A determinação social da epidemia de diagnósticos em saúde mental

Abstract

Abstract
In neoliberal capitalist society, the State assumes the role of mediator in social relations with the aim of maintaining the norm. In this scenario, contradictions and forms of class exploitation emerge that pressure workers to increase productivity and place work as a priority in life. The conception is created for the subordinate classes that individuals must accept their destiny, whether burdened by poverty, precariousness, or injustice. This is a way to distance the reality of exploitation among classes and create indoctrination and a pacifying behavior of the exploited individual. Thus, it is important to discuss how the epidemic of mental health diagnoses is part of this capitalist and neoliberal logic of exploitation and domination over the bodies and lives of working-class subjects. In approaching reality, the central aspect is the capitalist and neoliberal production plan constructed through labor, where we have the labor force implicated in guaranteeing productivity to meet the needs of the capital system. With the purpose of expanding and implementing surplus value and the accumulation of capital, there is an induction of anomalies in human physiology through work burdens, which can cause various damages and even genetic modifications, leading to a deterioration of health in favor of profit (surplus value) produced in the process of exploitation and the capital’s possession of the workers’ surplus labor time. Health and illness, investigated through the empirical dimension of the problem, allow for a study of the social character of disease, reaching the discussion that the bodies of subjects are socially required to be healthy and even unhealthy for the capital system to ensure the reproduction of the labor force, which it does through minimal health care actions for these bodies. Thus, pursuing the advancement of this understanding allows one to perceive health and disease within ontological dimensions of health, encompassing social characteristics along with biological ones that wear down in social reproduction. In this sense, the control over human mental health through the neoliberal lens maintains individual responsibility detached from the critical way of discussing — as proposed by Karl Marx’s dialectical method, which compels one to consider the historical contextualization of territories, culture, economy, and politics. With the absence of a contextualized analysis of individuals’ health, the system influences the understanding that the problem of mental illness occurs due to personal fragility, individualizing the issue. Over time, forms of control over individuals’ bodies have been modified and have come to feed the idea of broadly diagnosing any error or way of thinking differently from the normality that follows the system’s order, to feed the economy. This perception holds that the place of madness and normality are opposite extremes and never occur simultaneously. In current social relations, forms of social inequalities are created, disguised as false freedom. When individuals more easily access diagnoses and treatments, they are inserted into the implicit execution of neoliberal control through the pharmaceutical industry, with the intensified sale of medications fueled by the naturalization of suffering and reduction of access to reality. Diagnoses of psychological suffering are increasingly linked to individuals’ identities, bringing with them a new consumption profile for the market and a new logic in the pursuit of social rights. Mental illness here is seen as biological precisely for the purpose of individual blame, since illness, in this sense, is something abnormal within the subject and not something that needs to be evaluated to think critically about social, cultural, economic, and political transformations of the structure. Neoliberalism needs to maintain control of society, whether through deprivation of freedom or through false freedom, which encourages the feeding of financial capital through the buying and selling of products that promise to alleviate or cure mental suffering. It is worth emphasizing that the excess of diagnoses does not represent only a tool of neoliberal control but also demonstrates how the capitalist system, through class exploitation, can intensify individuals’ illness. Neoliberal society induces the disregard of social problems that cause mental illness, such as discussions about power, race, gender, labor, and class, which directly influence the health-disease process, leading to the deviation of criticism from concrete reality and the traumatic experiences that institutions and structures cause. The dictates of neoliberalism thus induce mental illness, formulate explanations for the phenomena of psychological suffering focused on individualism, and simultaneously establish medications to treat them. Mental health today, as found in capitalist society, is delineated by contradictory movements dictating that the sick being is not only a disposable entity in the capitalist mode of production but also a potential consumer of goods (medications, “healthy” lifestyles, etc.) that guarantee their cure. Thus, the logic of a productive subject is intensified — one responsible for their own life (including health-disease) — and who, even when ill, can be functional for the system. In this sense, psychological suffering becomes yet another instrument for market development, which does not fit into reflections and structural changes by the State, within a narrative of individualization of problems.

Descriptors: Health-Disease Process; Mental Health; Diagnoses; Capitalism.

Keywords: mental health; neoliberalism; diagnoses.