Biomedicine tends to treat “mental” illnesses as if they could be isolated from multiple social and somatic problems. Yet mental suffering is inseparable from complex somatosocial relations. Clinical fieldwork in a deprived area of the UK shows that nearly all the people treated for “depression” are chronically multimorbid, both in their bodies and in their social relations. Mental suffering is co-produced by poverty, trauma, and excessive medication use. Patients’ guts are as imbalanced as their moods. Single vertical treatments make them worse rather than better. In the UK, patients in poorer neighbourhoods do not “lack access” to healthcare. If anything, they suffer from taking too many medications with too little integration. I conceptualize the bad effects of excessive interventions in patients with multiple chronic problems as polyiatrogenesis.

生物医学倾向于治疗“精神”疾病，就好像它们可以与多种社会和躯体问题隔离开来一样。然而精神痛苦与复杂的躯体社会关系密不可分。在英国贫困地区进行的临床实地调查表明，几乎所有接受“抑郁症”治疗的人都患有慢性多病，无论是在身体上还是在社会关系上。贫困、创伤和过度用药共同造成了精神痛苦。病人的内心和他们的情绪一样不平衡。单一的垂直处理只会使它们变得更糟而不是更好。在英国，较贫困社区的患者并不“缺乏”获得医疗保健的机会。如果说有什么不同的话，那就是他们服用了太多药物而整合太少。我将过度干预对患有多种慢性问题的患者的不良影响概念化为多医发生。