Opinion | Is There Too Much ‘Mental Health’ Awareness in the United States?

The shift toward prioritizing mental health might be benign if it were only one way of reframing the question of what our priorities should be. But it comes with the imprimatur of clinical authority. As a result, therapists increasingly stray into a broader ethical arena while appearing to remain within their own zones of expertise.


Part I

We Are Aware and Unhappy

We Are Aware and Unhappy

During an inpatient hospitalization, the writer James Mumford took part in a form of therapy called acceptance and commitment therapy, which emphasizes the subjectivity and personal significance of our values — the idea being that we can better create a more meaningful life if we focus on what is important to us. Perhaps. But Dr. Mumford, an ethicist, observed that his therapist seemed to slide too readily into implying that values are entirely subjective, that there are no moral facts. This is a theoretically substantive claim, one that is controversial among philosophers; Dr. Mumford tried to engage the therapist in discussion but was brushed off. Here was a situation in which mental health expertise came into conflict with philosophical reflection.

The contemporary cultural landscape’s recent zeal for mental health as an important good has been accompanied by a faith in therapy as the best way to obtain it. Some, including Dr. Anhalt in a TED Talk, go so far as to propose that everyone should try therapy. Dr. Anhalt even suggested on Twitter recently that therapy become a prerequisite for becoming a parent. The tweet was enthusiastically embraced by some, though she received pushback from those who noted its cultural insensitivity and its resemblance to the eugenic idea of government-issued licenses for parenthood. In the end, Dr. Anhalt deleted the tweet.

I have had therapy at various points in my life, including right now. Many more people would likely benefit from therapy than currently engage in it. Nonetheless, I feel more circumspect about the generality of the prescription. Therapy is important as a valuable health intervention for many, rather than a universal prerequisite to a good life. Most people simply cannot afford to have lengthy therapy, or it doesn’t fit with their cultural or religious worldview. Do we really want to suggest that this compromises their mental health or their ability to do things like parent well?

The vagueness of the term “mental health” also means that it is ripe for cynical co-option. When, during the early stages of the pandemic, many Republicans opposed mask mandates in schools, the issue of masks’ effect on children’s mental health was a key talking point. Tucker Carlson specifically raised the issue in a lengthy anti-mask screed, the phrase lending a cheap veneer of clinical authority to his histrionics.

It is insulting to hear platitudes about children’s mental health from a part of the political spectrum that routinely blocks serious action to stop school shootings. Conservatives do draw on mental health as a talking point in this context too, but here it used to draw attention away from the political and societal causes of gun violence. Instead of seeing internationally unparalleled access to guns as a relevant public health issue, we are encouraged to consider the mental health of the shooter. A clear causal link between psychiatric illness and gun violence has not been established, but the imprecision of the term “mental health” allows the argument to prosper. When, in the wake of the Uvalde shooting, Greg Abbott, the governor of Texas, said, “Anybody who shoots somebody else has a mental health challenge, period,” he was saying something that was arguably true, but so trivial and imprecise as to be useless.

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