2013 was a remarkable year for reconsideration of the nature and causes of ‘madness’. In public mental health, the watershed moment came with the first report by the US Centers for Disease Control and Prevention on mental health surveillance among children: mental disorders that present before the age of 18 are becoming more common and more complex. The evolution of DSM-5 led to vigorous protests by groups such as Speak Out Against Psychiatry and interesting debates such as whether we need to change the way we are thinking about mental illness (The Observer, 12 May 2013). In his entertaining The Guardian review, titled Bipolar memoirs: What have I done? (26 April 2013), psychoanalyst Darian Leader makes a key point: ‘The narrative of human lives is more or less absent in healthcare economies’.

Liah Greenfeld is a professor of sociology, political science and anthropology. Mind, Modernity, Madness completes a trilogy detailing the decline and fall of national culture. She says she was helped to find evidence on modern madness from medical libraries by her son, who ‘served as [her] guide to the confused world of American young adulthood’. Since the time of Jung, anthropology has enriched our understanding of mind, and I hoped this book would add to the narrative of human lives in a way that enriched mental health policy.

Early on Greenfeld delivers her central thesis: ‘A clear sense of identity being a condition sine qua non for adequate mental functioning, malformation of identity leads to mental disease, but modern culture cannot help the individual to acquire such a clear sense, it is inherently confusing’ (p. 5). The emergence of nationalism has been the main cause of our deforming culture, through pervasive ‘anomie’.

Working from an axiom that ‘mind is a cultural phenomenon’, Greenfeld focuses on ‘psychotic disease’ as ‘fundamentally a malfunction of the ‘’acting self” (the functional system or ‘’structure” of will)’. She claims that ‘scientific skepticism’ is the ‘obvious reason for the lack of any attempt of an empirical, scientific study of the mind’, which she then attempts. Such sweeping, general assertions made reading more and more uncomfortable. For example, Greenfeld blames Tudor England for soulless science: ‘The immediate reason why science was institutionalized in England so early in the age of nationalism, while reflecting the growth of the national consciousness, was not directly related to the epistemological revolution it brought about. It was rather the inherent competitiveness of the national consciousness and the fact that the English felt their literature not competitive with those of Latin countries, which made them opt for a new area of cultural creativity - science, which did not really exist anywhere else - in which to challenge its chosen rivals.’ What would Shakespeare make of that ‘fact’?

Overall, this monotonous book makes little attempt at balance or accuracy. An avalanche of anecdotes is not a solid evidence base for policy.