Monday, October 02, 2023

The meaning of mental illness

Zsuzsanna Chappell has a rich article written in defence of the concept of mental illness. I have a previous post on the meaning of the concept of mental illness and various other previous posts on this blog relate to this topic. 

I agree with Zsuzsanna's argument that mental illness can be a useful way of understanding for at least some people to have a liveable personal identity within contemporary Western social and political culture. As she says, "there is a phenomenon ... which is usefully described as [mental] illness-like within our culture".

I have commonly emphasised the technical distinctions between illness and disease (eg. see my Lancet Psychiatry letter). Zsuzsanna helpfully adds the technical distinction from sickness as the social response to illness and disease. As she says, 
Disease is a biomedical, theoretical construct that is identified by the medical gaze; illness is the subjective experience of lack of health; and sickness is the bundle of social responses and attitudes which are provided to someone who is diagnosed with a disease, or is experiencing illness.

In her article, Zsuzsanna has an interesting section on the culture of medicalisation, which I would prefer to call the culture of over-medicalisation (see previous post). As she says, "By requiring that there should be something illness-like at play, we could guard against over-medicalisation". As she also recognises, "The promotion of mental health awareness may have led to people overinterpreting their experiences of mental distress as an example of mental disorder" (see eg. another previous post). She even recognises that "Over-spiritualising mental distress can be just as problematic as over-medicalising it".

She also helpfully forays into theories of intersectionality. I strongly recommend reading the whole article.  As she concludes "Crucially, by identifying our experience of mental distress as an illness, we are putting forward a claim towards a particular caring, affective kind of relationship with others”.

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