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>Because the census relies entirely on self-reporting, experts say the data could also be capturing a shift in how people perceive their cognition, even absent

>Because the census relies entirely on self-reporting, experts say the data could also be capturing a shift in how people perceive their cognition, even absent changes to their health. >People with disabilities might have taken note of rising disability acceptance and become more likely to answer the census questions honestly, researchers say. >But those changes in perception are likely to have a relatively small influence on the numbers, said Monika Mitra, who directs the Lurie Institute for Disability Policy at Brandeis University. Most of the increase is probably capturing real changes in people’s health, she said. [emphasis added] In conclusion, experts and researchers say one thing, Monika Mitra says the opposite, so we really don't know.

faeriechangling 3y ago
I can’t help but notice the word “honestly” there. I am sceptical that people are being more honest now than they were before. I think that people feel more sick than they did before. I also feel there is a huge societal trend of medicalizing how people act and feel and expressing it in terms of it being a mental illness or disorder. I’ve noticed that mental health outcomes keep getting worse and worse and doctors consistently go “wow that’s great there must be so much more awareness and acceptance of mental health problems!” That’s a very self-serving interpretation and I don’t understand why people don’t question it more.
- coffeesque 3y ago
  > That’s a very self-serving interpretation and I don’t understand why people don’t question it more. People say "don't talk to police" because they can fuck you over, legally speaking. Regardless of whether you're innocent or guilty, you stfu when police are around Psychologists can also fuck people over legally speaking (and likely will be able to even more so in the future), but the same standard doesn't exist for some reason, instead it's a bunch of people willingly talking. And there's also no due process either, the entire system goes around it
  - faeriechangling 3y ago
    This is a whole different tangent, but I could go on about 1: That psychiatrists can give you a lifetime diagnosis, without your consent to doing so, or agreement as to the diagnosis, with demonstrably negative social and legal consequences, without your consent or ability to remove the diagnosis from your medical history (barring exceptional circumstances). Being gay/trans already had to be removed as mental health conditions due to psychiatrists admitting they were only hurting them by labelling them mentally ill, but they fixed this by deeming these things as NOT mental health problems, but still not actually giving people the ability to refuse to consent to a diagnosis which would have prevented much of the harm to begin with. This is then reinforced by scheduling and denying access to useful medicines like amphetamines and insurance coverage UNLESS you accept a legally and socially consequential label of being mentally disordered first, so even if people had the choice not to be labelled as disordered, they may not take it anyways because they will live a lower quality of life if they do not accept that label. I have NO idea how to solve this issue. 2: the whole involuntary hold thing. This I won’t get into that much, because it’s one thing to come up with a morally self-righteous take on this issue, and it’s another to deal with the reality that some people if left to their own devices WILL hurt themselves. Also there really is a lot of due process around this matter, the problems are really around the details and implementation. I have NO idea how to solve this issue.
    - projectazorian 3y ago
