This is a subject that can be argued for hours and lead to no real conclusion. It really is a matter of perspective, and what an individual’s agenda is. Coming from a psychology background, and having worked in the field for nearly 25 years, I suppose it would be easiest to say yes to the question and call it a day. It isn’t that simple, though. If mental illness exists, what is it? How is it treated? If it can be simply defined and simply treated, then there shouldn’t be an issue. But, simple definitions aren’t easy to come by and agreement on treatment will probably never reach concensus.
First let’s try gaining concensus on what the term “mental illness” means. According to the American Heritage Dictionary (2nd College Edition-to which all definitions will refer), the word mental means, “Of or related to the mind.” Illness is defined as “Sickness of the body or mind.” It would appear that the editors at American Heritage have already voted on the matter and state that, yes, mental illness does exist. From here, the only nebulus term left is “mind.” MInd is defined as, “The human consciousness…manifested in thought, perception, feeling, will, memory or imagination.” Using this added term, it would appear that mental illness would be defined as “Sickness of the human consciousness, manifested by the symptomatic detriments to one or more of the following: thought, perception, feeling, will, memory or imagination.” That’s a fairly all-encompassing definition, but it at least gives us a starting place when deciding whether or not mental illness actually exists.
Who would argue against the idea that mental illness is a real condition? Many years ago, I worked as a mental health technician in a psychiatric hospital. The job sounds more interesting than it is. My basic job was milieu management (keeping the patients from harming themselves and others) and ensuring the patients were following the protocols and routines of the day. There is little a mental health counselor does to directly address mental health issues.
One of my co-workers and I would frequently get into discussions about the legitimacy of “mental illness.” His stand was that society encourages mental illness-or, rather, for people to claim to have mental illness issues. He would say that “mental illness” is a learned behavior-a sort of learned helplessness. That the person who claims to have mental health issues has actually received some sort of reinforcement for “acting crazy.” When I asked him why he worked in the field, he told me, “Well, by now it’s just for a paycheck.” Now, some of you may question his motives. I can only say this. Even though he may not have believed in mental illness, he always did his job correctly. He always kept the patients safe. He just didn’t believe in mental illness. His answer was always, “That (wo)man just needs some spirituality.”
Others who might argue against the legimacy of mental illness would include health insurance companies-who never want to pay for anything; people who get confused as to what mental illness really means-these may include people who view mental illness as a sign of weakness and anyone who considers him/her self an empiricist and can only believe that which can be experienced sensually. An argument could be made for any of these views, but if you’ve been in the field long enough, you can see the weakness in any of these arguments as well.
Now, even if mental illness does exist, what is the best course of treatment? Well, again, this can lead to a number of different conclusions. If you ask a psychiatrist, he would tell you that, depending on the particular affliction, he would prescribe various medications. It is true that, with certain forms of mental illness (i.e., schizophrenia), there can be a chemical imbalance. Replacing or substituting chemicals to restore balance can be very effective.
Unfortunately, a lot of mental health patients take medications, feel better, stop taking medications and go back to where they were before diagnosis. As far as talk therapies go, it is a very rare psychiatrist who will perform therapy. The days of Freud are long gone. I’ve known scores of psychiatrists. I’ve met a total of one who did her own therapy. The rest make referrals to psychologists and other therapists.
I kind of feel sorry for people with a Ph.D. It seems they’re always trying to legitimize themselves. In the world of mental illness, psychiatrists are, and always will be, the big guns. They see the whole problem through the medical model. People respect those who’ve been to medical school. Ph.D.’s, on the other hand, are viewed as too touchy-feely; dealing with the nebulus; Oprah with a higher degree.
This is often true, but just as often (perhaps even more so), these people work hard as well. Getting through four, five, six years of graduate school is not really any easier than the same amount of time in medical school. It’s just that the psychologist’s take on mental illness is very different. They believe historical events can affect current behaviors. And, in fact, this is largely true. A victim of abuse (or other trauma) as a child will often exhibit signs of mental illness in adulthood. Sometimes talk therapies do work, but they have their limitations.
This is perhaps the best argument against the legitimacy of mental illness. One cannot come up with a single concensus form of treatment for various ailments within the realm of mental illness. However, isn’t that true in regular medical illnesses, as well? For instance, if a person has high blood pressure one doctor may prescribe “Benicar” and another may prescribe “Bystolic.” One, both or neither of these medications may work for a particular patient depending on an individual’s chemistry and other factors. Medicine for physical ailments is not foolproof. Likewise in mental illness, if a person is diagnosed with schizophrenia, one doctor may prescribe “Risperdal” while another prescribes “Zyprexa.” Like the blood pressure medications, one, both or neither may work. In the end, medical treatment for mental illness is not that much different than that for physical illness.
Does any of this truly answer the question of whether or not mental illness exists? Probably not. If one holds a firm viewpoint one way or the other, then no argument will change one’s mind. For what it’s worth, by and large, I’d say that mental illness, does in fact exist. The problem with it is, it is so hard to nail down a specific definition and a correct course of treatment. That notwithstanding, persons with mental illness deserve treatment and deserve to be treated with dignity and respect. After all, mental illness is an illness.