On the Discourse Surrounding Mental Health

-The NotA Collective

The past year has witnessed a striking number of deaths by suicide at institutions of higher learning in India.1 It is often difficult to talk about these events, tragic and inexplicable as they are. Harder still is the task of navigating the discourse surrounding suicide and its prevention that inevitably follows. A reliable pattern of response has now been established, to which all concerned parties hew closely:

  • University press offices rush out statements, careful to distance themselves of all blame. Committees will be formed, which in a few weeks or months will invariably find that although it was all really very tragic, the only effective mitigation strategy is to spread “awareness”.
  • Tenured professors on Twitter will bemoan the loss of young, talented academics, and remind their followers of the importance of mental health and “getting help” in a timely and responsible fashion. They assure us that they too appreciate the pressures of being a young academic, having also been young academics once. For their part, students on Twitter will retweet these exhortations; most of them will do so mechanically but a few will do so with anger and passion that inspires hope.
  • Journalists interfacing with academia will mutter words like “systemic” and “structural” and quote tweet university press handles, focusing their criticism on how sentences are phrased. Some will commission articles on the ballooning crisis of mental health in academia, informed by what passes for progressive senior academics, and occasionally counsellors with experience treating mental illness.
  • Most of the above parties will congratulate each other on a job well done. Any differences that arise in this churning are buried, or left unaddressed.

Wash. Rinse. Repeat.

We believe that, like us, our readers are inundated with and sick of mental health advisories, op-eds, and press releases. Instead, we’re going to try and understand this crisis of mental health as an inevitable outcome of the way academia is organised.

Divide and Conquer

Dogma #1: Declining mental health is a problem faced by individuals, each facing unique circumstances. Since individuals and their histories are incommensurate, solutions to these problems must be personalised.

We may call this the dogma of individualisation. The Trojan horse of sensitivity to the peculiar trajectories and circumstances of individuals smuggles in a sinister lie by omission: that declining mental health is not a social problem. The dogma of individualisation holds that declining mental health is a problem faced by individuals, and not society.

Some readers might find this a strange fight to pick. Why, they might ask, is anxiety any different from a fractured wrist, if they’re both clearly problems faced by individuals? This is a useful prism through which to unpack the dogma of individualisation. If I break my hand because I imagined one day that backflips don’t look too hard, there are no structural forces at play, only my stupidity. But if I fractured my hand working with poorly designed machinery or inadequate safety equipment at a factory, it would not be controversial to claim that these fractures were bound to happen, that it was only a matter of time. To train our sights at the individualisation of mental well-being is to ask: is something similar true with the case of mental health in academia as well? Is it possible that structural factors — the way academia is organised, the way power is distributed, the way incentives and rewards are drawn up — cause or exacerbate the decline in quality of mental health? In characterising mental health as a social problem, we are not suggesting that the individual circumstances ought to be ignored. Rather, its framing as a social problem induces us to critically examine the social circumstances that may contribute to the decline of a population’s mental health.

There is, surprisingly, no contradiction between viewing mental health as an individualised problem, and lamenting the growing mental health crisis on university campuses. When liberal journalists and academics speak about crises of mental health, they are referring to the growing numbers of people diagnosed with, say, anxiety or depression being treated as individual “cases”. No common cause is indicated, no patterns identified or explanations sought after, and rarely, if ever, is the connection between mental health and the organisation of the university (or even society at large) made. The failure to do these things plays a huge part in why the discourse on mental health is so tedious. Here’s a good rule of thumb: if you hear someone talk about mental health without talking about the political, economic, and social contexts the mind must navigate, run for the hills.

More importantly, this individualisation of mental health is not accidental, and is in fact exceptionally convenient. It means that workplaces and/or institutions needn’t actually change any aspects of their organisation, and places the burden of seeking and coordinating help on the individual. The absurdity of this expectation acquires terrifying dimensions when one factors in the stigma associated with those struggling to cope with mental illness. On the rare occasion that “help” is provided by the educational institution itself, it is viewed as necessary, part of the cost of social reproduction of the university space, a point we will discuss in greater detail in the subsequent section.

