What is Mental Illness Today?
Five Hard Questions

Hugh Middleton, MD
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Subscribers to Mad in America might be interested in a Keynote Lecture given by Professor Nikolas Rose in Nottingham on May 15th 2013. Nikolas Rose is Professor of Sociology and Head of the Department of Social Science, Health and Medicine at King’s College, London. He was previously Martin White Professor of Sociology, and Director of the BIOS Centre for the Study of Bioscience, Biomedicine, Biotechnology and Society at the London School of Economics and Political Science. He is also co-PI for the EPSRC funded Centre for Synthetic Biology and Innovation (CSynBI). His most recent books are The Politics of Life Itself : Biomedicine, Power, and Subjectivity in the Twenty-First Century (Princeton, 2006); Governing The Present (with Peter Miller, Polity, 2008) and Neuro: the New Brain Sciences and the Management of the Mind (with Joelle Abi-Rached, Princeton, forthcoming, 2012). He is a longstanding member of the Editorial Board of Economy and Society, co-editor of BioSocieties: an interdisciplinary journal for social studies of the life sciences, Chair of the European Neuroscience and Society Network, and a member of numerous advisory groups including the Nuffield Council on Bioethics. In other words Nik is one of the UK’s leading social scientists, and he also has an explicit interest in “mental illness”.

In this lecture Professor Rose very thoughtfully challenges a number of  the assumptions which underpin conventional and contemporary psychiatric practice. He asks five hard questions:

  • Is there (really) an epidemic of mental illness?
  • Does the path to understanding mental disorder lie through the brain?
  • What is the role of diagnosis and of diagnostic manuals?
  • Should we seek early identification of those at risk of future mental pathology?
  • What is the place of patients, users, survivors, & consumers of mental health systems?

Conventional mental health systems are based upon assumed answers to each of these. By putting them one by one under the spotlight, Rose highlights the shakiness of ground conventional understandings and approaches are based upon. His conclusions might not surprise many MIA readers but he is able to substantiate them in novel and incontrovertible ways. The lecture is a  compact and convincing challenge to contemporary approaches to “mental illness”, and should be considered a landmark in our thinking. It is a great resource and it can be seen at http://youtu.be/KxI6DmbEKQg

6 COMMENTS

  1. Really great talk.

    I perticularly liked the question and answer session at the end where a psychiatrist said that epigenetics were proving very useful and the lecturer gave an intellectual, polite and incisive answer that I internally translated as, “Bollox mate, get a life.”

  2. Hard Questions lol – none of them are hard questions to me.

    Only how to implement the obvious answers is the tough one.

    I’ll give it a watch – thanks

    Here is a 10 min clip from 2 years ago

    What is mental health today – psychiatry, neuroscience & society – Nikolas Rose

    hXXp://www.youtube.com/watch?v=P8mkcXdTZ_g

  3. Despite many interesting observations Dr Middleton seems to assume that the idea of a mental disorder is a potentialy value-neutral construct or could be used in a value-neutral way, that he fails to grasp the degree to which the “medical model” in psychology is an inadequate model in large part because it IS a medical MODEL: it medicalizes ethical, political and social issues and obscures the ethical judgments that are embedded in and have always been embedded in psychodiagnostics. To give a lecture on this topic without even mentioning Thomas Szasz or R D Laing (Foucault was mentioned and even quoted but his point was notexpored) is itself a political act which legitimizes the medical model. As I see it it would be like discussing 20th century physics and not mentioning Einstein’s revision of Newton.

    Diagnostics takes place in a post-Szaszian universe in which every (psychiatric) diagnosis is ipso facto a misdiagnosis. Szasz’s point was proven in 1973 when the APA decided by a vote of a meeting of some of its members that homosexuality was not a mental illness, more specifically it was DECIDED that it was no longer a mental illness.
    Seth Farber, Ph.D.
    http://www.sethHfarber.com