The Field of Mental Health Has Gone Astray, But We Can Fix It


December 6, 2019, marked the launch of Mad in Norway. After weeks of planning and incredible effort from a group of dedicated people, we are happy that MIA’s mission to ‘rethink psychiatry’ has reached Norway.

But it did not start here. At least not for many of us. For me, doubts about the medical model in mental health have been at the forefront of my thoughts for most of my career. It is only in the past few years that it has been possible to speak about the issues in public.

Something is Wrong Within the Field of Mental Health

All over Norway, professionals, researchers and most of all, people with lived experience, all have their story on how they came to the conclusion that the medical model in mental health does not work. Ever since I graduated, I had a great curiosity to figure out what really helps people, which led me to countless conversations with people who had recovered both in spite of the mental health system and with help from it. It became clear to me that there was something fundamentally wrong with the way we approached these problems, and I became convinced that there had to be a better way.

I soon discovered that people from all over the world had come to the same conclusion. In 2016, two books were translated into Norwegian and the release was marked with a seminar and a panel debate. I was invited to sit on the panel and got the chance to meet the two British authors. I had already read their books with great interest. Peter Kinderman’s A Prescription for Psychiatry: Why We Need a Whole New Approach to Mental Health and Wellbeing and James Davies’ Cracked: Why Psychiatry is Doing More Harm Than Good give a thorough account of why we should leave the diagnosis-based model of mental health behind and aim for something better.

Reading these books empowered me, even though the knowledge they contained was not new. I was familiar with Robert Whitaker’s Anatomy of an Epidemic and with the growing number of books, blogs and articles on how the field of mental health has gone astray. But the fact that more and more professionals were speaking and confirming what the survivors of psychiatry for a long time have known to be true, gave me the courage to speak out as well.

A Different Way of Helping People

At the time I was the leader of a community-based service that offered services for all kinds of mental health problems, substance abuse, prevention, social interventions and public health. My early conviction that there had to be a better way had led me, together with my colleagues, to build a service based on feedback from the people we were going to help, and that took account of what mattered to them. Diagnoses turned out to be of very little importance, so early on we decided not to waste time using diagnostic assessment tools, and we did not diagnose in the medical sense. We collaborated with people, understanding their problems from a humanistic perspective and helped them based on both their and our knowledge.

My newfound courage from the book releases and my experiences led me to write a piece about why we should dispense with psychiatric diagnosis. It was published in a national newspaper, and I was invited to speak on national TV about it with more media attention following. This was, however, not without cost. Soon after speaking out I was put under review by the health authorities. The review lasted a year and found me and my service guilty of breach of conduct and breaking the law for not diagnosing.

Political Change

This devastating conclusion could have closed the service in its current form and forced it into a diagnostically-based way of working. Luckily, with all the attention and support the service had gained through the years, leading national politicians came to our rescue. The Minister of Health had previously visited the service and stated that the whole country should work this way. A paper was issued from the Ministry of Health that said that you should diagnose, but not always. We were off the hook, and it was a small step towards having a choice on how to be treated within mental health services, at least in the communities.

Within the hospital system, the diagnosis-based paradigm still forms the foundation of their work. But things are also happening there. The medication-free initiative in Norway started as far back as 2011 when five user groups got together. They spent years lobbying for medication-free treatment and succeeded in getting the Minister to decide that all public mental health regions should offer medication-free treatment and the first one opened in Tromsø in 2017. More units are now offering medication-free treatment, and this has raised the debate about the effects of psychotropic medication.

The system will not change from within. There are too many benefits to professionals with the most power when upholding the existing paradigm. There are clinicians working within the system trying to push forward change, but they need help from the outside. We need a clear change in the law that acknowledges a humanistic approach to mental health problems, that is not based on diagnoses. This would give people real choices on how to be treated.

To Be Part of a Movement

We have had successes in Norway, but there is still a long way to go. Services are still rooted in the medical model, and forced treatment is violating basic human rights. But those who speak up are no longer alone. In fact, we are growing in numbers to such a degree that we can neither be ignored nor ridiculed. As psychiatrist Magnus Hald from the medication-free clinic in Tromsø says “…we have been able to address this question of how drugs are being used, getting this on the agenda. That might be the most important thing we have achieved, is to be part of a movement, nationally and internationally, for this development.

