Wow! Most of my experiences of a book resonating with me so deeply that I'm practically vibrating--where I have to slow down and draw out the reading experience--where I know from the first chapter that the book is going to change the way I see the world--are reserved for fiction. I was not expecting to find it in a nonfiction book I found by chance while scrolling through the recently added audiobooks filter on Libby.

But this book articulated so many things I've instinctively felt but previously had no language for around the topic of mental health even as it taught me things I didn't know at all. Khameer Kidia draws on his experiences as a kid growing up in Zimbabwe, a college- and then medical student and then resident in the US, a medical practitioner and researcher and anthropologist in both countries, and a deeply compassionate human being wherever he goes to explain why we have a global mental health crisis, how it manifests differently depending on context, how we have tried and failed to treat it, and what it might really take to promote mental wellbeing for everyone.

It's way too simplistic to say "capitalism was the villain all along!" even though…that's kind of true? But this book doesn't read like a tankie Bluesky screed against some vaguely defined idea of capitalism; instead, it's a thoughtful examination of the ways in which colonialism, imperialism, and the hoarding of wealth by the powerful create a world so difficult to live in that of course people struggle.

Kidia doesn't deny that there are chemicals in the brain that can affect how we feel and operate or that certain medications can help people. But he views mental wellbeing as a holistic part of both individual and communal life that's deeply rooted in people's lived experiences, the support systems they have or don't have, and the way systemic hierarchies affect everything. He's not afraid to come right out and say, "This person probably has (what the Global North calls) severe depression because they don't know how they're going to feed their family tonight, and if you give them money, they will get better." And then backs it up with research that proves that sometimes money is the actual solution.

He's also very respectful of indigenous treatments for mental distress, not in a woo-woo kind of way, but because of an understanding that communities have created mechanisms over generations to make people feel more rooted, secure, and supported and that, when practiced in the context of the communities that created them, these can be as effective as medication or CBT or anything else that Western medicine promotes. I am famously allergic to woo, but this balanced approach seems very wise to me (and also helped me realize that I mostly hate woo because it's usually white people appropriating practices that belong to other cultures that only work within the context of those cultures, not because of those practices themselves. As usual, context is everything).

Throughout, the book is engaging, operating on multiple levels as diagnosis of a global health problem, multiple case studies both long-term (his mother) and short-term (patients he saw for a single appointment), a critique of colonialism, a sort of microhistory of the last fifty years of Zimbabwe's history, and a memoir of his own growth both as someone who experiences mental distress and someone who treats it.

I don't tend to enjoy memoir, and when a writer mixes personal experiences with cultural criticism or historical narrative, it usually doesn't work for me. But Kidia is an incredible writer in addition to being a skilled anthropologist and a caring doctor, and the way he uses the experiences of his family members, his patients, and his country in this book is really masterful. Moving backwards and forwards through time, talking about how colonialism affected both his parents and the country he grew up in, contrasting life and expectations and values in the US with Zimbabwe--he's weaving so many threads together that a less talented writer and thinker would have surely dropped a few or at least created troublesome tangles. But he carried me right through to the very end.

David Graeber (forgive me! I'm a caricature of myself!) popularized the slogan "freedom and care" as a way of describing the animating principle of anarchism. I don't quite consider myself an anarchist, despite how much anarchic thought has influenced me, but "freedom and care" are ideals I strive to live by. This book is an articulation of what happens when care is subjected to a market economy that doesn't actually care about it and where the burden for providing care falls disproportionately on under- or unpaid women, particularly black and brown women--and where that market economy creates entire societies that are leeching the resources and labor from other, poorer societies.

Kidia's prescriptions are a) redistribute wealth globally because humanity is an interconnected web, b) prioritize autonomy and dignity for those who are dealing with mental distress (this is where the "freedom" part comes in), and c) find treatments--from mutual aid to indigenous spiritual rituals to group houses to community aid workers--that work for the specific community you're working in. Things don't always translate across cultures or even across cities. One-size-fits-all solutions both do not work and also fundamentally misunderstand how people actually live in the world.

As is typical when I come across a book written by someone who is a keen-eyed observer of the problems of society but also works hard to care for those he can, I came away both discouraged and encouraged. The scale of the problem is huge. But economic eras wane, new ways of organizing ourselves emerge if we work hard enough, and change is always possible.

Protip: read the appendices first. Even if you listen to the audiobook. He talks a lot about language and why he uses the words he uses and I think it's really helpful in understanding his project.