A 2005 WHO feature, Denied Citizens, chronicles the inhumane treatment of mentally ill world wide, with graphic pictures reminiscent of Abu Gharib. In the United States, diagnosis is fraught with problems of cultural bias, if anyone notices at all. Treatment is often unaffordable or unavailable, and drugs are haphazardly tested on Caucasian males. Who are the mentally ill? The surgeon's general's statistics exclude the admittedly higher numbers for homeless and incarcerated, which are likely outcomes for untreated mentally ill, particularly among minorities.
Where are the best outcome for mental illness? Not in the West! According to a WHO study, schizophrenics show higher level functioning in the simple social structures of countries like Nigeria and India. This result so confounded Western psychiatrists and health professionals that the study was repeated, with the same result, in all lasting thirty years.
The buzz word is functioning—social supports are a larger factor in mental health functioning than medication. A schizophrenic man in a remote Indian village is less impaired than a schizophrenic man in a Western city for two reasons: simple accessible opportunities to belong and be useful, and a small accepting community with more survival supports and fewer stigma barriers.
Mental illness may result in mental health, just as mental health may erode to illness. David Lykken argues that sociopathy, particularly dissocial sociopathy in gang affiliations, helps explain the alarming increase in violent crime in the last 50 years. His 1995 study highlighted the dangers of ineffective parenting and inadequate socialization during childhood and adolescence. Yet low income and single parent families struggle just to feed and house children, let alone pay for quality daycare.
Not surprisingly, the WHO Department of Mental Health and Substance Abuse has two broad objectives: " (a) closing the gap between what is needed and what is currently available to reduce the burden of mental disorders worldwide, and (b) promoting mental health."
A key factor in mental health is peaceful conflict resolution. In the wisdom of Mahatma Ghandi, "Bring your opponent to his senses, not to his knees."
Sociologist Elise Boulding, major contributor to conflict resolution research nationally and internationally, advocates the use of social imagination to image the future. What do we want for the neediest among us?
If mental health is a casualty of war, it's also a hidden cost of social
inequity and neglected domestic programs.