      > This is then reinforced by scheduling and denying access to useful medicines like amphetamines and insurance coverage UNLESS you accept a legally and socially consequential label of being mentally disordered first, so even if people had the choice not to be labelled as disordered, they may not take it anyways because they will live a lower quality of life if they do not accept that label. I have NO idea how to solve this issue. Is an ADHD diagnosis really that "legally and socially consequential?" What are these consequences you describe, and how would one become subject to them? I'm struggling to think of any real consequences, unless you are an airline pilot or have a security clearance, and even then I don't think ADHD is a deal breaker.
techdragon 3y ago
/sarcasm… right? This “one person disagrees therefore it’s not settled”… this needs to die. We collectively need to raise the bar of human discourse above this tiny hurdle and put an end to anyone who isn’t drunk accepting the argument of one single person against the global consensus… And before anyone chimes in with arguments about examples of righteous crusades against genuine problems in the world sparked by a single person… the obvious counterpoint is that these people stop being “one single person” when they convince someone else in a one to one conversation… good arguments persuade people and gather people around them… one lone voice arguing against the consensus is a crank who should be ignored without guilt… not platformed under the guise of balancing some illusionary other side of an argument… Looking squarely at you BBC… the ABC in Australia aren’t particularly good at this either but the BBC are the absolute fucking worst at this.
- faeriechangling 3y ago
  The “global consensus” is decided by doctors who have a vested interest in claiming that any negative rise in mental health outcomes is a victory because it shows better mental health awareness, rather than a failure and showing that contemporary medicine is either ineffective or actively harmful. Relying on the “global consensus” here is a fox guarding henhouse situation. In any case, nobody has any real evidence as to what could be causing this effect, only conjecture.
  - dkonofalski 3y ago
    Wouldn't their interest be in the opposite? Wouldn't they want people to think that doctors have the answers rather than doctors failing at helping with mental health issues?
    - faeriechangling 3y ago
      That would be in their interest, but being concerned about things like declining mental health metrics only happens if there is public pressure for the mental health field to be accountable by some sort of empirical measure. What I sort of wish people did more was hold the mental health field, from pharmaceutical conglomerates to individual practitioners, to some sort of standard. What we have now is either the field is succeeding because self-reported mental health is improving, or it’s succeeding because self-reported mental health is going down which means mental health AWARENESS is improving. I feel how the mental health field has spun things like gradually increasing suicide and drug addiction rates (proof of mental health underfunding!) has been broadly successful for the field. What I would like to see mental health practioners just start treating a patient population and for them to improve so dramatically that they discontinue treatment and live “normally”. Or maybe their lifespans measurably improve. Or suicide rates plummet. What I see instead is this sprawl of mental health services which are big on promises, big on “pro-awareness” rhetoric, and short on results at the societal scale.
Erratic6576 3y ago
Yeah. I don’t believe I’m dumber now than when I was younger. I believe I’m more aware of the cognitive fog I’ve always had in my head, how unintelligent I’ve always been.
actuallyalys 3y ago
First, Monika Mitra is a professor of disability policy, so she is also an expert. Second, it's a little ambiguous how much they disagree. To use slightly contrived numbers, it's possible the first group of experts and researchers think perception changes and increased honesty explain 2/3 of the increase, but Mitra things it explains 1/3. The wording also leaves open the possibility they basically agree with Mitra and just feel less confident ruling out changes in perception.

