On Defining Mental Health, by Tina Minkowitz*
1. Mental health, like recovery, is individual and subjective. It cannot be judged
externally or with reference to any universal criteria. