{"id":6591,"date":"2018-06-03T17:02:50","date_gmt":"2018-06-03T17:02:50","guid":{"rendered":"http:\/\/www.dannydorling.org\/?p=6591"},"modified":"2022-09-19T21:37:46","modified_gmt":"2022-09-19T21:37:46","slug":"mental-distress-has-external-causes","status":"publish","type":"post","link":"https:\/\/www.dannydorling.org\/?p=6591","title":{"rendered":"Mental distress has external causes"},"content":{"rendered":"<p>To better tackle mental illness, look to the societies in which it occurs.<!--more--><\/p>\n<p>The enjoyment of the highest attainable standard of physical and mental health is a human right. That\u2019s according to the Office of the <a href=\"http:\/\/www.ohchr.org\/EN\/Issues\/Health\/Pages\/SRRightHealthIndex.aspx\" target=\"_blank\" rel=\"noopener\">United Nations High Commissioner<\/a>.<\/p>\n<p>Few <em>Prospect<\/em> readers would argue against human rights. But we usually view health, particularly mental health, as an individual affair, seeing it only as an internal state. In truth we are all greatly influenced by wider society.<\/p>\n<p>When large numbers of people become unwell, we need to <a href=\"https:\/\/www.theguardian.com\/society\/2016\/jun\/15\/growing-numbers-of-children-have-type-2-diabetes-figures-show\" target=\"_blank\" rel=\"noopener\">look beyond biology<\/a> and consider what is happening at the societal level.<\/p>\n<p>In their new book <a href=\"https:\/\/www.equalitytrust.org.uk\/inner-level\" target=\"_blank\" rel=\"noopener\">The Inner Level<\/a>, Richard Wilkinson and Kate Pickett reflect on the social factors influencing mental health. <a href=\"https:\/\/www.amazon.co.uk\/Inner-Level-Societies-Everyones-Wellbeing\/dp\/1846147417\" target=\"_blank\" rel=\"noopener\">They reveal<\/a> that the incidence of mental illness in the UK is twice that in Germany. Americans are three times more likely than the Dutch to develop gambling problems. The mental health of children is <a href=\"https:\/\/www.theguardian.com\/books\/2018\/jun\/03\/is-rising-inequality-responsible-for-greater-stress-anxiety-and-mental-illness-the-inner-level\" target=\"_blank\" rel=\"noopener\">worse in New Zealand than it is in Japan<\/a>.<\/p>\n<p>Wilkinson and Pickett examine the effects of living in such different societies. And this <a href=\"https:\/\/www.penguin.co.uk\/books\/188607\/the-inner-level\/\" target=\"_blank\" rel=\"noopener\">new understanding<\/a> of powerful societal influences chimes with much other recent work.<\/p>\n<p>People working in separate disciplines are coming to the same conclusion: that our social worlds impact on us, they can give us health or cause us harm. <a href=\"http:\/\/www.ohchr.org\/EN\/NewsEvents\/Pages\/DisplayNews.aspx?NewsID=21689\" target=\"_blank\" rel=\"noopener\">As the UN puts it<\/a>, \u201c<em>mental health policies and services are in crisis\u2014not a crisis of chemical imbalances, but of power imbalances. We need bold political commitments, urgent policy responses and immediate remedial action.<\/em>\u201d This <a href=\"http:\/\/ap.ohchr.org\/documents\/dpage_e.aspx?si=A\/HRC\/35\/21\" target=\"_blank\" rel=\"noopener\">recent report<\/a> calls for a shift from biomedical models of mental distress to a more radical, human rights-based approach, acknowledging the impacts of social inequality.<\/p>\n<p>Another <a href=\"http:\/\/: https:\/\/www1.bps.org.uk\/system\/files\/user-files\/Division%20of%20Clinical%20Psychology\/public\/INF299%20PTM%20Main%20web.pdf\" target=\"_blank\" rel=\"noopener\">recent report<\/a> published by the British Psychological Society, \u201cThe Power Threat Meaning Framework,\u201d looks at the contextual factors which may make us sick. PTM acknowledges power inequalities and the impact of oppression. Being on the wrong side of power can lead to feelings of entrapment, shame and humiliation, as well as a sense of lacking control.<\/p>\n<p>The framework highlights links between \u201c<em><a href=\"https:\/\/www1.bps.org.uk\/system\/files\/user-files\/Division%20of%20Clinical%20Psychology\/public\/PTM%20Summary.pdf\" target=\"_blank\" rel=\"noopener\">poverty, discrimination and inequality, along with traumas such as abuse and violence, and the resulting emotional distress or troubled behaviour<\/a>.