Alec Ward | Words, words, words

Fair Enough | We must be more precise in talking about mental health

By Alec Ward 04/19/16 11:51pm

In the short span of time since the Penn community received the tragic news that yet another student had taken her own life, there has been an outpouring of grief and resolve to take steps to prevent future losses. This is heartening and as it should be.

It seems to me, however, that, as in the past, there’s a subtle but critical distinction which has largely been missed in this most recent wave of campus discussions: the difference between emotional stress and mental illness. 

We all experience unhappiness, nervousness, pressure and hurt at times. It may well be true that situational factors at our University cause us to experience these unpleasant feelings more often than necessary, or more often than is constructive to our academic and personal development. That may be an institutional failing well worth taking on on its own.

None of these, however, is akin to the symptoms of a clinical mental illness. More relevantly, none of these is a statistically significant cause of suicide in the United States. The Department of Health and Human Services estimates that more than 90% of people who take their own lives have a diagnosable mental illness, such as clinical depression or anxiety.

Those ailments, much like their physical counterparts and unlike the negative emotions we all feel, don’t have explicable, situational causes. To the degree that they are understood by science, these ailments are thought to strike more or less at random. Current medical science theorizes a number of causes for clinical depression and anxiety disorders, including brain chemistry abnormalities, hormonal imbalances and genetic factors. Situational stresses simply don’t enter the picture.

The idea, therefore, that “Penn culture” or “Penn face” directly causes student suicides is most likely incomplete. A culture can no more cause a person to develop clinical depression than it can give them the flu. Students would not cease to be affected by depression and anxiety disorders if prevailing attitudes on campus were less stress-inducing.

That’s not to say, however, that culture doesn’t enter the picture at all. The broad range of social phenomena that we call “Penn culture” certainly seems to stigmatize deviation from a narrowly-defined set of expected “high-achieving” behaviors. Seeking out adequate treatment for mental illness seems to be one such deviation. While culture can’t cause major depression, it can certainly discourage those who have it from seeking the help they need. This, more so than the quotidian stresses of academic rigor, is what we must confront.

Given the strong emotional reactions we have seen from members of the school community since this most recent tragedy, I almost hesitate to make what may seem a semantic quibble. I will run the risk of over-intellectualizing, however, because I believe that in this case, the semantics are consequential. Whether we conceive of and talk about these terrible losses as the result of a toxic culture or as the result of a failure to connect students with mental illnesses to the care providers they needed has dramatic implications for what courses of remedial action we ought to pursue. Cultural change can only help students who struggle with mental illness insofar as it can make them more willing to seek out the care that they need. If that care is unavailable or insufficient, however, then those students are hardly better off.

Moving forward while keeping this distinction firmly in mind, I believe that Penn’s leaders need to think hard about the fundamentals. They must decide what role they ought to play in providing mental healthcare to students and how they are going to play that role effectively. The current situation clearly doesn’t reliably connect students in need with sufficient care resources.

I suspect that the solution lies in some change more essential than tweaking the logistical details of the extant system. But those are the discussions we ought to be having — the discussions which stand to make a real difference in the long term. The specific answers are for people more expert than myself to devise with appropriate input. But so long as the terms of our discourse remains muddied and confused, those conversations are far more unlikely to be productive. 

ALEC WARD is a College junior from Washington, D.C., studying history. His email address is alecward@sas. upenn.edu. Follow him on Twitter @TalkBackWard. “Fair Enough” usually appears every Wednesday. 

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