Peste Magazine is a new publication that focuses on health, both mental and physical. The founders of the magazine were angry about how the mainstream media talks about health—individualizing everything, not focusing on systemic causes and solutions. Two of the editors of the magazine were kind enough to speak with me on the need for a different approach to thinking about health in the media. Jason Silverstein is the editor-in-chief of Peste and teaches on media and health at the Harvard Medical School. Max Jordan Nguemeni is a medical resident at Brigham and Women’s Hospital, and an editor-at-large at Peste.

What made you want to start Peste? 

Jason: I had been really struggling with depression this summer and was at a really low point, and reached out to my friend John Shaffer. It’s really hard for me to reach out but he was really there for me, and at some point in the conversation I had been complaining a lot about how no one seemed to give a fuck in the media world about the things we cared about when it came to health and mental health. And he was like, “well why don’t we just start your own magazine then?” Everything poured out from there.  

Max: I’ve been writing for a while about health inequality and medicine. I had a column in a medical student magazine when I was in medical school. One thing that struck me in trying to write is that there’s kind of a void in a lot of these outlets—there’s no space for critical voices on these issues of health. Often when you try to write for most outlets they don’t want you to be too critical, they want you to sanitize things. 

How does the mainstream media get health, especially mental health wrong?

Jason: There’s just a lot of emphasis on individual, behavioral, lifestyle explanations for health disparities. You see that in academia and in the media. And that’s something we want to correct. There’s a lot of medicalization of poverty that you see in the media, even in so-called progressive outlets. They use the term “mental health” as an alibi for thinking about social, political and economic forces. And I think that’s pacifying in some way. That’s not to say people shouldn’t think about mental health—go to therapy, get on medication—I do all those things. But in the media there’s this focus on individual behavior and individual mental health; you get a lot of stories about neurochemistry, and what gets left out is all the things that affect that—poverty, incarceration, the police, violence, the general misery of many people’s lives. If we were to actually reflect on why people are struggling with their mental health we’d have to take a hard look at how societies are structured and not just what’s wrong with people personally. So I think a lot of mental health reporting plays into a kind of public abandonment. 

Max: I’m a medical resident. I often treat depression. I often treat addiction. I won’t malign the efficacy of medical therapy for those things. And we have a social justice curriculum in our school. But even as people who work in medicine, even ones in social justice-oriented programs or schools—we’re still working for large corporations. I work for the largest employer in the state of Massachusetts. And that’s tied to how the medical industry is today, how the healthcare system is set up. Everything is profit-driven. Workers are getting squeezed. There’s nurse shortages all over. And those kinds of issues, labor and profit, affect people’s health and mental health. And those issues are ignored in favor of, instead of in concert with, medication or whatever individual treatments for mental health.

We hear so much “everybody should go to therapy” these days. And to be honest therapy doesn’t work for a lot of people. And I think it also works as a kind of mind-numbing exercise to help people suffer through whatever exploitative experience they’re undergoing. Even in residency, when we’re talking about the social determinants of health, they’re making us work 80 hours a week—there’s this huge dissonance between how we talk about health and how we address it. 

You hear a lot about mental health awareness these days. But is that enough? We’re all very aware, but now what?

Max: I don’t want to pooh-pooh mental health awareness. That can be good. Destigmatizing mental illness is good. But we need to contextualize it in the world. People have psychotic breakdowns after they’ve been brutalized by the police. The world works in concert with biology, but the biology is not isolated. So yes we need to destigmatize, and be able to talk to friends and family about it, and not be afraid to seek care, but we shouldn’t think it’s all in our heads. It’s brought on by the material conditions we live in.

Jason: Much of what we see with mental health and health in general is the result of deliberate policy choices. With Peste, we want to name the names of the people making these policy choices; the people who are making the conditions that make people go into mental health crises, or that obstruct people from getting care.