There is currently more published information about mental health than ever before, and it has never been so easy to connect with experts, health workers and charities supporting mental health issues. Yet misinformation, stereotypes and stigma still exist, and often people still don’t know where to turn. The problem isn’t a lack of information, but in communicating what information we currently have, and what we need to have. One of the most basic pieces of information would be a clear description of exactly what people mean when they talk about mental health and mental health issues. Definitions are often expressed differently depending on who the target audience is; articles written for a general audience will often focus on a single problem or dysfunction, while medical articles get more of the complexity across. Here are some examples of different online resources, and their definitions.
Mind: “problems that affect they way you think, feel, or behave”.
Wikipedia: a mental or behavioural pattern or anomaly that causes either suffering or an impaired ability to function in ordinary life (disability), and which is not a developmental or social norm.
BBC Science: symptoms that go beyond typical responses, and are severe enough to interfere with a person’s ability to function.
Now for the big one, the DSM- IV. As you might expect, this is a comprehensive and rigid explanation:
A clinically significant behavioural or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom. [This] must not be merely an expectable and culturally sanctioned response to a particular event.
A manifestation of a behavioural, psychological, or biological dysfunction in the individual. Neither deviant behaviour (e.g., political, religious, or sexual) nor conflicts that are primarily between the individual and society are mental disorders unless the deviance or conflict is a symptom of a dysfunction in the individual, as described above.”
Breaking this down, the DSM requires a mental health condition to be a pattern of symptoms that cause suffering to the person, go beyond culturally normal experiences, and are caused by a biological or psychological difference in that person.
The ICD- 10 definition is a common research basis, striking a good balance between comprehension and simplicity. They define a mental illness as “a clinically recognizable set of symptoms or behaviours associated in most cases with distress and with interference with personal functions.”
From Illness to Wellness
An encouraging trend in mental health research is to separate “mental illness” and “mental health”. This isn’t a new trend, as the initial configuration of the World Health Organisation defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” in 1946. However, it’s a welcome return for the idea. Children’s mental health charity YoungMinds takes this route, defining mental health as:
The capacity to enter into and sustain mutually satisfying personal relationships
A continuing progression of psychological development
An ability to play and to learn appropriately for their age and intellectual level
A developing moral sense of right and wrong The capacity to cope with a degree of psychological distress
A clear sense of identity and self worth
While this definition covers a lot of areas, it’s great in a subjective sense- it feels like mental health. However, most of the sub-parts of the definition are hard to objectively explain or operationalise, meaning medical psychology routes can’t get much use out of it. NHS Inform– their Scotland-based information site- gives a concise explanation of both mental illness and mental wellbeing. More importantly, the definitions are not mutually exclusive- they allow for someone to gain mental wellbeing even when diagnosed with a mental health condition. The UK NHS also has a good article on how to develop mental well-being, unconnected to mental illness.
While there are many definitions of mental health available, covering a wide range of factors, very few of them paint a coherent picture or give many clues to causes or treatments. Many of the mental illness-based definitions lead up to the same problem – they sound confident and medical, like clear problems with a clear solution. However, that’s not the case. We still don’t know with certainty what the causes of mental illnesses are and what affects people’s recovery. More importantly, we still don’t know if our existing diagnostic system is the best way to diagnose illness. Regardless, awareness is still important – sharing our work-in-progress knowledge is better than sharing nothing at all.