The World Health Organization defines mental illness as “ a clinically significant disturbance in an individual’s cognition, emotional regulation, or behavior. It is usually associated with distress or impairment in important areas of functioning.”
This definition is problematic. Here’s why:
1. Important areas of function are cultural standards that change depending on the culture. While capitalism, globalization, and colonialism can make these differences difficult to compare, the differences exist nonetheless.
2. A person’s behavior, cognition, and emotional regulation is influenced more by their environment than their brain chemistry. Disturbances in these areas are frequently representative of cultural issues, abuse, or environmental factors such as weather, pollution, and poor conditions in working and living spaces.
3. Through evolution our bodies have developed methods of responding to situations. Anxiety, depression, and other reactions serve a purpose. An appropriate biological response to negative situations is not illness even if it causes clinically significant disturbances.
4. It excludes culture-bound syndromes and frequently ignores the mind-body connection.
This definition has led to a large number of misdiagnoses and contextually inappropriate treatment which cause years of lowered quality of life and sometimes permanent damage. So how do we redefine it?
Mental Illness is defined as causing a biological breakdown in a manner that promotes damage instead of growth in settings where the biological breakdown can not be explained by environmental factors or appropriate biological responses. This biological breakdown can occur internally within the person who is ill or in the context of abuse it can occur internally in others through injury.
Mental Injury is defined as experiencing a biological breakdown as the result of abuse. It also includes biological breakdowns caused by environmental factors and appropriate biological responses to situations.
Some illnesses can cause damage in other people. This is often described as unhealthy relationships, unhealthy dynamics, or exploitation. Illnesses that damage others might not cause the individual themselves to experience any distress or impairment in functioning.
The overwhelming majority of people who are ill do not cause damage to others. Among the small percentage of people who cause damage, the following should be taken note of:
A person who causes damage to others is experiencing illness.
A person who is experiencing damage caused by the illness of another person is injured, not ill.
A person who causes damage to others must be appropriately held accountable. Illness is not an excuse to expose people to injuries. The health of people being injured is the top priority.
There are many times when depression and anxiety is caused by abuse, especially emotional and narcissistic abuse. Children, dependents, and adults must be protected from injuries resulting from abuse with abusers being held accountable regardless if abusers are seeking treatment or participating in programs. Participation in treatment is not the same as an abuser making tangible behavioral changes in their life.
Victims and survivors of abuse are not responsible for rehabilitating abusers, giving them "second chances", or being part of an abuser's recovery process.
So how do you prevent people from getting injured?
Acknowledging the difference between mental illness and mental injury is the first step. Reforms to the economy, disability services, social services, healthcare, and immigration will exponentially improve these issues. Most importantly, we need to make legal reforms specifically around increasing people's ability to enforce healthy boundaries.
Each of these topics could easily be it's own book. Figuring out what specific reforms would actually help and getting them implemented is no easy task. That's why I created the Ahead of the Times forum as a place to do just that- make reforms and implementation easier. Click on the link below to check it out:
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