On the Concept of “Mental Illness,” the Harms of Psychiatric Labeling, and the Most Unrecognized, Oppressed Minority Group in America


Over the past thirty years, we Americans have been industriously exporting our ideas about mental illness… [And] how a people in a culture think about mental illnesses—how they categorize and prioritize the symptoms, attempt to heal them, and set expectations for their course and outcome—influences the diseases themselves. In teaching the rest of the world to think like us, we have been, for better and worse, homogenizing the way the world goes mad… In the end, all mental illnesses, including such seemingly obvious categories such as depression, PTSD, and even schizophrenia, are every bit as shaped and influenced by cultural beliefs and expectations as hysterical leg paralysis, or the vapors, or zar, or any other mental illness ever experienced in the history of human madness.”

-ETHAN WATTERS, from Crazy Like Us: The Globalization of the American Psyche 

As some of you know, I was profiled last week, along with two other “inspiring creatives,” by MATTERNCO, where I wrote about how I want to help change the way society views and treats the “mentally ill.” One quote in particular spurred a rather heated response from a friend. What I said was:

I want to show that ‘mental illness’ has a lot more to do with a sick society than a sick mind… Just as there are different shades of skin color in our society, so there are different varieties of minds. This does not diminish the fact that some people… [are] in [intense] psychological pain, and can hurt themselves as they try to cope with their invisible battle. And that these people – including me – need help. But society also needs to not treat us as third-class citizens lacking the insight, intelligence, or capacity to still fully function and have a voice in society.” 

Responded my friend: 

I have to admit that I was shocked to read that you don’t believe that mental illness exists!  Do you not believe that PTSD or schizophrenia are illnesses? From my vantage point as a [Deputy] D.A. I have seen so many cases where people hurt or kill people in the most horrific ways because they felt compelled to do so by voices or paranoia– wouldn’t you say this is per se mental illness?

First, with all due respect to my friend, I’m not quite sure how he/she interpreted my words to imply I don’t believe some people in the world struggle with various forms of mental distress of a serious and uncontrollable nature. Particularly since I happen to be one of these people. What I was trying to state – maybe not as effectively as I thought – is that while there are some biological (hence uncontrollable) roots to “mental illness,” society is just as much a culprit. What most people don’t realize is that how we identify, label and talk about mental health throughout the world is significantly culturally scripted. As psychiatric anthropologist Juli McGruder (more on her to come) put it: “What we say about mental illness reveals what we value and what we fear.”And in America, in particular, what we say about mental illness often results in the stigmatization, dehumanization, and oppression of the “mentally ill.” The mentally ill are the last minority group it’s completely ok to discriminate against – and nobody even realizes it, much less acknowledges it.

As I made clear – or so I thought – by my constant use of quotes surrounding the term “mental illness,” is that my problem is with how we label and define – not the existence of – mental illness. In other words, it is a primary mission of my writing to change the way we talk – and therefore view – those unfortunate enough to be permanently branded as “mentally ill” in America. Particularly the 6 percent of us who experience chronic and severe “mental illness,” and therefore bear the primary burden of the prejudice associated with that label.

I find it particularly unsettling that my friend – who, please don’t get me wrong, is a very good, supportive and compassionate friend, has the best of intentions, and as a deputy D.A. has seen a lot of horror that I have not – immediately jumped on the “The-mentally-ill-are-more-prone-to-commit-extreme-violence” bandwagon. This is one of the most incorrect and damaging stereotypes my minority group is afflicted with today. In fact, people battling mental health issues are no more likely to be violent than anyone else, according to the U.S. Department of Health and Human Services (you can visit this fact sheet on mentalhealth.gov to see this stat, as well as the truth behind other common myths surrounding mental disorders). Only 3 – 5 percent of violent acts are associated with people with severe mental illness. Actually, it’s the opposite that is true – people with severe mental illness are more than ten times likely to be victims of violent crime – rather than commit them.

Whenever a violent act such as the recent school shootings in Seattle occur, the first thing you hear from the media is, “What was wrong with this kid? We need more mental health resources! What were the signs? What mental disorder did this kid have?” Everyone was befuddled, of course, by Seattle’s particular scenario – lo and behold, a perfectly “normal” kid, it appears, committed this act. Apart from the fact that this supports the statistic I just noted above, it also highlights what the media never asks but should be asking: maybe it was a toxic society and its impossible standards – not a defective brain – that tipped this boy over the edge. I’m not justifying what he did, of course. I’m just saying, why is it America where mass school shootings occur now, on almost a monthly basis – and not anywhere else?

And then my friend also had to bring up the “schizophrenia” argument. Well, that was a bad call. Because guess what? It turns out I happen to know a lot about just how “relative” the diagnosis and behaviors of those labeled “schizophrenic” is, and that how they fare over the long-term is also significantly influenced by culture throughout the world. 

