The Cud

This is not just because of the stigma that the mainstream community still attaches to mental disease, but because trends suggest that illnesses of this type are becoming more widely spread. If you haven't suffered from a mental health issue (yet), you almost certainly know someone who has (even if you don't know that they have).

Despite all this, funding and facilities to address mental health issues remain spectacularly poor. This will come as no surprise to those who take a passing interest in the issue, or those who were subjected to Alan Jones' rant about it on the channel 9's ...Today... show on 20 September 2004.

There may of course be (and probably are) many explanations for this. For instance, rather than spending money on mental health issues, perhaps it is far more important that billions of dollars are spent deposing a regime on the other side of the world that the same western governments supported for years during its war against Iran. Perhaps, still billions more need to be spent on manufacturing an alignment with that dictator and a terrorist group that the same governments funded during the war in Afghanistan.

Yet even considered in the context of the priority given to the megalomaniacal pursuits that absorb our current batch of politicians, the minuscule importance that they give to the incredibly pressing issue of mental health in today's society, seems extraordinary. The reasons for this are as debatable as the reasons for mental illness itself. However, it seems possible to find at least some explanation for this extraordinary neglect if we analyse the very nature of the disease.

For starters, before the mentally ill can be treated, they need to be identified. At first glance, this seems relatively straightforward. Someone with a mental illness would seem to be someone who knows ...reality... to be different from the general objective understanding of the ...real... world. However, this at first seemingly helpful solution plunges us into the fraught pursuit of identifying what ...objective reality... actually is. Locke tried to tackle this question and concluded that all we can ever know is ideas, which are ...sense perceptions... about reality and not of reality. In other words, our individual perceptions of what reality is, are actually some (essentially unattainable notion of) objective fact, mediated through our subjective ...sense perceptions... or ideas about those facts. Berkeley and Hume considered the same issue and ultimately concluded that there is no such thing as objective reality, and that all we can ever know is subjective.

This might sound like the musings of a bunch of philosophers with too much time on their hands. But before you dismiss it as rubbish, try (as a mundane example) asking an All Blacks and a Wallabies supporter if that was in fact a "knock'on", or ask a Carlton and Collingwood supporter if that was in fact "holding the ball". You may get agreement, but you are just as likely to get different "objective" perceptions of what amounts to the same set of facts. More seriously, try asking the general public about whether billions of dollars are being misspent on the war in Iraq, or whether the money being spent there is appropriately nipping the bud of the most potentially destructive social, political and economic threat of our time. We all lived through the events of 11 September 2001, some of us lived through the war between Iran and Iraq. Others might even remember the USSR's invasion of Afghanistan and the USA's support of Osama bin Laden and the Muja haddin, but there will not be a single person on the planet whose considered "objective" perception of what is happening in the world today is identical in every respect to another's.

So if we accept (on one hand) that those in need of treatment for a mental illness are those that perceive ...reality... differently from the objective understanding of it, but (on the other hand) accept that there is actually no such thing as ...objective... reality, then
where does this leave the task of identifying the ...mentally ill... in order to provide them with the funding and assistance they require? In a pretty precarious place, I would suggest.

This problem seems even more complex if (assuming the mentally ill can be appropriately identified) we consider the way in which the success of their treatment might be measured. It almost goes without saying that in the absence of evidence of this success, further funding is difficult to come by.

The successful treatment of almost any other type of ...ill'health... can be measured (in its simplest form) by assessing the extent to which the patient has been returned to a state in which they feel well again. By contrast, sufferers of various forms of mental illness (such as acute psychosis) may typically not consider themselves to be unwell. Their experience of ...reality... in the height of an episode of this type is as real and ...objective... as the alternative ...objective... experiences of the ...mentally healthy... or those who are ...treating... their illness.

The success of their treatment then (and perhaps even the need for it), must inevitably rest in the hands of their medical practitioner whose perceptions of how a mentally healthy person should ...perceive... the world is inevitably (at least in part) tied up with the Practitioner's subjective perception of it. This perception inevitably changes both over time and between cultures and (at least to some extent) depends on the ...beliefs, religious and moral as well as factual..., of the practitioner in question (Alexander, P. (1973), Journal of Philosophy, 48, 137'151.). The unavoidable conclusion from this is that an ...objective... means of assessing the success of the treatment of the mentally ill (and thereby substantiating a claim for further funding) may be non'existent at worst and quite elusive at best.

The appalling lack of funding for the treatment of mental illness today undoubtedly has a number of causes. Almost certainly though, the philosophical and ideological problems inherent in identifying the mentally ill, treating them and measuring the success of that treatment, play an important part in the otherwise perplexing neglect of one of contemporary society's most pressing medical and social issues.