The Critique of “Mental Illness”: Conceptual and/or Ethical Crisis?

Abstract

Thomas Szasz’ critique of the concept of mental illness centers on the claims that (a) mental illness is diagnosed on the basis of objective medical criteria, and (b) mental illness is something which happens to the patient rather than something done by him. Neither of these claims, according to Szasz, is true: mental illness, in this sense, is a “myth.” Various attempts to meet Szasz’ critique and to define mental illness are examined and found to be unsatisfactory. The attempt to develop a limited conception of mental illness (Flew) shows some promise but has received little support from the mental health professions. Biblical and theological considerations underline the importance of the problem about “mental illness,” but do not provide a solution. Thus, it would seem that the critique of “mental illness” constitutes a conceptual crisis in psychiatry and possibly an ethical crisis as well.