The more a society is dedicated to the value of equality and the more choices it offers for individual self-determination, the higher its rates of functional mental illness

The West’s Struggle for Mental Health: Rates of functional mental illness are high in open societies and low in authoritarian ones. Liah Greenfeld. Wall Street Journal, Jun 2 2022. https://www.wsj.com/articles/the-wests-struggle-for-mental-health-illness-uvalde-shooting-depression-anxiety-religion-meaning-authoritarian-11654034338

The more a society is dedicated to the value of equality and the more choices it offers for individual self-determination, the higher its rates of functional mental illness. These rates increase in parallel with the increase in the available occupational, geographical, religious, gender and lifestyle-related choices. This explains why, since the 1970s, the U.S. leads the world as the country most affected by functional mental illness, though other prosperous liberal democracies aren’t far behind. Before the 1970s, first place belonged to the U.K., which lost that ranking together with its empire and the dramatic contraction in the number of choices the nation offered its members as a result. In contrast, rates of functional mental illness in societies that are insecure, poor, inegalitarian or authoritarian are remarkably low. For decades, the World Psychiatric Association has pondered the “perennial puzzle” of the relative immunity to such illnesses in Southeast Asian countries.

Equality inevitably makes self-definition a matter of one’s own choice, and the formation of personal identity—necessary for mental health—becomes personal responsibility, a burden some people can’t shoulder. A relatively high rate of functional mental illness, expressing itself centrally in dissatisfaction with self and, therefore, social maladjustment, thus must be expected in democracies. But while high rates of mental illness are an old problem, the soaring rates of the recent decades aren’t explained by equality alone. They are related, in addition, to what happened to Western values, especially in the U.S., since the dissolution of the Soviet Union.

The disappearance of the West’s common opponent rendered individual identities in the West more confusing and dissatisfying. Having lost sight of what they, as a society, were against, millions of Westerners lost the sense of what they represented, rejecting common reference points, such as personal responsibility, which previously constituted the core of the self in the West. Virtues and vices, Soviet-style, came to be seen as characteristics of groups, significant social groupings were defined genetically, all personal discomfort was attributed to society, and the burden of responsibility was shifted off individual shoulders.

This change transformed the understanding of justice from one based on individual actions to one based on collective, biologically determined dispositions. It encouraged social maladjustment because people believing themselves decent were naturally uncomfortable in a society that wasn’t decent. And at the same time it trapped huge numbers within vicious, yet inescapable genetically determined identities. While solving the problem for some, this change in values accelerated the increase in rates of mental illness.