Mental health is not just individualised by administrators and senior academics. Junior academics, too, reinforce this belief. While our emotional life is often something deeply personal, it is rarely appreciated that it can also have a “collective” or social component, influenced by material changes. For example, according to the All India Survey of Higher Education’s Higher Education Profile 2019-2020, while the total number of higher education institutions has witnessed a steady increase from 799 in 2015-2016 to 1043 in 2019-2020, the number of teachers (including the Professor, Lecturer, Reader, and Temporary Teachers) actually reduced from 1,518,813 in 2015-16 to 1,284,755 in 2017–2018, and only bounced back to 1,503,156 in 2019-2020.2 With no clear possibility of secure and stable employment, young academics are bound to experience anxiety. This all-pervading sense of uncertainty is collectively experienced, and must be combated collectively too.

Dogma #2: Declining mental health results from an imbalance of chemicals in the brain. It is a fact of an individual’s biology.

We may call this the dogma of essentialism.3 This is the idea that an individual is genetically or physiologically “predetermined” to suffer from a mental illness, that this illness is a part of the definition of who they are. A natural corollary to this attitude is that these imbalances must often (and sometimes can only) be corrected through pharmacological intervention.

The purpose of identifying essentialism as a limitation of mental health discourse is not to suggest that pharmacological intervention is unscientific, or fraudulent, or even ineffective. Many individuals take medication for a wide range of conditions, from attention deficit hyperactive disorder (ADHD) to manic (or bipolar) depression, and do report that the medication helps them function better. Rather, to take essentialism to task is to highlight another sin of omission: the effect of environmental factors on our state of mind. David Matthews crisply summarises this in Monthly Review:

“The intimate relationship between mental health and social conditions has largely been obscured, with societal causes interpreted within a bio-medical framework and shrouded with scientific terminology. Diagnoses frequently begin and end with the individual, identifying bioessentialist causes at the expense of examining social factors. However, the social, political, and economic organization of society must be recognized as a significant contributor to people’s mental health, with certain social structures being more advantageous to the emergence of mental well-being than others.”4

Applied to university spaces, we are now forced to ask ourselves: are there aspects of the way the university is organised that aggravates mental illness, or hamstrings attempts to improve the quality of one’s mental health? If so, how can we reshape the university so that it is least likely to cause an individual to fall prey to mental illness? Note that the second question requires collective action. The dogmas of individualisation and essentialism together function to deflect criticism of institutions and obviate the possibility of collective action, and that is why they must be resisted.

However, just as much as we find the dogmatic approach to mental illness counterproductive, we recognise that it would be equally absurd to argue that the particular circumstances of an individual are irrelevant to their mental health, and that the only relevant variables are those that decide how society at large is structured. Our argument is not with pharmacological intervention when it is deemed necessary by medical professionals, but rather against all forms of atomisation and determinism, whether biological or environmental. As with everything else in society and nature, phenomena and their contexts exist in a dialectical relationship, each shaping and influencing the other. The anti-dogmatic attitude must accord each element of this puzzle its proper significance and consideration, without falling prey to sluggish, uncritical, or senile attitudes.

Who Accommodates Who?

Having characterised the two principal dogmas that dictate how mental health is perceived and discussed, we turn now to a discussion of how mental health crises are responded to. In a nutshell, the response of institutions is focused on the social reproduction of the university space. In practice, this means: do whatever you have to do to make sure people keep coming to work, that they’re functioning at maximum capacity and efficiency. As with the case of individualisation, the bloody-mindedness with which productivity is pursued is fully consonant with the dominant political-economic-ideological framework of neoliberalism. The trouble with privileging productivity above everything else is that the possibility of having a sensible conversation about mental health is foreclosed upon.

For example, almost always under pressure from student groups, a precious few higher education institutes now have counsellors on campus. One might see this as a positive step, but there is something ominous about it: mental health comes to be seen as important, but only because it ensures continued productivity. Our readers will discern shades of this kind of thinking in the words of senior academics and administrators: “Are you feeling blue? Why don’t you head down to the on-campus counsellor and talk through your troubles? And since you’re seeing a counsellor and ‘getting help’, there’s no reason why you shouldn’t continue to come into work regularly.” In this framework, students and young researchers are seen not so much as actual people, but like cars that need a tune-up once in a while, especially when they start making irritating sounds. This instrumentalist attitude to mental health sees counselling as an important part of institutional response, but only insofar as it absolves the university of any responsibility to change itself in a substantial way.

