The essence of mental health
Ideally, healthy humans have:
- An ability to love and be loved. Without this cardinal asset, human beings, more than all other mammals, fail to thrive.
- The power to embrace change and uncertainty without fear and to face fear rationally and in a spirit of practical optimism.
- A gift for risk-taking free from endless worst-case-scenario-gazing.
- Stores of spontaneous joie de vivre, and a wide range of emotional responses (including negative emotions, such as anger; these may be important for motivation, as well as being a natural antidote to pain).
- Efficient contact with reality: not too little; not too much. (As T S Eliot said, humankind cannot bear very much reality.)
- A rich fantasy world enabling hope and creativity to flourish.
- A degree of self-knowledge to encourage the humane exercising of the skill of repairing the self and others following harm.
- The strength to say I am wrong, and to learn from experience.
- An adequate feeling of security and status within society.
- The ability to satisfy the requirements of the group, combined with a freedom to choose whether to exercise this ability.
- Freedom of self-expression in whatever way he or she wants.
- The ability to risk enchantment and to feel a sense of awe.
- The ability to gratify his own and others' bodily desires.
- A sense of humour to compensate should the foregoing be unavailable.
Happiness need not be an ingredient of mental health; indeed the merely happy may be supremely vulnerable. All that is needed is for their happiness to be removed. The above are important as they are what a person needs should this misfortune befall him. The above may also be seen as a sort of blueprint for our species' survival.
The essence of mental illness
Whenever a person's abnormal thoughts, feelings, or sensory impressions cause him objective or subjective harm that is more than transitory, a mental illness may be said to be present. Very often the harm is to society, but this should not be part of the definition of mental illness, as to include it would open the door to saying that, for example, all rapists or all those opposing the society's aims are mentally ill. If a person is manic (p 354), and not complaining of anything, this only becomes a mental illness (on the above definition) if it causes him harm as judged by his peers (in the widest sense of the term). One feature of mental illness is that one cannot always rely on the patient's judgment, and one has to bring in the judgment of others, eg family, GP, or psychiatrist. If there is disparity of judgment, there is much to be said for adopting the principle of one person one vote, provided it can be shown that the voters are acting solely in the interests of the person concerned. The psychiatrist has no special voting rights here otherwise the concepts of mental health and illness become dangerously medicalized. Just because the psychiatrist or GP is not allowed more than one vote, this does not stop them from trans- illuminating the debate by virtue of his or her special knowledge.
For convenience, English law saves others from the bother of specifying who has a mental illness by authorizing doctors to act for them. This is a healthy state of affairs only in so far as doctors remember that they have only a small duty to society, but a larger duty to their patient (not, we grant, an overriding duty in all instances eg when murder is in prospect).
Learning disabilities (mental impairment/retardation)
This is a condition of arrested or incomplete development of mind which is especially characterized by subnormality of intelligence.
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