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Comment by tomp | Hacker News Reader

My interpretation is the exact opposite.

Our society (well, the US and increasingly Europe where I’m from) has put a lot of resources and effort into mental health, largely by following “expert” recommendations.

Tons of people are being treated for mental health, children are medicalised, employers offer mental health courses and insurance, people sharing experiences about burnout, language being changed to avoid offending people, …

Yet the problems keep getting worse.

Maybe the experts are the problem?

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> Maybe the experts are the problem?

Or more likely, the current approach just doesn’t work very well.

If everyone with a disease starts taking a medicine, and nobody gets better, it doesn’t mean the medicine causes the disease, despite the correlation. It just means the medicine doesn’t work.

maybe it's difficult to call either way

But if, after the mass introduction of that medicine, the number of people with the disease skyrocketed, then there’s a decent likelihood the causality does actually go that direction.

With other treatments for diseases we always expect the incidence rate to decline — because the treatment works. If it stayed static or went up slightly, then the treatment doesn’t work (and you’re might have slightly higher rates due to new interest in the diagnosis). But huge increases…that’d not be good.

Right, I wrote the above comment in a way that implied I blame the experts; I didn't actually mean that, by first approximation my "most likely" belief is simply that experts don't help at all.

But it's not hard to come up with actual causal reasons why experts are actively making things worse:

1. if people have confidence in experts, they'll seek treatment from them, and forego other, potentially more effective, treatments (in this particular case: making and talking to friends, not therapists; prioritizing family, not shunning them; prioritizing community, not isolating; etc.)

2. experts make a living selling advice to patients, so it's in their implicit interest to keep having patients (either individually, not curing them, or society-wise, making more patients) (there's a lot of anecdata about "I asked a therapist how many patients they actually cured, and they looked at me bewildered")

3. I've seen some opinions, which echo mine, that experts seeking, reaffirming, and reminding patients of their "traumatic experiences" might hurt more than it helps (e.g. talking to therapist every week makes you re-live your traumatic experience; narrowing the definition of "consent" and convincing women they've been raped; convincing children they're trans (they used to be called "tomboys!"); in general marking fairly normal life experiences - job loss, job stress, death in family, etc. - as "traumatic" and "requiring therapy")

probably more

> Yet the problems keep getting worse.

> Maybe the experts are the problem?

I'm not sure I follow your logic. What do you hypothesise to be the causal factor linking these things?

I think we could look to any number of things that could exacerbate mental health issues. Climate disasters, social alienation, rapid inflation, political disillusionment, patriarchy etc.

> I'm not sure I follow your logic. What do you hypothesise to be the causal factor linking these things?

Hypothetically? It's common for an industry to want to expand their market.

Imagine you're a big drug company, and you make decent profits selling drugs to treat shell-shocked soldiers returning from the front lines after losing limbs and seeing their buddies die right in front of them.

You look for ways to increase your sales and add to your profits. What if you could also sell your drugs to people who've been in bad car accidents? And to rape survivors? And to refugees fleeing from war? And to mothers who had particularly difficult births? And teens subject to severe bullying? What about cancer survivors, or people who've struggled following the death of a grandparent?

It's easy to see how higher diagnosis rates could go hand in hand with higher sales and higher profits.

I imagine all of the people you listed would be suffering from mental health issues without the need for a conspiracy theory.

I can see some logic in you're hypothetical but there are numerous other causal factors which seem much more likely.

> I imagine all of the people you listed would be suffering from mental health issues without the need for a conspiracy theory.

Maybe, but I wouldn't dismiss hypochondria or mild hysteria that quickly. If you keep hearing people talk about skin infections, you'll notice yourself itching more...

The current movement focuses almost exclusively on the individual. When the best solution to most problems is collective as part of a society, community, family, team etc. It offloads structural problems on the individual and makes people feel bad when they inevitably can't fix themselves. All whilst making money out of solutions. It is similar to blaming climate change on individuals whilst ignoring massive oil companies.

Don't forget that there's money to be made in those medications and treatments!

And employers will pay for some cheap benefits to minimize chances of employees being able to win a lawsuit against them.

Isn’t this an “oncologists cause cancer” or “gerontologists cause aging” or “umbrellas cause rain” view?

No, because those things don’t dramatically increase the incidence rate.

We have far more oncologists now than we did 100 years ago, and far more cancer diagnoses.

If the correlation between increased attention on mental health and increased mental health diagnoses is sufficient to show causality, why not with oncologists?

People didn't start dying once they started getting diagnosed with a cancer, they were dying just the same undiagnosed. That sort of logic doesn't work as well on something as fuzzy as mental health or "are you happy?".

But, for example, deaths from e.g. breast cancer have gone way down since we started treating it.

If experts were the problem, then it would be statistically obvious that people were worse after meeting experts or taking their advice, and better off before.

But, that gets the order reversed. People seek mental health treatment after they already have a problem, not before.

It's much more likely that widespread effects are the cause: pollution, social media, poverty, capitalism, racism, etc.

Actually a lot of it is increasingly proactive not reactive.

I think what GP might be saying is that there is some risk associated with therapy (e.g. https://www.psychologytoday.com/us/blog/insight-therapy/2020... —- not sure if it’s a good source but you can find plenty more with a search) and, if today we push therapy widely even for relatively minor issues, in those cases that would have fixed themselves with time it’s possible to get a negative outcome.

I agree. Psychologists are almost always the most unbalanced people you can meet.

PS Apart from psychiatrists and priests. Probs they should all wear magic hats when pulling out their expert opinion in court.

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