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Although this campaign has the backing of the BMA and several of the medical royal colleges, you will nonetheless often hear representatives of these bodies justifying current prescription levels on the grounds that they merely reflect the rate of disease. In a letter to The Times last year defending anti-depressants, for example, the newly-elected president of the Royal College of Psychiatrists explained, “As more people seek medical help, the number of prescriptions rises. More people receiving cancer treatment would not lead to criticism. Similarly, more anti-depressant prescriptions simply mean more people getting treatment”. Once again this begs the question. The fact that there is medical treatment available for depression involving the use of drugs, just as there is for cancer, does not itself prove that the former is a disease — let alone one that is comparable to cancer.

Perhaps the disease that really needs treating — or, rather, careful exploration and understanding — is the belief that drugs of any kind, legal or illegal, can bring us happiness. I do not want to say that this too is mere wishful thinking, as though throughout history societies have not turned to intoxicants of all sorts and for an equally wide range of reasons: for everyday relief, in ceremonies and celebrations, and also for spiritual insight. But this seems to me very different from a view which may be starting to take hold in the Western world today that suffering of any kind is an affront or abuse and should be eliminated psycho-pharmacologically.

The ready availability of anti-depressants and prescription painkillers certainly reinforces this view, and I go along with those critics of “Big Pharma” who are scandalised by the huge profits some of these products make — especially where these owe something to ties between pharmaceutical companies and the medical profession that are clearly a conflict of interest. But my main point is far from being an anti-capitalist one. If Marx were alive today I think he would need to rephrase his famous statement about religion being the opium of the people. With the demand for analgesic medication as high as it is, and with the supply of same approved both legally and socially as never before, it looks rather as though opiates are becoming the religion of the people.

I observed at the beginning of this article that mental health seemed to be constantly in the news last year. Although I can understand why someone might welcome this, the argument I am making is that the concept of “mental health” — as it is generally understood in the media, public awareness campaigns and also the medical profession — is a flawed one. The flaws I have concentrated on fall into four main categories: philosophical, moral, political and socio-cultural.

Is there an alternative to this concept? Surely anything is better than a return to the days when, either out of ignorance or shame, people were unable to talk about what they found disturbing or distressing? Even if there is a bit too much hype around mental health at the moment, in subjecting this to criticism isn’t there a danger of our throwing out the baby with the bathwater?

I disagree. In my view, the trouble with the mental health paradigm is precisely that it is infantilising: we should take our medicine from the experts who know what’s best for us and be grateful for it. They may not mean to hold back our development into adults with a capacity for taking difficult decisions about our lives and for tolerating the feelings of sadness or guilt to which we are naturally vulnerable when things go wrong. But I think that this is what has happened, as a result of a model of illness drawn from the body being applied to the mind.

In 1961 the Hungarian-American psychiatrist Thomas Szasz warned against this danger in The Myth of Mental Illness. “Psychiatrists are not concerned with mental illnesses and their treatments,” he wrote. “In actual practice they deal with personal, social and ethical problems in living.” For this book and others like it, Szasz found himself at odds with most members of his profession as well as conventional opinion more broadly.
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