The reason I know this is – unlike most people who have the platform upon which to frame the discourse about mental illness in America today – I’ve done A LOT of research on the labeling,

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  1. Diane R. Anderson says:

    Good morning Jeanene,
    I am eager to read your entire article and I copied it into Words so I can have it with me at all times even when there is no internet access for me here.
    I did read the first page quickly and the last paragraph… My heart felt and my eyes are crying for the pain that you are going through. You are a wonderful writer and you have a lot to offer that the world sees and recognizes it or not. It takes more courage to fight and that is what you are doing right now. You have started a fight for you and to help others by making this disease more visible. Scientists can go to the moon but can’t figure out the intricacy of the human brain to cure mental illness. I can’t wait to dig further with you in understanding the dimension, the fears and the nutritional effects that could make a small difference.
    Always listening,

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  3. Jeanene, Just because we choose not to call it “mental illness” doesn’t mean we don’t believe the suffering exists. Your friend was using faulty logic. You did not state, “People aren’t really suffering.” What you did state, and I do too, is that we choose not to call this “illness.” We don’t deny the existence of suffering. As I said in my blog post, calling it “illness” actually diminishes our recognition of suffering, boxing us into categories and pre-determined “treatment.”

    As for the discrimination against ED, I see that everywhere. It even exists in the Movement. How many times have I heard, “My bipolar was real. Your eating disorder was a choice.” So a manic person doesn’t “choose” to waste thousands of dollars on a plane ticket to Hollywood, thinking he/she is having a love affair with a movie star due to either “I can’t help it it’s my illness” or “It’s not an illness but I was really suffering.” Either way, calling it “illness” or not, ED gets left between the cracks.

    Yes, ED impacts us physically and is often caused by something amiss in the body. How often have I heard, “After 20 years, I found out the cause was a food allergy.”? Or, “My kid wouldn’t eat, but we found out he had dental problems that made it impossible to chew.” The treatment centers don’t even address these things. They don’t care what the cause is, they only force-feed and monitor every function of the human body as if we are caged animals.

    I suffered from both anorexia and binge eating. The binge eating went ignored in the treatment center and the focus was on forcing food, or even fake food, into me. They assumed the binge eating came from hunger. If only they’d listen to patients and realize that it doesn’t. In fact, I’ve had uneducated doctors and well-meaning friends state that it’s good to binge because it puts weight on a person.

    Say, what? Is no one speaking out on this? I think there are more deaths from binge eating (stomach rupture, car accidents, suicide) than anyone wants to admit. I know that in 1986 and 2012, when I really did want to do myself in, it was because no one presented to me any reasonable solution to binge eating. I was either turned down, blamed repeatedly, or given pat answers by “staff” who really didn’t know what I and other men and women experience who do large-quantity binges.

    Even outpatient treatment is slavery. People with bipolar or OCD might see a therapist once a week, maybe twice, and the psychiatrist once a month, but with ED, you have to see not only a therapist who runs your life, but also a nutritionist, often weekly, and a PCP for the forced weigh-in, plus the psychiatrist. Some must endure the forced weigh-in twice weekly. For many, this means at least three appointments per week, and if you don’t show up for one, you risk sectioning, that plus living with constant threats, “If you don’t gain 1/2 pound by Friday, you’re sectioned!” That’s not a life. It’s hell. It’s treating an adult like kindergarten, basing “care” on distrust and suspicion. I’ve been told, “All ED’s lie.” That, too, isn’t true. We don’t lie any more than anyone else. When i see it in a young ED, it’s usually the result of repeated scaletime bullying.

    • Jeanene Harlick says:

      Julie, I can’t respond in full right now – but I am very much in agreement with so many of your points! I am not sure how people can be so clueless… Like I said on your blog – Western society is pathologizing what are natural human emotions and behaviors which stand outside what they deem “normal” – because they’re uncomfortable with people who choose to live authentic lives; who feel intensely; who are in touch with the true nature of world, being human, the faulty parameters of “success,” etc. I.E. people who are akin more to artists and seers, and choose not to take the easy route by trying to squeeze ourselves into the cookie-cutter living and emotional range that is considered “acceptable” today …. That’s one reason why it’s very informative to look back at the history of “mental illness” – by reading people like Foucault, Goffman, R.D. Laing, etc., and understand how much a construct mental illness labels are… And how society exacerbates what is actually normal human suffering – suffering which could be manageable if it weren’t stigmatized because we express it in unconventional ways…. That’s not to downplay that there is also a lot of struggle arising from past trauma, too, and that that is deserving of help and working-through — but not the stigma, labels, and prejudice which sometimes come with that…

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