The Americanization of Mental Illness
This article, a summary of Watters’s book, “Crazy Like Us: The Globalization of the American Psyche,” lays out how the U.S. has Americanized the world’s understanding of mental health and illness. While medical and health professionals aim to be “scientific” and objective in their understanding of mental illness, Watters provides evidence that all understanding of mental health is determined by specific cultural understandings and by the ethos of particular times and places.
“For more than a a generation now, we in the West have aggressively spread our modern knowledge of mental illness around the world. We have done this in the name of science, believing that our approaches reveal the biological basis of psychic suffering and dispel prescientific myths and harmful stigma.”
“Modern-day mental-health practitioners often look back at previous generations of psychiatrists and psychologists with thinly veiled pity, wondering how they could have been so swept away by the cultural currents of their time.”
The West has pushed “mental-health literacy” on the rest of the world, encouraging them to adopt Western biomedical conceptions of diseases like depression and schizophrenia. This theory suggests that mental illness should be treated like “brain disease” over which the patient has little choice or responsibility. Although the goal of pushing “mental-health literacy” was to decrease stigma for sufferers of mental illness, the reverse has actually been the case, and Watters lays out a number of studies that prove that stigmas have increased.
Watters also lays out evidence that Western style “mental-health literacy” as well as its connected treatments are also generally less effective at “treating” mental health problems than traditional socially accepted interventions and ministrations that keep the ill person bound to the family and kinship group. The research showed that schizophrenia patients outside the U.S. and Europe had significantly lower relapse rates– as much as two-thirds lower in one follow-up study.
“These Western ideas of the mind are proving as seductive to the rest of the world as fast food and rap music, and we are spreading them with speed and vigor.”
“All cultures struggle with intractable mental illnesses with varying degrees of compassion and cruelty, equanimity and fear. Looking at ourselves through the eyes of those living in places where madness and psychological trauma are still embedded in complex religious and cultural narratives, however, we get a glimpse of ourselves as an increasingly insecure and fearful people. Some philosophers and psychiatrists have suggested that we are investing our great wealth in researching and treating mental illness– medicalizing ever larger swaths of human experience– because we have rather suddenly lost older belief systems that once gave meaning and context to mental suffering.”
“If our rising need for mental-health services does indeed spring from a breakdown of meaning, our insistence that the rest of the world thinks like us may be all the more problematic. Offering the latest Western mental-health theories, treatments and categories in an attempt to ameliorate the psychological stress sparked by modernization and globalization is not a solution; it may be part of the problem. When we undermining local conceptions of the self and modes of healing, we may be speeding along the disorienting changes that are at the very heart of much of the world’s mental distress.”