"Policy-makers, especially if they are elected to their positions, have strong incentives to consider seriously the positions of powerful advocacy groups. For example, strong and effective advocacy by parents of children with ASDs led to substantial policy changes in the United States and other high-income countries, ranging from the provision of services (often paid for by school systems) to markedly increased government funding for research. However, the advocates for autism care and research were largely parents who were able to throw off decades of stigmatization during which they were often blamed by badly misguided mental health professionals as the psychological causes of their children’s autism. For mental disorders such as schizophrenia and mood disorders, however, for which symptoms begin in teen years or adulthood, the illnesses themselves often rob those affected of the ability to advocate effectively. In addition, the pharmaceutical industry has largely abandoned new research on mental disorders as being scientifically too challenging (22), thus sidelining advocacy based on commercial interests. The relative absence of voices advocating for individuals with mental illness puts an even greater onus on policy-makers to attend to the implications of public health data. The question then follows as to whether most policy-makers take data about mental disorders seriously. On the basis of their actions, I have come to believe that they do not...
"I believe that a seemingly more arcane but powerful cognitive distortion also plays a role in the deprioritization of mental illness: the belief that mental disorders should somehow be controllable, if only the affected person tried hard enough or adhered to a better set of beliefs. Given powerful and ubiquitous human intuitions seemingly (albeit falsely) confirmed by introspection, we generally believe that we have transparent insight into the reasons behind our choices and actions. In fact, nearly the entire weight of modern cognitive neuroscience argues that this belief is illusory and that the underlying mechanisms of thought, emotion, and behavior are largely, if not entirely, opaque to us. I have too often seen policy-makers from LMICs and high-income countries alike verbally attest to the importance of mental disorders on the basis of public health data, but then behave as if other disorders are more deserving of attention. My inference, perhaps flawed, is that many do not really believe that mental disorders are bona fide illnesses like any other or that the associated disability, with its invisible causes, is fully credible.
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