Chapter 3 – Where does Mental health train go?

We used the rail transport metaphor for no other reason than to make it easier for us to consider Mental Health as a system. Following the above mapping we can create a first (chaotic, unclassified,and indicative only) list of involved factors or related situations (properties, entities and processes):

Citizen, future affected, mental health services users, urvivors, health / MH professional, MH service delivery systems, National Health systems, scientific research, private business sector, politics / politicians, legislative / executive / judicial authorities, local and regional government, mass media, educational system, advertising, social networks, information, urban / rural environment, spatial planning, sport, art / culture, history, family, age segregation, gender segregation, employment / work environment, nutrition, physical activity, gene structure, religious backgrounds, national /
supranational structures, social stereotypes, interaction with other health problems, human rights, gross national income etc.

Α. It is relatively easy to quantify the above factors: a series of concentric circles are created where each of them adds one or more groups of stakeholders. However, starting from a cycle of a rare mental disorder with a minimal number of patients, this number is increasing exponentially according to statistics: according to the latest IHME estimates, more than one in six people across EU countries -17.3%- had a mental health problem in 2016, 84 million people. Source: PROMOTING MENTAL HEALTH IN EUROPE: WHY AND HOW? HEALTH AT A GLANCE: EUROPE OECD/EUROPEAN UNION 2018). This number is multiplied by 3 in case we include the close family environment of a patient who is affected respectively and reaches 252,000,000. And the final outer concentric circle reaches to cover the whole population when the dimension of prevention is added. Thus, from a very small initial total we reach 446,000,000 citizens of the EU or the total 747,000,000 citizens of the member states of the Council of Europe.

Β. It is obvious that random combinations of a limited number of factors in the above list would give completely different, often opposite, results for a request that would include them. It is also obvious that to date there is no common functional framework that is able to include, correlate and organize according to their characteristics and dynamics all the above factors as the initial arrangement of concentric circles seems to serve only quantitative representation needs. In the meantime, however, the dynamics increase dramatically as individuals / entities come together with multiple attributes that participate simultaneously in different cycles: a patient follows one or the other therapeutic direction, works in a pharmaceutical company, embraces the x religious doctrine, comes from the y state etc. Thus, the representation through concentric circles that we used to highlight the quantitative dimension proves to be insufficient as only new subsets as sets of sets are able to yield the dynamics resulting from the interrelation. And this happens in a typical way only. A first sense of correlation as a Health”.

Activating any cell in the table immediately displays only those associated with it according to the table’s syntax parameters:

C. During the creation of the above interactive presentation, it was realized that any attempt for a complete and functional description of even a small part of the field would lead to an entire universe. The most inclusive term that could be used up to this point for Mental Health to facilitate the evolution of reasoning would be “(global) social space” in the sense that it is not only individual, nor imaginary but also is not defined / limited by borders or levels of development of any kind (historical, economic, social) However, the term “space” does not include per sefunctional characteristics, it is limited only to the elements and theshell of the set and does not provide any information about the existing dynamic relations (interactions) between the elements of this set. To the extent that our goal is a transformation intervention, as stated in the introduction, the only term that would provide us with the necessary vision (and methodology) is the “system”. Generally speaking, in a “space” things are just located, while in a “system” things happen.