Mental Health as a Social Project


I was 34 before I knew I was autistic. For three decades, I tried to fit myself into the world like the proverbial round peg in a square hole. My sense of self was dominated by the conflict between what felt natural to me and what everyone else was doing. Much of my suffering could have been avoided had I grown up in a safe, nurturing mental health culture that provided the tools I needed to make sense of my own pain.

But I didn’t. I grew up like most Americans: born to parents who didn’t have the resources or know-how to deal with their own trauma before having kids and perpetuating their own coping mechanisms. This sucks—but it’s shockingly common in America in 2018.

It’s hard to come to a consensus about what exactly “mental health” means. In general, the phrase refers to the way we deal with our mental and emotional difficulties—what coping mechanisms we use, how we understand our shortcomings and limitations, and the way in which we interpret the seemingly irrational actions of others. Good mental health is largely informed by culture, and culture is shaped by mental health literacy—a concept we don’t talk about enough. As socialists, we can advance a vision of mental health, not just as an individual project, but as a social one.

If you’ve had the privilege of working through your own traumas, what made that possible? Did you figure it out on your own, or did you have help? Did you pick up a substance abuse habit, or did you learn healthy coping skills? When something caused you to enter a state of discomfort or anxiety, did you avoid thinking about that thing, or did you have the skills and support network to confront and process it?

These mental health questions indicate our larger societal health. Odds are that you address your traumas the way you were brought up to address them. For those with the resources and literacy to pursue a positive mental health culture—that works. But as socialists, we must be interested in improving everyone’s ability to handle trauma; we are in a system that produces an excess of it, and any transition out of capitalism will necessarily mean addressing that trauma.

Families that lack the resources to bounce between therapists, or to have neurodivergent kids evaluated, or to try a variety of medications until they find one that works simply don’t do those things. They opt out of that particular mental health culture and define their own. “I never had therapy, and I turned out fine,” a parent will say before modeling toxic coping behavior to their children.

And so those kids will turn to substance abuse or rage or displays of power or maybe they’ll just suffer in silence; they’ll struggle to understand the way their own choices contribute to their own unhappiness, and they’ll be eager to lap up any convenient narratives that blame all of their problems on someone else. Does this sound familiar?

In America today, the dominant mental health culture normalizes and even incentivizes toxic behaviors, which can be leveraged for political action and reap strong profits for industries that produce addictive substances or entertainment.  Inherent in the narratives of individual achievement and exceptionalism are very damaging consequences to the mental health of those who are not able to overpower the oppression of capitalism, who don’t achieve the expectations set upon them. Education and science and compassion, acknowledgement of the failures of our society to serve its members, are sneered at because they are— correctly!—identified as threats to that culture.

So what can we do about that? As I see it, there are two actions we can take.

The first is to fight for resources: NYC-DSA backs state- and national-level bills for universal healthcare, both of which include the elimination of deductibles, premiums, and copays for medical services including mental healthcare.

The Socialist Feminist Working Group has adopted healthcare as its main campaign, and several city branches have also launched campaigns. In South Brooklyn, comrades are canvassing for the New York Health Act (NYHA) in the district held by State Senator Simcha Felder—an IDC reactionary and key NYHA holdout.

NYC-DSA is also fighting for mental healthcare in northern Manhattan: The BUM branch is organizing to save the Allen Hospital psychiatric unit, a vital community resource. New York Presbyterian wants to replace its psychiatric beds with a lucrative spinal surgery practice. Even as universal healthcare gains traction nationwide, privatization and profit motives weaken traditional safety nets. We must engage the battle at both ends.

The second action we should take is one we don’t talk about nearly enough: fostering mental health literacy within our spaces and among our members.

Do you know how to have a healthy, productive disagreement with your romantic partner? Do you understand how to set boundaries with the people in your life—and respect theirs? Do you have a good sense of how to tell when you’re being irrational? Are you able to accept feedback that makes you uncomfortable?

Mental health requires this sort of literacy. It requires you to be able to (1) perceive that a problem exists, (2) identify the nature of that problem, and (3) know which “learned skill” to apply to solve that problem. People from poor mental health cultures can often do 1 and sometimes even 2, but when it comes time to solve the problem, they’re pulling tools from the wrong toolbox.

Healthy coping mechanisms are often deeply counter-intuitive. “Take that horribly painful emotion and just sit with it.” “Your family is within their rights to not want to talk to you about this; you have to respect that.” “You have a unique neurology that makes your experience of the world different from everyone else’s, and you’ll continue to feel like a failure until you hold yourself to a standard that makes sense for how your brain works.”

Mental health literacy is the broad set of knowledge necessary to know how best to cope with disorienting or uncomfortable mental and emotional states—states that our society, with its rising debt, precarious employment, persistently low wages, and impossibly high rent, offers consistently. None of these solutions offer relief, exactly. Each of them requires work, a mental and emotional effort whose result is not immediately obvious. These are not behaviors that a reasonable person would randomly discover; they have to be learned, which means they need to be taught.

If we want our society to be able to respond with compassion, kindness, and empathy to the very real problems that its citizens face, then we need to do the work to shift our collective mental health culture toward one that is capable of addressing real problems in healthy ways. This is a social project that acknowledges the past violence and resulting traumas that have created this country, as well as the ongoing trauma generated by the continued exploitation of the majority of people in our society. We already know that we need to provide people with the resources and access that they need to do this, but let’s not forget that we also need to be creating spaces that foster this sort of literacy and working to build a society in which trauma is no longer reproduced.