I’ve had enough experience with speaker events about mental health to know that they proceed in predictable ways — the speaker’s story will strike a chord with the audience, who will then crowd the speaker to tell them about how much they related to their story. I was one of these speakers once, at the 2018 New Student Orientation. After my talk, I was bombarded with compliments from well-meaning people ranging from audience members to a Vice Provost: things like how much my mental health struggles resonated with people, how powerful the narrative was and how important it was that narratives of mental health are being elevated, especially at a time when so many people are facing similar struggles in their own lives.
On the one hand, I of course appreciated the kind words and take them for the compliments that they were clearly meant to be. But, on the other, I couldn’t help but feel how strange it was that something like this would be considered a compliment. Replace “mental health issues” with any other illness, and you’ll see what I mean. Imagine someone saying something like:
“It must be so rewarding to see and know that there are so many people in that audience who also struggle with pneumonia, and who deeply resonate with your story and love that these pneumonic narratives are brought to the forefront…”
We can and should be grateful that increased mental health awareness has resulted in decreased stigma and taboo. But to declare victory on this alone would be ludicrous. Just because there has been a reduction in the taboo around mental health doesn’t mean there isn’t still plenty of stigma for talking about it or seeking treatment — even in places like Stanford where mental health issues are comparatively less stigmatized.
For one thing, cultural change must be accompanied by robust improvements to an institutional and medical infrastructure that is, at present, sorely lacking. Both access to and quality of care continue to be dangerously inadequate, and one doesn’t need to look far to see these conditions. On Stanford’s campus, Counseling and Psychological Services (CAPS) continues to struggle with long wait times and an inability to provide adequate long-term care.
As much as we can talk about the need for the University to increase funding for CAPS, the situation remains that even at a place of such concentrated wealth and resources, mental health services are just not keeping up. Though the necessity of better infrastructure for treatment and services is real, we must confront the underlying crisis and ask: What exactly has turned the mental health issue into an epidemic?
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When Betty Friedan’s “The Feminine Mystique” was first published in 1963, it sent shockwaves through society by being the first to point out the “problem that has no name” — namely, the widespread unhappiness of middle-class housewives in American society, which Friedan attributed to their societally-enforced exclusion from the workplace. Friedan argued that middle-class women should be allowed to head to the workplace rather than be confined to domestic roles. That suggestion was revolutionary for the time. It showed that the way society was organized — that is, the status quo, the accepted way of doing things — was actually causing deep hurt to women and their psychological well-being on a horrific scale.
And, indeed, it is high time to question once again whether the way our society works in our “business as usual” manner is making us sick. Research has already demonstrated that economic anxiety tends to translate to worsening of mental health in myriad ways: For example, that unemployment worsens one’s mental health, that poverty and mental health issues often go hand in hand, or that, as one group of researchers from Columbia put it, if you’re “anxious” or “depressed”, “you might be suffering from capitalism.” We also know that the economic anxiety of this kind is very real at Stanford (as obscured by our obscene outward wealth as it can often be), where students are at times reduced to literally foraging fruits just so they could feed themselves.
When talking about mental health, then, we can’t forget about the overall economic state of our society, which is progressively worsening — especially for young people. The costs of basic life have skyrocketed. The cost of a home has risen to $119,000 in 2000, up more than threefold from what it was in 1940 even after accounting for inflation. It is no surprise, then, that the age profile of homebuyers in the US have changed significantly — in 1981, they were 25-34; now, they are 44. Cost of education has also skyrocketed to around 17 times what it had been in 1971. In fact, the cost of a college education is currently growing eight times as fast as wages. It is also no surprise, then, that the typical U.S. college student is now carrying $30,100 in student loans at the time of graduation.
Yet, at the same time, the job market has not kept up. Millennials, for example, currently face a 45 percent underemployment rate, which makes actually landing a decent-paying job that could enable paying for these increased costs — especially a job in a specific field of study — far from a certainty. Moreover, entry-level wages have noticeably sagged. The average young worker in 2012 was paid about 58 percent of the average wage in the country, compared to young workers in 1980, who were paid about 82 percent of it. All of this has millennials as the first generation in American history to earn less than their parents. For the average millennial born in the 1980’s, the chance that they will outearn their parents is less than half, which means that only a minority of millennials could be winners of this economic game by out-competing the majority of their peers either through circumstance or hard work.
In light of all this, it is plain to see that this mental health epidemic, while it may have caught many by surprise, did not come from nowhere: It came from a society that is becoming increasingly stratified and hypercompetitive, leaving everyone feeling more precarious, more under pressure and more stressed to push themselves to their limits to emerge as the winners of an increasingly winner-take-all system. We are rushing to optimize everything else in our lives at the expense of the most basic aspect of our existence — the health of our minds and bodies, and it is leaving us all more miserable because of it.
In the short term, I would love for everyone to be able to sit down with a professional and talk about their mental health, and I would love for everyone to be able to get the mental health treatments they need and deserve. This would not come cheap, but it would certainly be cheaper than the $16 trillion that the mental health crisis is on track to cost the global economy within the next decade. However, just as importantly, I also am certain that merely offering treatment for the symptoms would not be enough. We need to confront the root cause of the problem and examine the frightening ways in which, somehow, a mental health epidemic has become just another negative externality of the culture and society we live in. As one panelist at a February mental health event here at Stanford put it:
“We can’t stay on the merry go round, we have to fix the merry-go-round.”
Contact Terence Zhao at zhaoy ‘at’ stanford.edu.