Post-World War II, the Western world's food industry leveraged wartime advancements in food stabilization, initially developed for military needs, to increasingly produce processed foods. These were easy to prepare, inexpensive, and flavorful. However, these affordable foods often contained high levels of calories, salt, sugar, and fat (1).
Decades later, the widespread consumption of ultra-processed foods has been linked to escalating rates of obesity, type two diabetes, and some cancers. People often find it challenging to avoid these tasty, inexpensive, and unhealthy foods, eventually resorting to medication to manage their illness. This issue might have been prevented if people had only eaten fresh food, avoiding excessive sugar or fat. Unfortunately, maintaining such a diet is not feasible for the masses; and it's definitely less tasty and more expensive.
Today, as we confront a decline in mental health and an increase in mental illnesses, scholars face the challenge of providing effective and scalable mental health services (2). These services include digital interventions, such as apps and web-based programs, peer led interventions, and single-session-interventions.
All these interventions are set to provide support to the masses. Scalable interventions at reduced costs.
I am personally developing and researching all these new cures. Therefore, I feel confident stating that we must ensure that the novel treatment offerings we present are not the equivalent of a high-calorie, tasty, and inexpensive food that is also a slow killer.
So, what makes a mental health intervention become the equivalent of ultra-processed food?
When people receive an intervention aimed at supporting their mental health, we would like them to actually feel much better and content with the life they create for themselves.
We definitely don’t want them to just stop complaining.
And this is our mental health intervention equivalent of high-calorie slow-killer: providing scalable-interventions which are also not very effective, and having people stop complaining instead of realizing the intervention was not good enough. This phenomenon could be categorized under the definition of “treatment failure” – a phenomenon that regards a person who decides to seek mental health services, receives a service that doesn’t help, and then stops seeking for different services.
Combating this phenomenon starts with the intervention’s targets.
A good starting point would be ensuring that the values at the core of how we perceive emotional wellbeing are the target of any intervention people receive. I previously wrote a post about the struggle for relevance. Most people with mental health problems suffer due to loneliness, lack of supportive social relationships, unhappiness with their work environment, or difficult transitional periods (due to loss, job change, divorce). These should be the targets of any interventions, as otherwise we fail to reduce the human experience to merely the way they feel or think about their life, rather than their life by itself. When we only target how people feel or think about their life, we build interventions that are like drugs, set to change people’s experience without making sure this enables them to improve the actual problems.
The mechanisms of change through which interventionists aim to help are largely through changing thought patterns or behaviors. Yet, most outcome measures are not whether people, after receiving proper support, are less lonely and lead a life in which they feel more relevant. The outcome measured are sometimes not even whether a sustainable clinical change, such as clear reduction in anxiety or depression, was noted.
Like drugs, the new cures – single-session interventions, digital interventions, non-professional-led interventions – should be tested based on their ability to help people build better lives, rather than merely reducing complaints. It begins by the research scientists lead, but it ends with each and every consumer. It relates to consumers ability to ask the right questions about the interventions they receive, and to make educated decisions about which intervention to use and why. For this reason I co-founded Mindtools.io several years ago, and keep working on different ways to educate the public on the services they choose to consume.
Be well, Amit
1. Food and Agriculture Organization of the United Nations. (2019). Ultra-processed foods, diet quality, and health using the NOVA classification system. FAO.
2. Kohn, R., Saxena, S., Levav, I., & Saraceno, B. (2004). The treatment gap in mental health care. Bulletin of the World health Organization, 82(11), 858-866.