In September this year, the International Institute for Psychiatric Drug Withdrawal held a meeting in Gøteborg, Sweden. Forty international experts came together to discuss how to best help people getting off psychotropic drugs and changing our current diagnosis-based paradigm of mental health. As one of the attendees, I got a chance to talk to Robert Whitaker about starting a Norwegian branch of Mad in America with the aim of raising the debate even further in Norway and eliciting real change.

Mad in Norway

On the train back home, I wrote an e-mail about the initiative. I reached out to the people I have gotten to know through my career that were in some way opposed to the medical model and wanted change. This was a mix of people with lived experience, their relatives, clinicians and researchers. Would they join me on this adventure? The response was overwhelming. Many of them were almost sitting at the edge of their seats waiting for such an initiative and were ready to get to work.

After the initial e-mail, more people wanted to join, and these highly engaged people constitute the editorial board and writers of Mad in Norway. Together we want to push forward the change that is necessary for the mental health field. We believe that the current diagnostically based paradigm has comprehensively failed and that the future lies in non-medical alternatives.

Mental health and wellbeing touch on all aspects of life and the field needs to acknowledge and act based on this fact. Multiple disciplines must collaborate with the people seeking help as equals, putting the person seeking help in the lead position. No professional group should have power over others to define people’s struggles and what constitutes good help.

People should have real choice. The research and knowledge about how to work differently are already there. Now we need politicians and policymakers to force the change and make it happen in the established services. Mad in Norway will be a leading voice in ensuring this change.


  1. ‘Forty international experts came together’

    We don’t want any of that, we don’t want any help from anyone, especially if it’s ‘experts’. We don’t need any help to get off psych drugs and I’m sure as hell not going to ask an ‘expert’ – of what ever kind – who could then put me on a CTO. We want rid of the whole lot. It’s all rotten to the core. What we are interested in doing is exposing the crimes of psychiatrists, their collusion with pharma and predicting their future crimes by reading their deluded thinking, that they seem to want to put out into the public space.

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    • street
      Yes we can all individually not buy into psychiatry but oops, we got the tag.
      I’m not concerned with me only, I am concerned for the kids that have no voice.
      I hope people like Birgit can get the ball rolling and keep it rolling.
      I feel bad that I cannot do more.
      Psychiatry itself is nothing but a crime, that much we know. It has to become known on a political
      level and I can’t imagine they are not somewhat willing, because the costs of seeing half the world as MI
      well, it is becoming not so sustainable plus logically is not making sense.
      And the ONE important thing is, no government should be in bed with shrinks that drug people, children against their will.

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  2. Birgit, you are a survivor.
    You risked everything, your career but it allowed you to see how absolute power, if able to try and destroy people within the system, imagine the most vulnerable that come for help, not knowing what a diagnosis actually means.
    I have not read your whole article, because I just had to applaud you.

    Thank you as always, to MIA, Brigit,and MIA Norway,

    Thank you as always to MIA, MIA Norway, and Brigit
    Be tough, be strong, keep looking for help, you can’t do this alone.
    This has to become a human rights issue and that human right is, I do not want a mental health tag. It is harmful on ALL levels.
    Of course you know it.
    I wish you tenacity.
    It is much better to leave a legacy of empowerment than a legacy of destruction.

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  3. “Mental Health” is the problem, not the solution.

    I thought MIA (and presumably its various franchises) was trying to go beyond “rethinking” psychiatry. There’s only so much to think about before coming to the conclusion that it needs to go, period. Hopefully MIN will accommodate anti-psychiatry perspectives.

