The Psychiatric Times has an interesting article discussing whether bigotry should be classified as a mental illness. The author concludes no, but the discussion gives an important insight into how we decide what is a mental illness and what is not.
Most people might think that an opinion, no matter how disagreeable, shouldn’t get someone diagnosed with a mental disorder.
The difficulty comes when deciding what criteria you should use to decide that someone’s mental state has gone beyond what is normal and should be considered an illness.
Generally, if a mental state is considered to cause distress or impairment, it’s considered to be a sign of mental illness.
This goes for physical illness as well. A physical difference is only considered an illness if it causes problems as a result.
However, someone who is extremely racist might genuinely suffer problems as a result of their opinions.
As we reported previously, a small group of psychiatrists are pushing for a diagnosis of ‘racist disorder’ to be included in the next revision of the diagnostic manual on this basis.
One argument to be wary of in the justification of this, or any other mental disorder, is that ‘it must exist because biological differences can be found between people thought to have the condition and those without’.
As the mind and behaviour is just a reflection of brain function, any difference, no matter how trivial (ice cream preference for example), will have a related biological difference.
As with physical illness, biological differences in themselves can’t define an illness, because they have to be linked to what is considered serious distress or impairment in everyday life.
Biology might tell us why the difference occurs, but it can’t tell us whether the difference should be considered good or bad.
This decision is essentially a value judgement, because what is considered serious, distressing, impairing or relevant to everyday life aren’t cut-and-dry decisions and are made on the basis of a consensus of opinions.
In some cases, such as cancer, it’s easy, because everyone agrees that an early painful death is bad.
In other cases, particularly for mental illnesses, the issues can be a lot less straightforward because there there are few obvious and direct effects of mental states.
These issues ask us to question what we consider an illness and highlight that the decision is as based as much on social considerations and context, as on the science of biology.
The Psychiatric Times article tackles exactly these sorts of issues in its discussion of bigotry, and is a great guide to the philosophical issues involved in classifying mental disorder.
If you want to explore further, the Stanford Encyclopedia of Philosophy has a great entry on mental illness that tackles many of the conceptual difficulties.