mental health away from individual fitness in a social Darwinist dystopia, toward a vision of collective healing through mutual aid.”

“Here we offer descriptions of three sociogenic mental health movements that contrast with American psychiatry and are based on our collective participant observation data. These movements work to restore justice rather than reinforce social inequality. They foreground the knowledge and techniques of people who have survived marginalization and existential threats, rather than pharmaceutical and health insurance company–generated treatment protocols. They honor historical memory and ancestral solutions to health problems rather than patented intellectual property as marketable “innovations.” They prioritize ecological sustainability over expanding markets for mass-manufactured consumables. Last, they forgo pathology-focused disease in favor of hopeful structures of feeling–styles of affect that emerge at a historical juncture–generated by collective practices.”

What I expect is that, since the authors include art therapies, ‘energy-based’ and massage-based therapies, Reiki, nutritionism, gardening, acupuncture, healers, and yogis, is that the physicalists will reply with a loud “no, no, no.” But, they should only blame themselves if people perceive their biological-based therapies as something that couldn’t go beyond a modern form of ‘pharmacological alchemy’ that after decades of trial and error didn’t make much progress.