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    • Oldhead, I saw IT. I saw the words “mental health”. I get it, the opposite is “mental illness”
      But I sure don’t see many people risking their job. Some go on to become therapists which often is only a bit better. So if someone is willing to speak to the overlords and get political, and don’t get me wrong, I don’t want it to be someone that still believes in a little bit of “sick”.
      If at least they have ONE system where you can go without needing some sham diagnosis, after all she is against diagnosis and sees the future as non medical. perhaps she does not view people as MI. if we are lucky.
      I am impressed she bucked the overlords. It does not seem she had a great time of it, a year in limbo.
      I rarely support anyone, I often think my posts are too negative on articles, and I like you, am leery of change, and not abolition. However, I hope she goes further, I hope it becomes illegal to entice anyone to take drugs. And I hope she gets support in her vision of actual choice.
      We don’t have much choice in how we are viewed but should have choice on if that view counts.

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      • “Mental health treatment” is the problem, not the solution. Go imprison, insult, defame, torture somebody else. You want a “cure”? Stop imprisoning, defaming, and torturing people. Once you’ve imprisoned, defamed, and tortured them, then you start talking “recovery”. I’m saying the “recovery” is “recovery” from abduction, imprisonment, defamation, and torture, not “disease”. The “disease” is a fiction, and a convenient way for a person to get rid of people that that person disapproves of, or finds annoying.

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          • Take away the “inherent in or incidental to lawful sanction” loophole being exploited by the various Mental Health Acts around the world and what have you got? Exactly what Frank describes.
            Question, how do you torture, maim and kill a citizen of your country and get away with it? Call them a “patient” and subject them to “mental health treatment”. Police will actually assist the ‘doctor’ in the process.
            Hence the reason for the statement by the UN that Australias Mental Health Laws ARE a violation of human rights, and that the treatments MAY constitute torture (because one can’t prove intent if doctor shuts his mouth about motive). Means and opportunity both present, but without doctors confession that it is being done to torture, you’ve got nothing more than a doctor patient relationship. And in psychiatry this is carte blanche to do whatever you want and call it medicine. Other fields (eg cardiology) have standards that need to be met and may result in claims should negligence be demonstrable. Not so in psychiatry, have you seen some of the ‘patients’ that they call a success? Like a panel beater who crushes a car and calls it fixed lol. At least they could call you a taxi once they get the Medicare Forms signed.

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      • My comments are rarely directed towards individuals, and this is no exception. We’re talking primarily about systems. So I’m addressing the MIA conglomerate, not Birgit, and I wish her the best as far as that goes.

        I think it can be agreed that we need to work to delegitimize psychiatry as a branch of medicine — this includes the administration & prescribing of neurotoxins — as part of an overall strategy to defeat it. However even eliminating all such fraudulent “medicating” would not address the essential problem of psychiatry, i.e. the principles and premises upon which it is founded.

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      • As long as psychiatry is forced on unwilling victims, I have no use for it. When psychiatry is entirely voluntary, I will cease having an issue with it. The biggest “fix”, if ever a “fix” was needed, would be the “fix” that would end forced treatment, and. in the process, restore full citizenship rights to people abused by the psychiatric system in their respective countries. As long as you don’t get rid of forced treatment, mental health treatment is nothing more than an excuse to abuse certain people. Yep, that’s right. Criminals and mental patients are not the only people who routinely use the abuse excuse.

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        • I have a huge problem with Psychiatry that goes way beyond “force”.
          Because even if you CHOOSE to walk in, you lose rights, such as medical care that is equal to the non labeled, parenting rights if some family member decides to hate you.
          In fact most of your complaints will go unheard or minimized, and all complaints, all issues, all needs will be viewed through the lens of your label.

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          • Way beyond force? Like if you choose to be deprived of your liberty? Or if you boarded ship in chains and bound for some colony somewhere? Deception, in my view, complements force because if people were open and honest about it, if it was all open and above board, they wouldn’t be resorting to force in the first place.

            Another matter is that this isn’t completely about “disease”, it’s about morality or something else. People are being punished for some transgression or other, for disobedience, for rule breaking, but not, and this is important, law breaking. Quasi-medical, quasi-legal, in this instance, sort of detours both. All the more reason, in the authorities view, for lies and non-transparency.

