I'm in graduate school to be a therapist. All of the students, and the professors, acknowledge that managed care/insurance is absolute bullshit and limiting; however, we're told we have to learn to maneuver the system in order to work. At least at my school, there's a large cohort who critique capitalism and pretty much recognize how solution-focused therapy, CBT, etc. are just tools to be able to create functional workers--professors laugh and agree--but there's little discussion about what to do about it.

If I'm being totally honest, as someone who has been in therapy since 15-years-old, in-patient rehab, IOP, etc., what helped me the most was using mushrooms therapeutically and connecting with nature, meditation, and reading spiritual texts (Taoism, Mahayana Buddhism). I am embarrassed to admit this, as I'm well aware of the pitfalls of "new age" thinking. But it took something radically different for me to see the bigger picture. Is it possible to spawn this kind of change through talk-therapy alone? Probaly not. Mental health research is not making any important discoveries (apart from neurological advances), things are getting worse. Labels provide a convienant language to discuss mental health but it's to complex to narrow diagnosis down to "depression, bipolar, anxiety" etc. As you can tell, I'm frusterated to no end about this and trying to figure out how to create systemic change (or atleast acknowledgement of the problem?) within the system itself.

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Disclaimer: of course mental health is a serious phenomenon that has solid grounding to be treated as a medical condition. I myself struggle with MDD and treat myself with micro-dosing psilocybin, and I HAVE to maintain healthy practices or I will devolve into a miserable blob. Getting rid of capitalism wouldn't solve conditions like this, and I'm not going to argue that it would. Instead, I want to argue that mental health problems that exist naturally are exacerbated by capitalism, and a great deal of mental health problems are straight up caused in people who otherwise would not have them.

I think you're 100% right, and Citations Needed (a podcast) did a great episodes on this phenomenon, or at least that touches upon it.

https://m.soundcloud.com/citationsneeded/episode-109-self-help-culture-and-the-rise-of-corporate-happiness-monitoring

The pathologizing of depression or unhappiness as purely an individual condition, viewing it as product of someone's brain chemistry or personal outlook, conveniently ignores the material conditions that might rationally cause someone to have a very negative world view. Like - the entire world is fucked, isn't a negative world view and psychological distress a reasonable reflection of that situation? It would take an extreme form of solipsism to tune out the massive suffering going on in the world and collective failure of all institutions to adequately handle our compound crises.

Pills and therapy aren't a real solution to the mental crisis, I think they're better seen as a coping mechanism (and I don't have a problem with them being used as such when necessary, like I said upfront, I 100% acknowledge the medical basis), but they are the mechanisms that requires the least systemic change and protects power structures so they have become our ONLY tool. The market won't provide what isn't profitable, so shop around for your coping mechanism that we can make a buck off of and get back to work: don't you feel so free?

Access to secure housing, medical care, time for leisure and self-enrichment or education, a sense of community and belonging instead of vapid consumerism, healthy and whole foods; all of these things (especially together) would probably do more to reduce, 'cure,' and prevent mental illness than all the pharmaceuticals in the world, but these solutions would require fundamentally changing the way we organize production and power in our society. Many of these solutions might have, technically speaking, a net reduction in productivity as our culture and institutions shift towards enrichment of human life instead of productive output - so it would literally be inefficient in our current cost-benefit analysis models. That's the problem with the assumptions of capitalism and contemporary economics, though, that accumulation of capital and increased consumption are fundamentally good things. We should maximize production and cut costs and anything short of that is inefficient; only problem is we've abstracted labor to a letter in a formula instead of acknowledging that it is comprised of real humans whose happiness and interests and needs are ends in themselves, not just another input. Just because we can crank out more widgets doesn't necessarily make us any better off, and late-stage capitalism is the perfect example of that.

So, we keep on shoving the responsibility of happiness and mental health onto individuals instead of looking at it as a collective endeavor, and follow with the market trend of atomization. We all medicate ourselves one way or another (if it's not pharmaceuticals, it's something else) to get through this hell world because the models tell us that's what's rational. It's the ultimate case of the tail wagging the dog. We shape ourselves and society in a way that agrees with the models instead of changing the models to fit our needs. It's absurd in a kafkaesque kind of way.