Lancet Commission to probe systemic roots of schizophrenia beyond biomedical models, integrating global mental health inequities
Original framing: “[Comment] Announcing the Lancet Commission on schizophrenia and psychotic disorders” — The Lancet
Future models must prioritize prevention over treatment: reducing childhood trauma, decriminalizing drug use, and investing in housing-first programs. Scenario planning should explore 'psychosis-friendly' cities, where community spaces and peer support reduce isolation. The commission could model the economic costs of untreated psychosis versus systemic interventions like universal basic income and green spaces.
The Lancet Commission’s biomedical framing of schizophrenia reflects a long history of psychiatric imperialism, where colonial nosologies pathologized resistance and difference while ignoring structural violence.
To move beyond this, the commission must confront the racialized and classed origins of 'schizophrenia' as a diagnosis, centering marginalized voices who experience psychosis as a response to systemic oppression rather than a 'disease.' Indigenous and survivor-led models—from Māori 'whakapapa' healing to the Hearing Voices Network—offer alternatives to the biomedical monopoly, but require dismantling the power structures that sidelined them. Future solutions must integrate trauma-informed care, housing justice, and psychedelic therapies, while reimagining cities and economies that prevent psychosis before it occurs. The trickster’s laughter reminds us that the 'broken brain' narrative is itself a construct—one that obscures the real work of healing: restoring connection to land, community, and meaning.