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          • Perhaps, but then there’s that question. Is the problem psychiatry or force? Perhaps we disagree on this one. You seem to think the problem is psychiatry while I think the problem is force. Get rid of psychiatry, but don’t get rid of forced treatment, and where are you? I think you’d kind of be back at square one.

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          • Frank, not sure who you typed to,
            but my position is that the concept of “MI”, already infiltrates every system, so even if no physical force is used, once I get a label, it reduces any power I have, or completely eliminates any validity, voice I have. Anywhere. Psychiatry would love to “soften” the blows and perhaps fool the public about the damage by getting rid of force. Then the cops will handle the force. And people in psychosis will sit in a cell. It doesn’t bother psychiatry because the silent forcing of drugging kids and youth is well managed. And the numbers are much larger than people who get visibly forced. These kids have done nothing wrong either and don’t even have a clue of why their head feels weird after drugs, nor do they know how to express change. That is the sickest form of practice, and is a horrible form of abuse. They also do not inform parents. Many parents are low income and lack knowledge. The fact is, they prey on vulnerable people, but when they stoop to using the poor, weak, children and ruin people’s history and future, well Psychiatry is all around bad.
            I am against ALL things psychiatry, unless a psychiatrist has the guts to speak up.
            There would be no force if the DSM and psychiatry did not exist.

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        • I don’t think the problem is both. I think the problem is force, and the power that psychiatry has been granted by legislators and in courts of law.

          Forced treatment is the law now. Get rid of the law which allows it, by circumventing the law, and there you are, that is, not locking up people under a medical pretext who have broken no laws.

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        • “In order to script a new narrative, one not written by old, white, wealthy men, but one written by people and by communities…”
          Can I call this comment out as racist? (Disclosure – I am white, although I am neither old nor wealthy.)
          Plenty of good things have come to the world via old white and wealthy men. Even if that were not true, it is discriminatory to write such a thing.
          I do agree with your other point – that a new narrative needs to be written. But I think that the lack of community structure in much of today’s world is precisely the reason for all this “mental illness,” coupled with (and it’s all the same thing really) the breakdown of family life. Which is probably why it won’t happen.
          And yes – it would be wonderful to abolish psychiatry and forced treatment. But somehow I don’t think that would go very far towards abolishing human distress which has always existed (and been “treated” by alcohol and “street” drugs).

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  4. I am of two minds. You seem very sincere and have taken great risks to stand up to the psychiatric and medical establishment at the governmental level. That should certainly be applauded. I’m sure you’re a wonderful person that it would be a pleasure to know.

    I am also in agreement with those who say “no thanks, not interested in ‘professional’ ‘help'” – those are two words that when strung together should be considered an oxymoron. I’d sooner declare mad pride than trust a treatment professional again.

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    • Yes Kindred, I understand the “no thanks” as much as anyone.
      I understand the bitter taste left behind, and want this whole theory business, the help, the experiments done with. It just keeps everyone focused.
      However, I also know that we are all at different places of understanding and experiences.
      I myself see a need for people like Birgit to keep marching on. It does expose the system, and people willing to risk it, is big. Thing is, we have people stuck within the system, kids lives attacked. We need alternatives to help people get out of the trap.
      Perhaps if some parents go to this clinic, it might be valuable for their kids.
      I wish I had a clinic like this when I was 4, and 18 and 28 and on. Would I trust again? It would take a LOT to convince me and not at all if I am seen from a “mental health” view.
      I think places like this would be well off to talk about possibility of herbs, but with a grain of salt, because often I see people from another “alternative cure” touting their latest fix. But still to direct people to sources such as forums that use alternatives such as “pheonixrising” or peer support places, and always with an explorative view, might be helpful for some.
      I think the message people should get at these places that they are not MI, but if something helps them be more comfortable, then go for it.
      It should focus on harm reduction which includes “MI”, the labels, meds and herbs and reducing the belief in distress as being MI.

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  5. “When you were discovering what happened in the world of psychiatry in Germany during the Nazi period what was the most shocking discovery for you, the most surprising or most disturbing discovery.”

