Published 27 June 2023
When “mental health” and “economy” make it into the same sentence, it’s for studies that highlight productivity loss and benefits dependence. The conventional wisdom suggests that addressing mental health will yield economic benefits. While this perspective is well-intentioned, it overlooks a fundamental question: What if the key to addressing the mental health crisis lies in transforming the very fabric of our economy?
Let’s consider the critical domain of work, an essential aspect of modern life and a fundamental driver of economic activity. Surprisingly, even in Finland, renowned as the “happiest country in the world,” burnout and an increased risk of burnout afflict every fourth individual under the age of 36. Mental health disorders rank as the most common cause of sickness allowance among individuals aged 16 to 67, and they constitute the second leading factor behind disability pensions in Finland (source). Notably, the prevalence of mental health-based disability pensions for those under 30 has steadily increased throughout the 21st century. While improved awareness and a tendency to overinterpret mild symptoms contribute to the growing number of diagnoses, a more profound story awaits our attention.
The dominant explanatory model of mental health in Western societies places individuals at the centre, emphasising access to care and medication, particularly evident in the United States. In recent years, scientific, policy, and advocacy communities have rightly shifted public opinion away from stigmatising mental health sufferers as moral failures. However, the persistent narrative attributing mental health issues primarily to biological disorders perpetuates the focus on the individual. The biomedical model’s historical emphasis on individual dispositions, such as genetics, has unduly overshadowed the role of structural drivers. Psychiatry’s long-standing pursuit of locating mental problems within the brain can be reductionist, leading to overmedicalisation, and underestimating the impact of social and environmental factors. Diagnosis and treatment have not progressed in tandem with this societal perspective.
This individual-centric focus has significant implications for policymaking. The typical response to address an individual’s mental health revolves around enhancing access to mental health services and medication. In Finland, barriers to accessing such services have been acknowledged and are subject to extensive discussions. The citizen initiative “Immediate Access to Therapy” (Terapiatakuu) has called for easier and faster access to mental health services. While providing therapy to all is a laudable objective, we must consider if our society has reached an ideal state when, say, 80% of the population requires therapy to address direct and immediate mental health concerns.
Scientific literature demonstrates the social determinants of mental health. Material needs, deprivation of psychological wellbeing, and the varying quality of workplace and community relationships profoundly impact overall wellbeing. Factors such as intense competition, the rise of the gig economy, and the erosion of cooperative dynamics have all contributed to diminishing mental health (Kokorikou et al., 2021; Knapp, 2012; Eisenberg-Guyot & Prins, 2022; Patel et al., 2018). Although these social determinants are well-known, policies have only recently begun to address them. These do not rest within the individual’s biology, or even their choices.
A significant hurdle in addressing the mental health crisis lies in the limited capacity of social policies to lift individuals and communities out of situations closely tied to mental health deterioration. At a time when structural transformation may be unfolding beneath our notice, we must acknowledge that our current economic system offers few escape routes from job insecurity, stress, economic precarity, and the commodification of healthcare. Consequently, efforts to manage the mental health crisis strictly within the “social policy” realm are only piecemeal. As such, they will prove futile unless they confront the socioeconomic aspects affecting vulnerable segments of the population. Policymakers must recalibrate their focus away from strictly social policy and into transformative economic policy; for example, exploring an economic system that prioritises the wellbeing of both humanity and the planet. This exploration should rightfully occupy a prominent position on the policy agenda, along with investing in building communities of care and nurturing interpersonal relationships that foster fulfilling and purposeful lives.
Importantly, the future of care itself hinges on this vital conversation. Amidst ongoing political debates on healthcare, welfare, and family policies, policymakers can redefine and shape a care concept that aligns with the realities of the 21st century. How can we forge a path forward that fundamentally transforms our understanding of mental health, dismantles the barriers created by the current economic structure, and cultivates a society that genuinely cares for the wellbeing of all its members?
As we transition towards a more inclusive, compassionate, and resilient future, we can usher in a new era of care, but only after we are deliberate about what fundamentals of our economies we want to keep and what we need to phase out.
Feature Image: Benjavisa / iStock.