mental health

[OPINION] DASS boot

Ronald Del Castillo
[OPINION] DASS boot
'Do we believe others to be so gullible that they are easily influenced by a number? Do we think them incapable of distancing one psychological test from the complexity of a mental health diagnosis?'

Did you take an online psychological test recently, and now others are socially signaling their concern?

Good.

No worries; their already-warped caution says more about them than it does about you. You carry on, they’ll Karen on.

The trend goes something like this: Someone takes the Depression, Anxiety, and Stress Scale (DASS), a well-validated, self-report questionnaire easily available online. They announce their score and then wait for a reaction. And since the internet maximizes our opinion and overvalues our opposition, our attention is arrested and there is an upswing on Google Trends.

I assumed a few things. Some took the test because there is an increasing online audience to watch that performance. Others posted their scores in the fuzzy realm of sentiment for an audience that never has to leave. Perhaps some wanted to express their distress but left us wondering if the experience of communicating that feeling was engineered to create specific impressions or, worse, to misrepresent.

But I was also left puzzled. Why did others, including professionals and expert-adjacent advocates, presume that something troubling was afoot and that the ideal, or even helpful, thing to do next was to correct it?

We should not rely on only one psychological test, they say. We should be careful about what the numbers really mean, they add. We should ask for help from professionals, they insist. All that seemed sensible enough. They cannot be denied a genuine wish to lend a hand. But my own wish is to more deeply understand what appears to be yet another signal from the code of elite, “educated” manners.

The claim is all about monitoring and safeguarding our health and safety. This would be convincing if it was not some sort of attempt to signal power – digitally mediated, utterly consumed by so-called experts.

This path is predictable, because it is old. Professionals and experts alike will praise us for the help-seeking behavior. Then, in the same breath, they will invalidate with a warning. It is a locus of shame disguised as benevolence.

The enterprise stinks of mental health microaggressions. For one, it is an attempt to retain what accounts for problematic behavior. It is no longer about individuals engaging in carefree curiosity about the valence of their mental world. It is no longer about decent people likely caught up in yet another asinine trend that will be dismissed to the backstage of the internet the next day.

Do we believe others to be so gullible that they are easily influenced by a number? Do we think them incapable of distancing one psychological test from the complexity of a mental health diagnosis? Do we place such grim value in the communication of vulnerability that instead of opening ourselves to personal allegory or metaphor it is now symptomatic of population ill health?

For another, the warning is a reminder of who gets to frame so-called issues as problematic in the first place. This virtual signaling is a descendant of a mental health system historically dependent on uneven access of information. But the trouble for knowledge holders is that the internet has collapsed our world. The energy of professionals these days is diverted away from communicating that knowledge and is pivoted towards keeping in check that the knowledge is not contaminated.

We claim empowerment among the most vulnerable but demand restraint, nearly hidden in jargon that borders on condescension, when they exercise that self-determination. There is reconsideration of power dynamics so long as knowledge holders do not lose theirs. Public information on mental health becomes an “issue” that needs “experts” to ensure that things do not “get out of hand.”

This medical gaze denotes a humanizing attitude towards mental health but makes actual mental well-being very hard. We end up using self-diagnosis as a peg for professional entitlement without the discourse needing to supply evidence that that is what is actually happening. Calling it “trending” neither verifies that it is nor warrants a response.

And what I find disappointing is witnessing well-meaning students and early-career Filipinos who hold the promise of transformational changes to our mental health care system become enablers of the old order. If this DASS non-starter is any indication, there will be progress but progress on their own terms. They will concede the necessity of deinstitutionalization but resign to it as a longer term plan.

And when that time comes, the framework – and it is always some framework – is based on the medicalization of illness. They will rally for social inclusion and community integration of Filipinos with mental health problems but will stop short of the social identity and social status necessary to combat structural changes. And when that structure does not change according to their image, they will demand accountability but not of themselves.

It is perfectly plausible that for some who did the online test it was the first step toward naming their inner world when the outer one has been a slow-burning horror. This is not the problem. That grim reality lies elsewhere. – Rappler.com

Dr Ronald Del Castillo is professor of psychology, public health, and social policy at the University of the Philippines Manila. The views here are his own.