    “That the psychiatrists were not monsters that they are people like you and me”

    “And why was that disturbing”

    “Because as you have mentioned before physicians have learnt to help people and not to kill patients”

    The far right wing have come to power in the UK on December 12, 2019, now with almost unstoppable majority.

    Expect UK psych to start to seek sterilizations and long term incarceration via their special interest group: Evolutionary Psychiatry in the near future. Expect them to use other people to put forward this.

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    • So it has begun, sooner than I thought. In a Queens speech which sets out the Johnson Govt intention BBC state they will plan longer incarceration for violent criminals. Ostensibly that seems fine, but for those of us who know full well that psychiatric drugs cause people to be violent once toxic, there will be no real justice.

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  6. birgit,
    As per usual, I revisited your article. I enjoyed reading about how the system never made sense to you, and how you have read the books, to bolster your thinking.
    Many people don’t go farther than to say “yes, psychiatry needs tweaking, or it fails somewhat”. They see the failure, the bogus lies within the DSM, and pharma, but no guts to name it exactly what it is.
    I believe we are of the same mind, in getting rid of psychiatry and it’s dogma.
    I liked this quote
    “…how to best help people getting off psychotropic drugs and changing our current diagnosis-based paradigm of mental health….”

    The word “mental health” obviously bother me, IF used in the way that the opposite exists, which is “mental illness”. I would so much like to get away from that.
    Suffering exists. But I found to subscribe to “mental illness” always left me in search of “mental health” in that I somehow failed myself, yet by looking, we often never reach that illusion or delusion. It can certainly keep people trapped, by either their suffering in self comparisons or others.
    To that observation of mine, there are no quick answers, but I certainly know that the view itself, of “mental health”, IS the basis of psychiatry.

    So yes, just my two cents worth and I hope in some way I contributed to keep you keeping onwards.

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  7. In the UK expect Hong Kong type situation. Expect Extinction Rebellion, Brexit leave/remain to start peaceful demonstrations, it will deepen. There will then be a police crack down trying to prevent demos starting in London. It will again deepen. UK political establishment has no answer to this – proven over the recent years – other than to use the police and probably turn to psych. In all this UK psych will seek to further promote it’s new agenda: Evolutionary Psychiatry.

    Then remember these words of a top German psychatrist to know that they are still very gone wrong:

    “That the psychiatrists were not monsters, that they are people like you and me”

    NO they are not people like us !

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  8. “The Field of Mental Health Has Gone Astray, But We Can Fix It.” Only if the psychologists flush their DSM, agree to stop “conspiring” with the neurotoxic poisoning psychiatrists against your shared clients, and agree to get out of the systemic child abuse/rape covering up and profiteering business.

    But, of course, you wouldn’t have much business if you got out of that criminal child abuse covering up business.

    Welcome to the MiA family, Birgit. And I hope you female psychologists will start speaking out against these historic and continuing, systemic child abuse and rape covering up crimes of the paternalistic “mental health” industries.

    Oh, and these systemic crimes are by DSM design. So aside from the “invalidity” and “unreliability” of all the DSM disorders, you have one more reason your DSM “bible” must be flushed.

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  9. Psychiatry is a pseudoscience, a drug racket, and a means of social control. It’s 21st Century Phrenology, with potent neuro-toxins. Psychiatry has done, and CONTINUES TO DO, FAR MORE HARM than good….
    Remember, 100% of the DSM was either CREATED, or else INVENTED. Literally NOTHING in the DSM was “discovered”. When something is “discovered”, it existed before it was discovered. When something is either invented or created, it did NOT exist before it was created or invented. So-called “mental illnesses” literally DID NOT EXIST, before psychiatry invented and created them. Go ahead, prove me wrong….

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    • That’s not really true and it undermines the rest of your argument. The sanitariums were quite literally nearly emptied in the late 1930s after antibiotic treatment was discovered to cure late stage Syphilis. Incidentally, Syphilis is caused by a spirochetal bacteria very similar to Lyme’s borrelia.

