From sickness to illness, we have now birthed the modern mental health disorder

From sickness to illness, we have now birthed the modern mental health disorder

There are many articles on changing the mental health system and the great crisis in mental health today.

Well, I haven’t been practicing forever—I am relatively young—but it seems as if the situation in mental health has been upon us since I first understood mental health as an entity, thing, or discourse.

The crisis is now decades-long, and I am beginning to see the situation as something quite different. Perhaps there is no crisis; I would hazard to say, with some pause and disclaimers, that this does not mean things are going the way they should for those needing help with their condition.

Thus, the crisis is not rooted in available treatment, access, best practice, or quality of care. Sure, these aspects of mental health are vital and integral parts of the entire picture. But, are these the realms that are indeed suffering? Are these the layers and intersections of mental health that need a radical course correction?

I will go out on a limb here; I will suggest that the crisis is how we, as a culture, understand madness, illness, and disorder. 

This is going to sound rather sociological or Foucault in theory, so let’s really think about this for a minute. Before institutionalization, mental illness or “madness” wasn’t discussed in mainstream culture for centuries. The rage was hidden away and concealed—taboo.

Now, in comes the age of pre-institutionalization, and early forms of treatment, right through the heights of great psychiatric warehouses. Still, the madness is tucked away, with the slight adaption and shift in language. From sickness to illness, we have now birthed the modern mental health disorder. We are coming to understand these disorders as aberrances in health and wellness.

These trends, shifts, and ways of talking about mental health can be located in more than just the day’s language. These shifts are visible throughout the discourse and every intersection that society crosses path with the psychiatric patient, most significantly in the treatment of the disorder.

From an illness of the soul to the mind, medicalization has crept into mental health in all ways. My point with all this change talk is that when it comes to the great crisis…there is no crisis! 

The problem is how society shapes the discourse. 

The concern is embedded within the ever-moving social apparatuses that hail each of us as healthy, contributing members of the community.

Conversely, these apparatuses identify, mark, and point to parts of our population that aren’t congruent—the ones that just don’t fit. The crisis is not one thing and will not be solved by changing one or even multiple aspects of the mental health system. 

Maybe this can be best proven by talking about the evolution and beginnings of the crisis. When did it start?

For centuries, the way society understood mental health has gone through radical course corrections, but the crisis only began a few decades ago. Why? Because now mentally ill people are out among us, with us—they are everywhere.

For the first time, except for indigenous cultures in South America and Eastern stretches of Western civilization, people with a mental health disorder are allowed to roam the streets with other people without a mental health disorder and mix freely.

The crisis must, therefore, be fear—the unknown.

It revolves around the supposed “dangers” lurking just ahead of when someone with a mental health disorder creates a ripple in the norm. When someone is labeled as different, they also get attention from the media and apparatus structures in culture. In turn, this creates panic and continues the need to label, mark, and treat this population differently.

In doing so, the crisis is really human-made; we created it. 

Who are we? Society, and the apparatus forces governing the expression of culture. This force is the semiotic locus of the crisis. From this locus, extended out to the radius and periphery, is fear. This fear is thus preemptively manufactured.

I am also theorizing that this fear is caged concerning people’s health with a condition to “help them.” Still, in reality, it is to hurt them, mark them, and label them as potentially dangerous.

When you begin to map these changes or shifts in the law and how the treatment is regulated through the law, the real crisis becomes apparent. This fear allows society to supersede and transcend the law at times.

The fear, the so-called problem, is just another ploy to create new law-and-order around disorder until dysfunctions function throughout the culture.


J. Peters

J. Peters

Max Guttman '08, MSW '12, is the owner of Recovery Now, a private mental health practice. Through his work as a Licensed Clinical Social Worker, therapist and disability rights advocate, Max fights for those without a voice in various New York City care systems. He received a 2020 Bearcats of the Last Decade 10 Under 10 award from the Binghamton University Alumni Association. Guttman treats clients with anxiety and depression, but specializes in issues related to psychosis or schizoaffective spectrum disorders. He frequently writes on his lived experiences with schizophrenia. "I knew my illness was so complex that I’d need a professional understanding of its treatment to gain any real momentum in recovery," Guttman says. "After undergraduate school and the onset of my illness, I evaluated different graduate programs that could serve as a career and mechanism to guide and direct my self-care. After experiencing the helping hand of my social worker and therapist right after my 'break,' I chose social work education because of its robust skill set and foundation of knowledge I needed to heal and help others." "In a world of increasing tragedy, we should help people learn from our lived experiences. My experience brings humility, authenticity and candidness to my practice. People genuinely appreciate candidness when it comes to their health and recovery. Humility provides space for mistakes and appraisal of progress. I thank my lived experience for contributing to a more egalitarian therapeutic experience for my clients."
%d bloggers like this: