Social psychiatry focuses on the interpersonal and cultural contexts of mental disorder and mental wellbeing. Research in this area examines the relationship between psychiatric disorders and the social environment. This includes the consequences of positive or negative life events at the individual level, as well as broader themes – such as discrimination and inequality - at the societal level. This chapter aims to illustrate how research in social psychiatry has advanced our understanding of the role of social factors in the aetiology and management of mental disorders. We provide breakdowns of six high-impact research studies including summaries of background, methods, results, conclusions, strengths, and limitations. In addition, we provide some information about common pitfalls and methodological considerations that are specifically relevant to social psychiatry for novice researchers in this area, and our thoughts regarding future challenges and opportunities in this field.

Oliver Cromwell was a stern, Puritan dictator from the seventeenth century, and Kylie Jenner is a twenty-first-century pop culture princess and lipstick mogul. They could not be more different, yet they have in common that they’ve been tagged with the provocative and powerful label “self-made.” Their stories bookend the history of how what was once a sin became an accolade. For Cromwell, a claim of self-making would have endangered his social and political standing, as well as his soul. Jenner, in contrast, proudly accepted this label as a badge of esteem, a reward for being a “selfie-made success.” Over the centuries between them, the concept of self-making evolved, always serving storytellers as a tool for judgment. It became socially and politically destructive along the way because storytelling based on its false assumptions and judgments has fostered policies and cultural attitudes that advance inequality and absolve the affluent of community obligations. Although much of its modern persuasiveness comes from claims that it belongs among core American values, the myth’s history reveals that there is nothing intuitive, stable, or tied to the real world about the idea of self-made success.

Democracy is one of India’s great achievements. However, it is undeniable that Indian democracy has been under considerable strain in recent years. Chapter 1 analyzes these trends linked to Indian democracy and their underlying determinants. In particular, the chapter emphasizes the link between growing economic inequality and India’s recent democratic decline through two mechanisms – the decline of the Congress and the rise of the BJP under Modi.

The term “self-made” was fully embedded in 1920s popular culture, intertwined with individualism. Master of positive thinking Dale Carnegie dominated armies of cultural entrepreneurs selling tales of success. The Crash of 1929 and the Great Depression turned many Americans against businessmen’s leadership, but business advocates militantly circulated the myth of self-made success to justify why the privileged still deserved esteem and power. They rejected efforts at systemic change. They used the myth of self-making to explain success and failure as individual matters, and explicitly upheld inequality as a valid outcome of merit alone. To resist the progressive state, conservatives invested enormous resources to attack reformers for threatening freedom and opportunities. Among their rhetorical tools were fantasies of self-made success that they often imagined came from Horatio Alger, distorting his legacy into an individualistic and often harsh “bootstraps” mythology. Into the 1950s, positive thinker Norman Vincent Peale and others magnified the faith that people could “make” their own lives regardless of what the world handed them.

This chapter provides an introduction to the book. It sets the stage by highlighting contrasts in India’s economy, democracy, and society. It then discusses the main topics covered in the book – democracy and governance, growth and distribution, caste, labor, gender, civil society, regional diversity, and foreign policy. The chapter also outlines the three themes that comprise the main arguments of the book. First, India’s democracy has been under considerable strain over the last decade. Second, growing economic inequalities that accompanied India’s high-growth phase over the last three and a half decades are associated with the country’s democratic decline. Third, society has reacted to changes from below but there are limits to societal activism in contemporary India.

After 1960, well-funded campaigns advanced individualism and reduced support for community-based progressive programs, including Great Society programs. The term “meritocracy” spread quickly, adopted by progressives and conservatives alike. Conservatives asserted that unions, poverty, and public institutions manifested unwillingness to “work hard.” They argued that democracy depended on “free enterprise,” which they imagined could solve all problems. Economic and cultural turbulence energized organizations such as the US Chamber of Commerce and the Horatio Alger Association of Distinguished Americans. Ronald Reagan, George Gilder, Milton Friedman, and others flourished selling individualism. Their accusations of self-made failure shamed anyone who struggled against social or cultural circumstances, racial or gender inequalities, the results of globalization, or inadequate access to education and other opportunities. Presidents Reagan and Clinton both rejected the welfare state and demanded “personal responsibility,” an updated term for self-making. A constant refrain that taxes punish success also drew on the myth and painted the recipients of progressive programs as freeloaders.

