I have been a participant in the mental health field for over half a century as a practitioner, researcher, educator, and advocate. When I presented the first World Mental Health Report to the United Nations in 1995, I nonetheless had too little an appreciation for just how huge and severe the mental health crisis would become. Nor did I understand that the stigma regarding common mental health problems would lessen under the pressure of the current mental health crisis, exacerbated by the COVID-19 pandemic and the escalating drug-use epidemic, such that ordinary public discourse about mental health would become mainstream. The time to engage deeply and actively with mental health has come. I thank the American Academy of Arts and Sciences for giving me the opportunity to organize this issue of Dædalus entirely around the subject of mental health, and the authors themselves for their important contributions.
As editor, I have brought a perspective to bear that places the burden of mental suffering in societal context, where history, economic forces, poverty and violence, race, gender, cultural norms, personal agency, and social experience are given prominence. And where tough questions also beg to be asked about the biomedical-research, institutional, and policy orientations and commercial considerations that have come to dominate the field and constrain the responses of clinicians and health agencies.
The contributors’ engagement with mental health illustrates the profound suffering and the search for healing and relief confronting so many in our own society and in countries poor and rich across the globe. While this volume has fourteen essays, they are still insufficient to convey the breadth and reach of this vast subject. Collectively they offer timely illustrations of what much of mental health and care is, or should be, about. Yet they are only an introduction to the key issues that matter to ordinary people and professionals. They convey the extraordinary seriousness and scope of the mental health crisis, but they also describe approaches and interventions that have promise in quite different contexts. I trust that the wisdom and experience of the contributors will inspire, inform, and validate the efforts of so many who are working to find ways to relieve mental ill health and suffering in the most diverse of social and economic contexts.
We urgently need a political movement for mental health that is grounded in a moral purpose, similar to that for HIV/AIDS in the late 1980s and 1990s that produced such wide-ranging benefits for treatment, policy, research, teaching, and advocacy. In 2016, together with Jim Yong Kim, then president of the World Bank, and Margaret Chan, then head of World Health Organization, I organized a multiday conference, Out of the Shadows. We hoped the international gathering would be one inflection point for building a global movement. The contributions to this volume of Dædalus are intended to orient and inspire conversations and action toward such a movement at global and local levels. It is my hope that these essays will provide encouragement to those living with mental health conditions and those working in the community and clinic, as well as researchers and teachers of coming generations, who are committed to the relief of mental and social suffering. If stakeholders ranging from major multilateral organizations to local communities can be supported to fight the most devastating of infectious diseases, so too could we see a global force for mental health in prevention, care, and treatment.
I wish to thank the contributors, especially Anne Becker and Giuseppe Raviola, as well as Phyllis Bendell, Key Bird, and Peter Walton of the Dædalus staff, and our readers for focusing on what is at stake for mental health and those who care deeply about it.
© 2023 by Arthur Kleinman
Published under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license