Society Needs Madness

Over the last decades, with an improvement in technology, a refinement of mental health services, and significantly more research, we have transformed the way mental health problems are approached and perceived. From treatments like blood-letting, and lobotomies from the 17th to 19th centuries (Concordia University, St. Paul, 2020), we have arrived at an integrated bio-psycho-social perspective that prioritises the patient. An extensive amount of resources has gone into research regarding treatment, prevention, and etiology. So, naturally, one would expect a decrease in mental health problems. Yet somehow, the prevalence of mental health disorders has nearly doubled in the last decade (Ten Have et al., 2023).

The prevalence of mental health disorders refers to the specific proportion of people within the population that have these mental disorders. Studying prevalence is important when considering the resources that need to go into planning for services and treatment on a global scale (Ravichandran et al., 2025). Additionally, it can also help us study patterns of change, to help identify relative increases or decreases in the number of people with a certain disorder. (Coughlin et al., 2021). For these reasons, prevalence is considered an important part of mental health research, and reasons behind changes in prevalence are often debated heavily.

Unsurprisingly, extensive research has been conducted to identify why the prevalence of mental disorders has increased from approximately 25% to approximately 50%  (Ten Have et al., 2023). A big part of the rise in prevalence could be linked to the society we live in and the pressure that comes with it (Zeira, 2022). A predominantly capitalist society such as ours revolves around success and achievement. From the moment we are born, we are taught to fit into socially constructed structures that reward productivity and efficiency. Under this constant duress, failure seems almost unacceptable and even moderate success is looked down upon (Nunes et al., 2022). Not only are we trying to meet high standards, we must also be better than the person beside us. With people on social media broadcasting every impressive aspect of their lives, we start to lose sight of the person and instead, see the things we can’t do (Testa, 1990). Comparison quite literally is the thief of joy— it’ll leave you feeling like less the more you do. Honestly, it makes the fact that at least half the world has had a mental disorder at some point in their lives that much more understandable. 

Additionally, with an increase in urbanisation comes a reduction in mental health. With fast-paced urbanisation and an increasing population, people are exposed to greater amounts of stressors and environmental adversities, ensuring that every individual struggles to remain unscathed by daily life (Srivastava, 2009). Was my father right then? Does the privilege that comes with living in such urbanised societies increase mental health struggles.

Yet, as easy as it is to claim that privilege and urbanization is causing an increase in mental health problems, we are missing one crucial factor. With an increase in urbanization and scale of research conducted also comes an increase in awareness. As a society, we have become more accepting of mental health problems, and with research comes greater insight into what the true prevalence of our population really is. While some skeptics argue that psychology is dangerous because we run the risk of pathologising everyday emotions (Ratnayake, 2022), I would argue that we have finally started paying attention. Disorders that were previously labelled as the behaviours of the mad are now recognised as symptomatic behaviour, allowing individuals to seek help for it with a significantly lesser risk of being ridiculed or criticised for the same.

So if the current research is more reflective of the true prevalence, can we ever truly see a complete reduction in mental health problems? If we continue living in the society we live in, most probably not. Michael Foucault, a French historian and philosopher, who studied the power dynamics within society,  had much to say on this line of thinking. According to his ideas, we need madness. Society needs people “lesser” than us to feel better about ourselves. He reasoned that the concept of “madness” itself is primarily a social construct created to control and exclude (Rousseau, 1970). Even if we somehow manage to rid the world of every mental health problem that exists today, it is highly likely we will create other problems due to this need for social comparison. Essentially, it isn’t only the privileged that suffer from mental health problems, but rather the privileged who decide which forms of suffering are paid attention to. 

With this in mind, the question of why there has been no reduction in prevalence does not require the importance it is given. Mental health problems will exist regardless. Our focus should shift toward trying to help anyway. The fact that people are suffering should be reason enough to act, and endlessly debating the mechanisms of the cause of disorders on a group level will get us nowhere.