Chapter 2 discusses how India’s rulers have used state power to promote economic development, both growth and its distribution. While India’s growth record is relatively impressive, it is also the case that this growth has not been accompanied by the creation of well-paying jobs, and economic inequality in India has increased sharply.

The myth of self-made success triumphed in the new millennium, incentivizing claims that are impervious to reality. Prominent examples include George W. Bush, Donald Trump, and Kylie Jenner, who began their lives in great financial and social wealth, yet they all believe they were self-made. Bush and Trump endorsed policies that lowered taxes for elites but cut programs that served everyone else, arguing that taxes punish success and social support programs foster irresponsibility. The myth eased reducing constraints on financial exploits, making possible both great fortunes and economic crises, such as the Great Recession that began in 2007 and led to taxpayers’ bailouts of private institutions. The megahit reality TV show Shark Tank displayed the myth on steroids, starring “self-made” entrepreneurs. In contrast, the despair of struggling people accused of self-made failure and willful irresponsibility has been deadly. Such accusations can be profitable, as J.D. Vance’s career has shown. This myth-made culture ignores the communities and institutions that make wealth generation possible. It frees tycoons to acquire and donate large fortunes, garnering acclaim as philanthropists.

In this chapter we explore concepts and practices related to diversity. This is a complex terrain to navigate as we are all ‘diverse.’ However, diversity (or our differences) have personal, social and political effects; many of which involve power and engender various forms of inequality, privilege and oppression. Critical social workers have been considering the ‘dilemma of difference’ for decades. In 1985, for example, Martha Minow observed that, rather than avoiding this dilemma, we should ‘immerse ourselves in it’, not necessarily to seek a final resolution, but to engage in a ‘more productive struggle’ for equitable processes and outcomes’. Challenging privilege and oppression is at the heart of critical social work and our journey is both personal and professional as we grapple with how to respectfully listen, learn and engage in mutual consciousness-raising across difference, while advocating for social and systemic change to address inequality.

Contemporary interest among American progressives in using antitrust law to address wealth inequality lacks a firm intellectual foundation. Indeed, both the original American progressives of a century ago and Thomas Piketty, whose work sparked contemporary interest in inequality, agree that inequality’s source is scarcity, rather than monopoly, and so inequality will persist even in perfectly competitive markets. The only real solution is taxation, not a potentially destructive campaign of breakup. Why, then, is antimonopolism so popular among American progressives today? There are two reasons. The first is American anti-statism, which has closed off tax policy as a viable political solution to inequality, forcing progressive scholars and activists to seek a second- or third-best workaround in antitrust policy. The second is the American press, which is actively promoting antimonopolism as a way of fighting back against Google and Facebook, two companies that have badly outcompeted the press for advertising dollars in recent years.

Since the Reagan era, American economic policy has amounted to self-colonization. Democratic majorities have consistently supported legal regimes that have enabled corporations to extract the lion’s share of the gains from trade from the public. For example, they have supported a corporate law regime that denies the public democratic control over the behavior of corporations and instead gives dictatorial powers to shareholders and managers. The Internet has made it even easier for firms to extract surpluses from consumers through surveillance and algorithmic pricing. One small contribution toward a project of decolonizing the public would be for consumers to obtain a property right in their personal information. This would allow them to claw back some of the surpluses that technology has taken from them.

This chapter examines the intended and unintended consequences of American hierarchy on partner states. It analyzes the impact of increased state capacity resulting from American economic hierarchy on civil conflict, human rights, democratization, and inequality. The results suggest that economic hierarchy reduces conflict, human rights abuses, and promotes democracy primarily through direct effects rather than via increased state capacity. However, both economic and security hierarchy exacerbate political inequalities. The chapter highlights the complex implications of American hierarchy.

This chapter examines the long-term development of inequality in Europe, focusing on disparities between individuals, households and nations. It explores how social and economic inequalities have evolved over time, influenced by economic forces as well as factors such as gender, race and class. The chapter also considers global inequality, discussing the gap between rich and poor nations and the factors that have contributed to economic divergence or convergence. By analysing the historical roots of inequality and the role of institutions in mitigating or exacerbating it, the chapter provides insights into the social and economic consequences of unequal income distribution and how it shapes economic policy debates today.