Mental Health as Rational Autonomy

Abstract

Rather than eliminate the terms "mental health and illness" because of the grave moral consequences of psychiatric labeling, conservative definitions are proposed and defended. Mental health is rational autonomy, and mental illness is the sustained loss of such. Key terms are explained, advantages are explored, and alternative concepts are criticized. The value and descriptive components of all such definitions are consciously acknowledged. Where rational autonomy is intact, mental hospitals and psychotherapists should not think of themselves as treating an illness. Instead, they are functioning as applied axiologists, moral educators, spiritual mentors, etc. They deal with what Szasz has called "personal, social, and ethical problems in living." But mental illness is real.

Reason, emotion and embodiment: is ‘mental’ health a contradiction in terms?

“…See also James and Gabe (1996) for other applications to health. 2 For other interesting discussions of these and related matters, see Radden (1985) and Edwards (1981): the latter focusing more specifically on issues of`mental health as rational autonomy'. 3 Health, for Parsons, involves the`teleonmic' capacity of an organism, or its propensity', to successfully undertake`goal oriented' actions ± see, Frank (1991) for a useful reconstruction of the Parsonian`health' as opposed to thè sick role'.…”

“…Undoubtedly, this is correct, extending to current debates over thè (un)reasonableness', if not`irrationality' of a wide array of 20th century mental disorders such as anxiety, phobias, anorexia nervosa and drug addiction (Busfield 1996: 72). What it neglects without denying, however, is a sustained set of reflections on the contribution of emotions to`mental' health and wellbeing as opposed to illness, and through this to thè rationality' of the individual (Edwards 1981) and the`rational functioning' of society as a whole (i.e. emotions as a functional prerequisite of both social order and social action (cf.…”

A proposal to classify happiness as a psychiatric disorder.

“…According to Radden (26), behaviour may be described as irrational if it is bizarre and socially unacceptable, reduces the individual's expected utilities, or is not grounded on good (ie logically consistent and acceptable) reasons; in the latter case, in particular, Radden believes that the behaviour should be the subject of psychiatric scrutiny. A similar view has been taken by Edwards (27) who claims that bona fide cases of psychiatric disorder are characterised by actions that fail to realise manifest goals, thinking that is illogical and replete with contradictions, beliefs that should be falsified by experience, the inability to give reasons for actions, unintelligible or nonsensical thinking, and a lack of impartiality and fairmindedness.…”

Rationality, Diagnosis, and Patient Autonomy in Psychiatry

“…Some authors remain unconvinced that there is continuity between familiar and more exotic forms of irrationality, and argue that pathological irrationality is more persistent and severe (e.g., Edwards 1981), or is of a different quality because it signals a more dramatic failure to be in touch with reality (e.g., Gallagher 2009). But the epistemic irrationality exhibited in the context of many psychiatric disorders is often not persistent, and, as we shall see, is not necessarily more severe than the irrationality found in the non-clinical population (Bortolotti 2013).…”