The topic of mental health is being brought up in conversation more in educational institutions, physician’s offices, the workplace, and social media platforms. This dialogue has encouraged the new generation of aspiring mental health professionals, from counselors to policy-makers and medical doctors/ psychiatrists. While these conversations have an overall de-stigmatizing impact, humanizing those who would have been historically demonized (i.e. those who process through different psychiatric, psychological, and cognitive disorders), they also unveil ongoing critiques of the industry.
In their 2022 opinion piece, The New York Times discussed the concept of “punishing” a child’s psychological problems “away.” It was revealed from interviews by 50 former patients, experts, clinicians, legislators, and employees in the industry that current treatment facilities do not adequately address the core problem of one’s mental health. Instead, these facilities use practices to attempt to “punish” attitudes away. Former patients have compared modern-day inpatient centers with “insane asylums” from centuries ago. The piece proclaims that “future generations will look back on… tactics used… in the same way we look back on forced lobotomies and ask: How did we allow these practices to pass off as [treatment] for so long?”
With adolescents in particular, the editorial continues to state that options for “troubled-teens” include boot camps, wilderness programs, therapeutic boarding schools, and residential treatment centers meant to help children with mental health issues through “tough love.”
The writers point out that most of these children already have been through enough “tough”-ness in their short lives, ranging from foster care to rehab and even the criminal justice system. There is also the issue of overgeneralization and grouping together those who have needs vastly different from one another. For instance, it is objectively not reasonable to place children who need long-term professional care for autism with teenagers who struggle with addiction and eating disorders, as their treatments are not comparable. Merging them together under the guise of needing professional “mental health help” is not specific enough.
Furthermore, the method of sending these children away tends to have greater adverse effects. One former patient admitted, “it felt like I was too much for people to handle.” In reality, what these children and adolescents need are feelings of support, hope, agency, and resilience.
Another major critique is that, at the end of the day, the mental health industry is also an INDUSTRY, meaning that there is a heavy focus on generating profit. The writers of The New York Times opinion piece conclude that one of the causal factors of the negatives in mental health facilities is “a lack of oversight… and a focus on maximizing profit.”
This also extends into the pharmaceutical industry. Dr. Sharfstein, MD, points out in his 2005 piece in Psychiatry Online that the US pharmaceutical industry is one of the most profitable industries in the world, with antidepressants ranking third in pharmaceutical sales globally.
He continues to describe this issue, stating that the financial “incentives” have contributed to the “quick fix” misconception of taking a pill, thereby reducing the significance of psychotherapy and psychosocial treatments. He raises his concern of the “pill and an appointment” becoming the dominant treatment. By emphasizing the issues with “Big Pharma” and its contribution to allowing the biopsychosocial model to transform into the “bio-bio-bio” model, Dr. Sharfstein highlights the need for advocacy and education to reform the mental healthcare system.
He ends his statement by stressing that the doctor-patient relationship should not be a “market-driven phenomenon”– that people should be prioritized over profit.
To combat these complications in the mental health industry and field, it is essential that the new generation of professionals in-training are aware of these issues. There should be a focus on training and employing competent people who will humanize patients while maintaining the difference between enabling their condition and holding them accountable for treatment. Those who aspire to have a career in mental health, whether that be from an educational, law-making, or clinical adjunct should be well-versed in the past, present, and future of mental health.