The Problem with “Resilience:”​ Whose Responsibility is Mental Health?

BY PETER VARNUM

Googling “manage your mental health” will turn up pages upon pages of results with tips and tricks for just such a task. The message behind this content is that it is the responsibility of each person who is struggling to figure out how to “be resilient” when facing struggles. The responsibility for mental health lands on the struggling individual. This is a convenient excuse for policymakers to sidestep their obligation to shape societies that are more equal, less stressful, and less anxiety-inducing.

I have lived through this skewed view of my own mental health for nearly 20 years. After four hospital visits, countless therapy sessions, myriad medication changes, battles with insurance companies and uncomfortable conversations with employers, I now manage my mental health with a regimen that works for me. My journey toward a life where I am comfortable and thriving has largely come despite interactions with the health system, not because of them.

Notably, this regimen is now 100% outside of any system. I pay $115 US out of pocket every week for my virtual therapy session with a therapist I trust and have worked with for nearly seven years. I am very good at understanding and listening to myself to know my own triggers, vulnerabilities, and limits – an invaluable skill honed through years of practice.

I am also extremely privileged. I was given multiple chances to recover and succeed – chances that many people are not given – and my family’s ability to pay out of pocket for private university education allowed me to circumvent the American student loan crisis. At least until graduate school. But I did go to graduate school; I moved from the US to Switzerland and found work; and a high Swiss salary allowed me to pay down graduate school debt and build my career. All while learning, growing, managing my mental health – a time period that included suicidal ideation and an episode of psychosis. I met my wife in Geneva and followed her to where we are now, in Oslo, Norway, because she was offered a critical job opportunity here at a critical time. It was not hard for me to find remote work, and I have European citizenship because of my family’s history. This allowed the transition to Norway to be relatively straightforward.

My privileges have been exceptional, and I fully reject any notion that I am where I am solely because I have “resilience,” whether innate or learned.   

I am not advocating against formal interventions that help individuals build mental health resilience, such as therapy or medications. I recognize the importance of building skills to manage oneself in the world we live in, and I myself am in therapy and on medication as needed. What I am saying is that the onus to manage a person’s mental health should not fall squarely on the shoulders of that person.

In many parts of the world, we have done so much good work to eliminate stigma of mental health. Particularly among young people, the subject is no longer taboo in much, though not all, of the world. But as Colette Shade wrote a couple months ago in The Nation, campaigns to fight stigma can miss the mark: encouraging folks to reach out is great and may be well-intentioned, but what are folks to do when the system to which they “reach out” meets them with extended waiting times, prohibitive costs, and clinicians who view them as problems to solve rather than people to care for?

Indeed, stigma fighting is necessary, but it’s as important to recognize the conditions that people encounter in their lives that influence their mental health. Shade also penned a brilliant piece recently on why addressing mental health at the population level is a political question, not an individual one. She writes about a thriving society wherein people have basic needs such as access to food, water, healthcare and steady income covered, and wherein they can also engage in meaningful pursuits and relationships fueled by love and innate value.

The concept that societies should be responsible for their citizens’ wellbeing is not new. It is in fact a fundamental reason for the existence of government. But we have consistently created systems, over centuries, that guarantee privilege to some and poverty to most. The capitalism of today has widened that inequality, but the fact that where and to whom you are born dictates much of how your life may look is not new.

We now know, with greater certainty than ever, that there is a bidirectional relationship between mental health and poverty: a loss of income can lead to poverty and worse mental health; and worse mental health can lead to reduced employment and therefore poverty. The converse is also true: an increase in income can lead to better mental health, and people with better mental health are more easily employable. There is much still to learn about the effects of economic interventions on mental health over time, but the basic premise that people are more likely to experience depression and anxiety if they are poor than if they are not poor is inarguable.

So why is much of the messaging focused on things like “tips for managing your mental health?” Why do so many tech solutions promise a flashy new way to track and improve your mental health? Why is the buzzword “resilience” showing up everywhere from workplace mental health initiatives to actual legislative programs? Why is the onus on individuals and not societies?

Why are people in power – the same people leading the charge toward individual resilience in the face of an unfair world – not using their power to make the world fairer?

To claim that people, workplaces, and communities need to “learn resilience” is to admit that there are conditions within people’s environments that require such a skill. Furthermore, there is an implicit message in the concept of resilience that there is “something bad out there” against which we must shield ourselves. I fear that, though well-intentioned, champions of resilience will actually create clusters of individuals who are more untrusting, more isolated, and lonelier than they are now. Society would be increasingly made up of factions for whom critical thinking and productive discussion would threaten the experience of being human, not enhance it.

Life requires handling adversity, but leaders have the power to influence how much and what types of adversity happen – or do not happen – as a result of our economic and cultural systems. I dream of a world in which individuals are not the sole bearers of responsibility for figuring out a mental health regime that works for them. Not because we have solved for “how to teach resilience,” but because mere existence will not require us to be quite so battle-ready.

*Originally published on Linkedin.

Peter Varnum is the Chair of the Board of The Stability Network and Associate Director for Orygen Global, looking after Orygen’s collaboration with the global youth mental health community. Prior to Orygen, he built and led the World Economic Forum’s work on global mental health. He also serves on the Healthy Brains Global Initiative’s Lived Experience Council. He earned a BA in English from Carleton College and an MA in Law and Diplomacy from The Fletcher School at Tufts University and completed the World Economic Forum’s Global Leadership Fellows executive education program.