This attitude dovetails smoothly with a larger set of beliefs, reinforced in the little conflicts and minor crises that mark the life of a young academic, about how the university works. While we weren’t paying attention, an orthodoxy was whispering in our ears, prodding us to think that the university is unchanging and eternal and any expectations of reflexivity are foolish delusions; that the young must rearrange and even upturn their lives to accommodate the old; that it is not meaningful to expect the university to accommodate us, that we should instead focus our efforts on how to better fit into the university as it exists. As always, these markers of orthodoxy place exceptional strain on marginalised sections of the student body.

Except, the university should accommodate us, not the other way around because, as we have argued elsewhere, we make the university.5

Anatomy Of A Powder Keg

So far we’ve seen that institutions of higher education respond to mental health crises by individualising the problem, by essentialising it, and by disorganising any efforts that aim to point out structural flaws in academia that doubtless exacerbate these crises in both magnitude and frequency. We also saw that we were expected to accommodate the university, to contort ourselves to suit its purposes, as opposed to the university adopting consultative processes that result in its reshaping to better suit the needs of its members.

So, what aspects of university spaces need reshaping?

Academia, as we have highlighted before, is organised in an intensely hierarchical fashion.6 This lends itself to plenty of room for (physical, verbal, psychological, and sexual) abuse, most of which goes unreported. Those at the bottom rungs of academia have very little freedom or say in how the university functions. This is not some abstract quibble. For example, young graduate or project students routinely find that they cannot independently decide how to organise their day; their schedule is entirely decided by their supervisor. Ask yourself this: how are you supposed to form meaningful networks of care and support if you can’t even make plans ahead of time? Or, can you really relax when you’re constantly worried your advisor will call you (over weekends, after work hours, etc.) and ask for an update on the work you were assigned? This is cause for concern not just among the student body, but also for junior faculty members. The system of tenure and the increasingly contractual nature of academic employment creates a stressful environment where failure to perform may well lead to unemployment. How do we expect people to be creative in their research and teaching if they find themselves high-strung and ill at ease all the time?

Academic spaces are not removed from the society and are therefore segregated along lines of gender, caste, class, religion, ethnicity, and sexuality. In a campus that is cut across with so many divisions, the possibilities for isolation are increased significantly. Where non-academic activities like sports, theatre, cultural clubs, and the like might have helped break down these barriers, these pursuits are either frowned upon or openly discouraged, and lead to the uneven (social, physical, and psychological) development of individuals. Even something as simple as hostel curfews, especially in the case of women, are frequently unreasonable and restrict movement. These restrictions can and do affect the mental frame of people subject to them.

Perhaps the biggest issue is that university work (learning and research) is alienated, meaning that it leaves one with a generalised sense of estrangement from the subject matter under investigation and from one’s colleagues. Science, increasingly compartmentalised, fragmentary, and reeling under the weight of contradictions between production and scholarship, no longer succeeds in inspiring wonder and awe. What might have been a heroic collective effort is reduced to a decades-long tournament-style cage-match that pits individuals against each other. An all-permeating sense of helplessness and an isolation from oneself is entrained.

These difficulties are not insuperable and can be combated, though.

The parallels our crisis of mental health has with our earlier example (of fractured wrists on a factory floor) suggest a plausible starting point. Like the factory floor, it is how our workplace is organised that causes the problem. And like the factory floor, the only way to effect substantial change is for us to band together, organise, and fight for change.

  1. See Agrawal, S. (2021, September 21). 4 suicides in 7 months at IISc Bengaluru during Covid put spotlight on mental health issues. ThePrint; Hindustan Times (2021, September 23). 22-year-old student dies by suicide at IISER Mohali. ↩︎

  2. Higher Education Profile 2019-20, Ministry of Education, Government of India. ↩︎

  3. This is a topic of heated debate. A short introduction to this can be found in Ferguson, I. (2019, January 2). Marxism and mental distress: a reply to Shirley Franklin. International Socialism. A more extensive discussion of these arguments can be found in Ferguson, I. (2017). Politics Of The Mind: Marxism and Mental Distress. Bookmarks. ↩︎

  4. Matthews, D. (2019, June 1). Capitalism and Mental Health. Monthly Review. ↩︎

  5. The NotA Collective. (2021, June 18). We Make The University. Notes on the Academy. ↩︎

  6. The NotA Collective. (2021b, July 22). The Gig Academy Part 1: The Enduring Tenure of Academic Tenure. Notes on the Academy. ↩︎

4 thoughts on “On the Discourse Surrounding Mental Health

Leave a Reply to Privatisation is Violence: On the Predicament of Medical Students in Ukraine – Notes on the Academy Cancel reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s