faeriechangling 3y ago

I can’t help but notice the word “honestly” there. I am sceptical that people are being more honest now than they were before. I think that people feel more sick than they did before. I also feel there is a huge societal trend of medicalizing how people act and feel and expressing it in terms of it being a mental illness or disorder. I’ve noticed that mental health outcomes keep getting worse and worse and doctors consistently go “wow that’s great there must be so much more awareness and acceptance of mental health problems!” That’s a very self-serving interpretation and I don’t understand why people don’t question it more.

coffeesque 3y ago
> That’s a very self-serving interpretation and I don’t understand why people don’t question it more. People say "don't talk to police" because they can fuck you over, legally speaking. Regardless of whether you're innocent or guilty, you stfu when police are around Psychologists can also fuck people over legally speaking (and likely will be able to even more so in the future), but the same standard doesn't exist for some reason, instead it's a bunch of people willingly talking. And there's also no due process either, the entire system goes around it
- faeriechangling 3y ago
  This is a whole different tangent, but I could go on about 1: That psychiatrists can give you a lifetime diagnosis, without your consent to doing so, or agreement as to the diagnosis, with demonstrably negative social and legal consequences, without your consent or ability to remove the diagnosis from your medical history (barring exceptional circumstances). Being gay/trans already had to be removed as mental health conditions due to psychiatrists admitting they were only hurting them by labelling them mentally ill, but they fixed this by deeming these things as NOT mental health problems, but still not actually giving people the ability to refuse to consent to a diagnosis which would have prevented much of the harm to begin with. This is then reinforced by scheduling and denying access to useful medicines like amphetamines and insurance coverage UNLESS you accept a legally and socially consequential label of being mentally disordered first, so even if people had the choice not to be labelled as disordered, they may not take it anyways because they will live a lower quality of life if they do not accept that label. I have NO idea how to solve this issue. 2: the whole involuntary hold thing. This I won’t get into that much, because it’s one thing to come up with a morally self-righteous take on this issue, and it’s another to deal with the reality that some people if left to their own devices WILL hurt themselves. Also there really is a lot of due process around this matter, the problems are really around the details and implementation. I have NO idea how to solve this issue.
  - projectazorian 3y ago
    > This is then reinforced by scheduling and denying access to useful medicines like amphetamines and insurance coverage UNLESS you accept a legally and socially consequential label of being mentally disordered first, so even if people had the choice not to be labelled as disordered, they may not take it anyways because they will live a lower quality of life if they do not accept that label. I have NO idea how to solve this issue. Is an ADHD diagnosis really that "legally and socially consequential?" What are these consequences you describe, and how would one become subject to them? I'm struggling to think of any real consequences, unless you are an airline pilot or have a security clearance, and even then I don't think ADHD is a deal breaker.

techdragon 3y ago

/sarcasm… right? This “one person disagrees therefore it’s not settled”… this needs to die. We collectively need to raise the bar of human discourse above this tiny hurdle and put an end to anyone who isn’t drunk accepting the argument of one single person against the global consensus… And before anyone chimes in with arguments about examples of righteous crusades against genuine problems in the world sparked by a single person… the obvious counterpoint is that these people stop being “one single person” when they convince someone else in a one to one conversation… good arguments persuade people and gather people around them… one lone voice arguing against the consensus is a crank who should be ignored without guilt… not platformed under the guise of balancing some illusionary other side of an argument… Looking squarely at you BBC… the ABC in Australia aren’t particularly good at this either but the BBC are the absolute fucking worst at this.

faeriechangling 3y ago
The “global consensus” is decided by doctors who have a vested interest in claiming that any negative rise in mental health outcomes is a victory because it shows better mental health awareness, rather than a failure and showing that contemporary medicine is either ineffective or actively harmful. Relying on the “global consensus” here is a fox guarding henhouse situation. In any case, nobody has any real evidence as to what could be causing this effect, only conjecture.
- dkonofalski 3y ago
  Wouldn't their interest be in the opposite? Wouldn't they want people to think that doctors have the answers rather than doctors failing at helping with mental health issues?
  - faeriechangling 3y ago
    That would be in their interest, but being concerned about things like declining mental health metrics only happens if there is public pressure for the mental health field to be accountable by some sort of empirical measure. What I sort of wish people did more was hold the mental health field, from pharmaceutical conglomerates to individual practitioners, to some sort of standard. What we have now is either the field is succeeding because self-reported mental health is improving, or it’s succeeding because self-reported mental health is going down which means mental health AWARENESS is improving. I feel how the mental health field has spun things like gradually increasing suicide and drug addiction rates (proof of mental health underfunding!) has been broadly successful for the field. What I would like to see mental health practioners just start treating a patient population and for them to improve so dramatically that they discontinue treatment and live “normally”. Or maybe their lifespans measurably improve. Or suicide rates plummet. What I see instead is this sprawl of mental health services which are big on promises, big on “pro-awareness” rhetoric, and short on results at the societal scale.

Erratic6576 3y ago

Yeah. I don’t believe I’m dumber now than when I was younger. I believe I’m more aware of the cognitive fog I’ve always had in my head, how unintelligent I’ve always been.

actuallyalys 3y ago

First, Monika Mitra is a professor of disability policy, so she is also an expert. Second, it's a little ambiguous how much they disagree. To use slightly contrived numbers, it's possible the first group of experts and researchers think perception changes and increased honesty explain 2/3 of the increase, but Mitra things it explains 1/3. The wording also leaves open the possibility they basically agree with Mitra and just feel less confident ruling out changes in perception.