Healing in a Broken World: Mental Health as a Social Issue

Too often, conversations about mental health focus inward – on personal histories, brain chemistry, or coping mechanisms. While these factors undoubtedly matter, they do not exist in a vacuum. Psychological distress does not simply emerge from within; it is shaped by the world around us. Our economic conditions, historical legacies, and social structures all play a role in defining what it means to be “mentally well.” Despite this, mainstream psychology has historically emphasised individual pathology over systemic influences. The field, pioneered largely by white men from the Global North – such as Wilhelm Wundt, Sigmund Freud, and B.F. Skinner – developed in a specific cultural and historical context, often reflecting Western ideas of selfhood, normality, and well-being (Danziger, 1990). The dominance of these perspectives has shaped not just how we diagnose and treat mental illness but also how we understand suffering itself.

The dominant biomedical model of mental health, which often attributes conditions like depression and anxiety to neurotransmitter imbalances, has been widely critiqued for oversimplifying complex phenomena (Moncrieff, 2008). One of the most persistent myths within this model is the idea that depression is caused by a deficiency in serotonin. This belief, popularised in the 1990s alongside the rise of selective serotonin reuptake inhibitors (SSRIs) like Prozac, has shaped both public understanding and psychiatric treatment. However, a comprehensive review of the evidence found little to no support for the idea that low serotonin levels cause depression (Moncrieff et al., 2023). This challenges the widespread assumption that antidepressants correct an underlying chemical imbalance – an idea that, while useful for reducing stigma and depressive symptoms in many cases, may also limit how we conceptualise and address mental health. While neurobiology is a crucial piece of the puzzle, an overly narrow focus on brain chemistry can isolate individuals from their social environments, shifting responsibility away from the structural conditions that shape well-being (The Guardian, 2020).

Building upon this, meta-analyses have suggested that while antidepressants can be effective for severe depression, their efficacy for mild-to-moderate cases is often comparable to that of placebo (Kirsch et al., 2008). Some critics argue that this overreliance on medication reflects a broader tendency within Western psychology to offer individualised, technical solutions to what are ultimately social problems (The Guardian, 2020). Certain scholars have even framed psychotherapy itself as a neoliberal practice – one that encourages individuals to adapt to their circumstances rather than challenge or change them (Illouz, 2008). Therapy, in this view, becomes something that fits neatly into a workday schedule, reinforcing personal responsibility for distress while leaving broader political issues unaddressed.

Similarly, diagnostic frameworks like the DSM have expanded over time, making mental health conditions more widely recognised and increasingly destigmatised. However, critics argue that this expansion risks pathologising normal responses to adversity (Horwitz, 2002). This is relevant because when suffering is medicalised rather than seen as a legitimate response to social conditions, it depoliticises distress. If systemic inequality, racism, or job insecurity lead to widespread anxiety and depression, but these experiences are primarily understood through a medical lens, the responsibility shifts away from policymakers and onto individuals. In this way, an overly broad diagnostic framework can inadvertently serve as a mechanism for social control, encouraging adaptation rather than systemic change (Conrad, 2007). A more holistic approach might integrate social and cultural dimensions into mental health care without dismissing the role of medical treatment – recognising that while some individuals benefit from psychiatric interventions, broader societal reforms are also necessary to address the root causes of distress.

If mental health is deeply social, then rising rates of anxiety, depression, and burnout must be understood within broader structural realities. Economic precarity, the climate crisis, political instability, and relentless exposure to media-driven fear narratives all contribute to distress (Fisher et al., 2020). For marginalised communities, these issues are compounded by historical and systemic inequalities. Research on historical trauma suggests that the psychological impact of colonisation, slavery, and forced displacement can be intergenerational, influencing stress responses and vulnerability to mental illness (Brave Heart, 1998). Indigenous communities, for example, exhibit disproportionately high rates of depression, suicide, and substance abuse – not simply due to personal histories, but as a result of centuries of systemic violence and cultural disruption (Kirmayer et al., 2009).  

At an individual level, this raises an important question: how much of what we see as personal – like fear of abandonment – may stem from broader social realities? For example, colonial displacement, forced migration, and family separations have been shown to disrupt intergenerational attachment patterns, predisposing individuals to relational insecurity (Nelson, 2012; Mitchell, 2019). In families affected by such histories, caregiving environments may be marked by unresolved grief, hypervigilance, or emotional unavailability – conditions that disrupt secure attachment formation in children (Danieli et al., 1998). These patterns are not simply “passed down” through stories or behaviours, but can become ingrained in neural and physiological systems, shaping how people regulate emotion, trust others, or form intimate bonds. Chronic social exclusion that stems from racism, homophobia, or caste-based prejudice fuel feelings of alienation, correlating with anxiety, depression, and low self-worth (Hossain, 2022; Page-Gould, 2014). Internalised stigma adds another layer, making individuals more likely to see themselves through a lens of shame or insecurity (St. George University London). Recognising these links can not only be beneficial for individual therapy within the current framework, but also shift mental health conversations and attitudes towards the social conditions that shape emotional well-being.

If mental health is shaped by systemic forces, then mental healthcare must move beyond purely individualistic solutions and focuses. One alternative is Liberation Psychology, a movement pioneered by Ignacio Martín-Baró in Latin America, which emphasises community-based interventions and challenges the idea that mental illness exists in isolation from political realities (Watkins & Shulman, 2008). Similar approaches are seen in Indigenous models of healing, which center collective well-being and cultural continuity alongside biomedical treatments (Dudgeon et al., 2014).

A decolonial approach to psychology would also mean reassessing the frameworks we use to understand mental health. For example:

• Expanding research beyond WEIRD (Western, Educated, Industrialized, Rich, and Democratic) populations, as psychological studies overwhelmingly rely on Western subjects yet claim universality (Henrich et al., 2010).
• Recognizing that distress is not always a dysfunction to be treated but sometimes a rational response to an unjust world.
• Integrating community-led mental health initiatives alongside clinical interventions rather than viewing them as separate or oppositional approaches.

Of course, this is not to say that personal experiences and neurobiological factors are irrelevant. Rather, the challenge is to find a balance: acknowledging individual pain while also recognising the systemic forces that shape and amplify it.

If mental health crises are growing, perhaps the issue is not simply a lack of therapy or medication, but also the conditions in which we live. Critical psychologists argue that distress is not necessarily an isolated malfunction of the mind – it can also be an understandable response to broader social forces (Parker, 2007). Addressing mental health meaningfully requires more than self-care or medication; it demands systemic change. However, this does not mean discarding existing psychological models, but rather expanding them to better reflect the complexities of human experience. <<