The United States of Adversity

There are Deeper Causes to Our Collective Mental Health Crisis

As a “public health” psychiatrist, I have often said that violence is a good barometer for (a lack of) mental health in a society.  It is not that “mental illness” causes violence, but rather violence—behavioral or structural—worsens our mental health.

Kids are a good barometer for societal wellbeing, and the Centers for Disease Control and Prevention recently released some stark results: nearly 1 in 3 high school girls related that they had seriously considered suicide.  Teen girls are “engulfed in a growing wave of violence and trauma.”  And they face stressors that include sexual violence, emotional and physical abuse, fear of parental job loss, housing insecurity, and hunger.

Adults cannot buffer them if they are suffering: 1 in 5—nearly 53 million—had a mental illness in 2020, ranging from anxiety to depression to psychotic illness.  As children themselves, 61 percent of American adults experienced violence, abuse, neglect, or separation from a parent such as through incarceration, or suffered structural violence in the form of poverty, gender-based discrimination, or racism.  Adverse Childhood Experiences (ACE) studies show that these stressors contribute to chronic physical and mental problems, substance use disorders, and early death.

The Covid-19 pandemic is often cited as “the cause” of recent escalating behavioral violence and mental health problems, but these trends were present far before the onset of the pandemic.  Rather, the pandemic itself is a byproduct of worsening societal mental health, which led to disproportionate attraction to a mentally-impaired leader, who in turn maximally worsened a pandemic—if not created it altogether by failing to contain it at the epidemic stage.

Four decades of structural violence, mostly in the form of escalating economic inequality, is now manifesting in rising rates of violence and a societal mental health crisis.  While the immediate impulse is to suppress discourse—as has happened during the Trump era—hearing from mental health experts will be critical to public health interventions and solutions.