Ethics Finder

Mental Health / Illness

The expressions ‘mental health’ and ‘mental illness’ derive from 19th century medical and public health discussions in which the term ‘mental hygene’ was also introduced. At that point modern psychology was still in its early stages and these notions in their negative forms were applied somewhat indiscriminately to describe or explain what was viewed as morally transgressive activity, dysfunctional personal patterns of behaviour, melancholy, neuroses, mental incapacity, and what we would now classify as serious clinical conditions such as schizophrenia. There were two broad tendencies at this time: to attribute mental ill health (and health) to physical and biological fitness and deficiencies or impairments in respect of this; or to regard it as a matter of moral (dis)order and (lack of) self-discipline. Notwithstanding the development of theoretical and clinical psychology, to some extent these tendencies persist and correlate with chemical and cognitive-behavioural approaches. Philosophically there have been two important approaches to the issues: the first going back to Plato, the second associated with interwoven strands in continental philosophy integrating ideas of Nietzsche, Freud and Marx. In the Republic Plato draws an analogy between good order and well-functioning in the state and in the individual, and in the case of the latter explains this in terms of three components of the ‘soul’: the appetitive, the spirited and the rational parts. A healthy soul is one in which these are in functional balance with the first and second subject to the governance of reason. In this account mental health and illness are objective conditions relating to the intrinsic structure of the psyche. According to the second approach, by contrast, these conditions are social constructs reflecting the interests of elements within society to control others by deeming them defective or deranged. An influential advocate of this view was Michel Foucault presenting it in his book Madness and Civilisation (1961).

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