<\/em>\u201d <a href=\"https:\/\/www.blackburn.gov.uk\/Pages\/aces.aspx\" target=\"_blank\" rel=\"noopener\">Adverse childhood experiences<\/a> have a negative impact on health and wellbeing, for example.<\/p>\n<p>Both The <a href=\"https:\/\/www.theguardian.com\/books\/2018\/jun\/03\/is-rising-inequality-responsible-for-greater-stress-anxiety-and-mental-illness-the-inner-level\" target=\"_blank\" rel=\"noopener\">Inner Level<\/a> and PTM reframe the narrative around why people get sick\u2014refocusing the question from \u201cWhat\u2019s wrong with this individual?\u201d to \u201cWhat\u2019s going wrong in this society?\u201d<\/p>\n<p>Whilst these new ways of thinking are works in progress, they open up new vistas. There is a renewed possibility of collaboration between geographers, sociologists, psychologists, public health and local communities to really understand the pathways from oppressive inequality to ill health.<\/p>\n<p>But as Wilkinson and Pickett say, \u201c<em>Change on the scale needed\u2026 can only be achieved if large numbers of people commit themselves to achieving it.<\/em>\u201d And as they conclude in a recent <a href=\"https:\/\/www.theguardian.com\/books\/2018\/jun\/03\/is-rising-inequality-responsible-for-greater-stress-anxiety-and-mental-illness-the-inner-level\" target=\"_blank\" rel=\"noopener\">newspaper interview<\/a>: &#8220;It is clear that differences in cognitive development and intelligence are the consequence of inequality rather than its cause.&#8221;<\/p>\n<p>That is a call to action, and we need to rise to the challenge for the sake of a <a href=\"https:\/\/thepsychologist.bps.org.uk\/volume-30\/september-2017\/un-report-points-power-imbalances\" target=\"_blank\" rel=\"noopener\">healthy and sustainable future<\/a>.<\/p>\n<p><strong>The original article by Danny Dorling and Khadija Rouf that this post is based on was published in Prospect Magazine on June 1st and is available <a href=\"http:\/\/www.dannydorling.org\/?page_id=6584\" target=\"_blank\" rel=\"noopener\">here<\/a>. The Book, &#8216;The Inner Level&#8217;, is available <a href=\"https:\/\/www.guardianbookshop.com\/inner-level.html\" target=\"_blank\" rel=\"noopener\">here<\/a><\/strong><\/p>\n<div id=\"attachment_6592\" style=\"width: 630px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-6592\" class=\"size-full wp-image-6592\" src=\"http:\/\/www.dannydorling.org\/wp-content\/files\/The_Inner_Level.jpg\" alt=\"\" width=\"620\" height=\"997\" srcset=\"https:\/\/www.dannydorling.org\/wp-content\/files\/The_Inner_Level.jpg 620w, https:\/\/www.dannydorling.org\/wp-content\/files\/The_Inner_Level-187x300.jpg 187w\" sizes=\"auto, (max-width: 620px) 100vw, 620px\" \/><p id=\"caption-attachment-6592\" class=\"wp-caption-text\">The Inner Level: How More Equal Societies Reduce Stress, Restore Sanity and Improve Everyone\u2019s Wellbeing by Richard Wilkinson and Kate Pickett (2018)<\/p><\/div>\n","protected":false},"excerpt":{"rendered":"<p>To better tackle mental illness, look to the societies in which it occurs.<\/p>\n","protected":false},"author":1,"featured_media":9230,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"footnotes":""},"categories":[19],"tags":[],"class_list":["post-6591","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=\/wp\/v2\/posts\/6591","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=6591"}],"version-history":[{"count":3,"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=\/wp\/v2\/posts\/6591\/revisions"}],"predecessor-version":[{"id":9231,"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=\/wp\/v2\/posts\/6591\/revisions\/9231"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=\/wp\/v2\/media\/9230"}],"wp:attachment":[{"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=6591"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=6591"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=6591"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}