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*The first three paragraphs of this post contain graphic themes. Please skip to paragraph four if you prefer not to read them.
As you are reading these lines, a smart and pretty young woman seeking a better job in a country not infested with corruption like her own, is being abducted by modern day slave-masters that will make her body into a commodity to be bought, used and discarded. And as she lays stunned beyond tears after her first night in the basement of a brothel, the fear and vigilance regions of her brain are “short-circuiting” and she begins to develop post-traumatic stress disorder.
Right now in a dark cell, on a cold, damp floor, bitter with the smell of urine, a man is slowly oozing blood from where his two front teeth were before the police club of an abusive regime knocked them out. His attempt to give voice to the voiceless has been blocked and his hope fades with the last of his happy memories as clinical depression sets in.
At this moment a teen living in a poor corner of a wealthy cosmopolitan city has been kicked out of his overcrowded classroom for ‘daydreaming’ because his ADHD has gone unrecognized. Heading to the local gang hangout he can already feel the coming cool bite of a needle pushing into a vein in his left forearm sedating his fears and murdering the memory centers of his brain. His reward for selling the same drug to his friends.
I beg you do not misread my intentions for I am not affiliated with a political agenda or party. I am a doctor and the healing of humanity is my creed. In mental health the modern mantra is that psychiatric illness is caused by an interplay between biological, psychological and social factors. Yet when assessing social factors we are often focused on the immediate and personal: financial difficulties, rocky relationships, migration and immigration. But what of larger ingrained social injustice across our world? Racism overt and hidden. Sexual enslavement of women and minors. Systematic suppression of basic human rights and its proponents. Stigma and mistreatment of the mentally ill, physically impaired and developmentally delayed.
Psychiatry has made tremendous progress in the understanding and healing of depression and other mental illness. Our patients have a far better chance of recovery then they did 100 years ago. Yet there remains much to improve upon. Less than a third of depressed patients improve with the first try of an antidepressant medication. Only about 60% recover after four different trials with medications. So many medications cause side effects that are harmful or difficult to bear. I am not against medications. I prescribe them all the time and have seen lives change with their help. But mental health professionals can no longer afford to focus all efforts on the same targets of treatment. We must expand our sights from the individual to the society and from chemicals to injustice.
When we do that we can actualize that noble motto: Saving lives.. Millions at a time
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