What is the Price of Freedom?

As the sun goes down this evening, millions of Jews around the world will celebrate the first night of Passover. The Passover Seder tells the story of the exodus of the Jews from Egypt. We are to tell the story as if we too were once slaves. It is a quintessential story of freedom.

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The Seder is filled with questions that invite us to pause and reflect. The questions are at once specific and universal. In the spirit of posing questions that get us thinking, here are a few about mental health and mental illness that I hope you will join me in pondering.


What would happen if we allocated our healthcare and research spending in proportion to the burden of disease? Mental illness is the leading cause of disability in the world. Imagine what would happen if it were also first in terms of funding dollars for health care and research. If that were the case, we could predict that health across the board would improve, as mental health and other health conditions are so deeply interconnected.


Why have we made individuals with mental illness criminals? In the United States, there are more individuals with serious mental illness and substance use disorders incarcerated in jails and prisons than hospitalized for care in psychiatric hospitals. In light of the ongoing debates about government spending and the true ethical and economic costs that come with incarceration, how could reorienting towards rehabilitation serve all of us better?


Who among us does not have personal experience with mental illness? Globally, we estimate that one in four individuals will have a mental health condition at some point in their lifetime. That’s over 1,875,000,000 people based on today’s world population. If we assume that these individuals don’t live in a vacuum, and if we assume that each of us knows at least four people in this world, it’s safe to say that personal experience with mental illness is universal. So why do we feel so alone when we or someone we love has mental health needs?


How can I make decisions at work and in my personal life that respect my own mental health needs and those in my personal and professional communities? Decisions that we make every day – how we mentor junior colleagues, how we treat strangers on the subway, whether we accommodate students who have special needs in the classroom, what we do about our sleep, exercise and eating – impact our own and other people’s mental health. What would be different if we maintained this awareness as we make our way through the day?


What have I learned from others who inspire me with their courage, resilience, perseverance and hope when it comes to recovering from and living with mental illness? Who are these individuals? Have I told them how important to me? How can I honor them in word and action?


So, what is the price of freedom? This is the question my father-in-law always added to our family’s Passover Seder. Everyone around the table knows the answer by now: eternal vigilance. Yes, freedom requires us to be vigilant, and failure to do so have led to heinous slaughters of people throughout history. By analogy, we pay dearly when we fail to be vigilant about protecting mental health as a basic human right. With vigilance, we reap invaluable benefits.


Kathleen M. Pike, PhD

Kathleen M. Pike, PhD is Professor of Psychology and Director of the Global Mental Health WHO Collaborating Centre at Columbia University
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