Brains around the World: New Thinking on Mental Health Disparities

Some new research and reporting on global mental health and mental health disparities has me thinking about these topics in a new way. This is the kind of context that can add more nuance and sophistication to your reporting on mental health, particularly in ethnic minority and immigrant communities, so read on:

First on the list is Ethan Watters' new book, Crazy Like Us: The Globalization of the American Psyche and his related New York Times Magazine article. Earlier this week, I heard Watters interviewed on NPR's Talk of the Nation program and was struck by his thesis that we are exporting our versions of mental disorders such as anorexia, depression and schizophrenia around the world, along with Western treatments, with dismaying results. Here's an excerpt from Watters' NYT magazine article:

We have for many years been busily engaged in a grand project of Americanizing the world's understanding of mental health and illness. We may indeed be far along in homogenizing the way the world goes mad.

This unnerving possibility springs from recent research by a loose group of anthropologists and cross-cultural psychiatrists. Swimming against the biomedical currents of the time, they have argued that mental illnesses are not discrete entities like the polio virus with their own natural histories. These researchers have amassed an impressive body of evidence suggesting that mental illnesses have never been the same the world over (either in prevalence or in form) but are inevitably sparked and shaped by the ethos of particular times and places.

To which veteran science journalist Paul Raeburn responds: piffle.

When Watters is critical of Western views of schizophrenia, he doesn't challenge the science; he challenges the "biomedical narrative," a fuzzy notion that is neither provable nor unprovable

A recurring theme in the piece is that "indigenous forms" of mental illness are somehow superior to, or less harmful than, scientific understanding and treatment of illness Would Watters really argue that an incoherent, hallucinating person with schizophrenia living on the streets of New York needs a belief system rather than an antipsychotic drug?

Then, I happened upon this large new study on similarities among schizophrenics in 37 countries, and Watters' arguments (and Raeburn's contrarian analysis) made me think about the study in an entirely new way. Did the fact that almost all of the study's authors work for drug maker Eli Lilly, maker of Prozac, affect how the study was designed? The study is partly behind a firewall; here's a Medical News Today article on it.

Related historical research on racial disparities in diagnosing schizophrenia in the United States also appears in a new light. From a Medical News Today article on "The Protest Psychosis: How Schizophrenia Became a Black Disease," a new book by University of Michigan researcher Jonathan M. Metzl:

Black men are over-diagnosed with schizophrenia at least five times higher than any other group - a trend that dates back to the 1960s, according to new University of Michigan research.

Would these books and studies change how you report on mental health? Share your thoughts in the comments below. You need to be a registered member of Center for Health Journalism Digital to leave a comment, so if you haven't joined yet, click here. It's easy, quick and free. You can follow us on Twitter, too, @ReportingHealth.