      In 1994, researchers published a study in Schizophrenia Bulletin showing a nearly identical geographic overlap between areas of greatest risk of schizophrenia diagnosis and areas of greatest Lyme disease and tick-borne encephalitis diagnoses.

      Copper truncheons were discovered to cause madness in the Middle Ages due to reactions from acidic foods leaching toxic amounts of copper into people’s food.

      And frankly, our environments are so polluted now, and our food of such poor quality (for many debatable reasons) that it’s perfectly plausible that some of the rise of neuropsychiatric illness now seen is a direct result of these things.

      The problem arises when the person’s distress is removed from their environment and placed within them, which is what the DSM does. The focus on the brain and genetics doesn’t allow for infection (except sometimes for PANS) or nutritional deficiencies or lead leaching from urban pipes, or pharmaceutical contamination of water systems, or Roundup in our food (killing off our microbiome), or toxic stress from living under constant surveillance in a racist, sexist, nationalist, capitalist-driven, materialist-obsessed culture, or bad parenting, or neglect, or domestic violence. Or just having the terrible bad luck to have dealt with many of these things at once. That’s where the DSM does it’s best work to create a narrative where none of these environmental causes matter.

      You may very well have an illness or a state of disease in your body causing you mental distress and extreme states as an effect from a toxic environment, but adjusting your neuro chemicals and searching for causative genes will NEVER discover or cure those causes.

      The DSM has worked very well to classify behaviors as if they were the actual issue needing treatment, and the psychology industry (Therapy) has played right into their hands for their share of the profit pie.

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    • I like that: “A drug racket.” Very descriptive of the 5 minutes spent with a licensed person.

      I would not, however, call it intentional. Maybe, more accurate would be “denial.”

      History repeats. Right? But not always. There’s lots of room for something more promising.

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  10. Do Family Constellations have a place in these initiatives? I am a PhD psychologist and Family Constellation facilitator and training who has worked regularly in Norway since 2010. Our approach looks at the systemic roots of emotional, behavioral and relationship difficulties. Many symptoms that are considered chronic in psychiatric medicine can be relieved in just a few sessions with Constellations. Are they are your radar?

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  11. Kudos Birgit! I greatly appreciate every professional who speaks out against the current harmful medical model of psychiatry and I thank you for all your work in setting up Mad in Norway.

    “We need a clear change in the law that acknowledges a humanistic approach to mental health problems, that is not based on diagnoses.”
    Yes, this is SO important because the root of all harm starts with a psych label.

    “No professional group should have power over others to define people’s struggles and what constitutes good help”.
    How crazy that a psychiatrist gets to define someone’s reality when the psychiatrist don’t know anything about them or what has happened to them, etc. – and worse DOESN’T even want to know.

    Thank you and best of wishes going forward with Mad in Norway.

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  12. What you are doing by not diagnosing is removing a name with no further scientific attempt of defining the cause. Getting rid of what doesn’t work is good, but I wouldn’t be so sure that there is enough science behind what you are trying to do. Yet, with current day theories, it seems the correct thing to do is the most humane thing to do even if all the answers aren’t available yet!

    Asking more questions might help.

    So, I ask everyone:

    MENTAL ILLNESS. What is it?

    My clue…

    It is NOT behavior.

    (How about you?)

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    • I’ll go with Oldhead on this one, and say that a MIND is an idea, or a set of ideas and processes, and ideas can’t be “ill.” There are neurological illnesses, which should all be detectable by some physiological means. But it is a mistake to equate neurology with “mind.” No one really knows what “mind” is, and until we do, it is going to do nothing but add confusion to call a mind “ill.”

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      • Neurology regularly suggests people to go to shrinks and will deny drug damage done by psych, simply because their science is so pathetically scant, it should not even be mentioned.
        Neurology itself, as do other MD’s are very willing to use psychiatry.
        Psychiatry is the go to, last option in the face of lack of science.
        Yet even, what in science should we look for? Mental illness? And what does that look like? Is it yelling at inappropriate times? Arguing and debate? Opinions? Crying? Grieving? Shyness? All Anger? Not thriving in crappy situations?

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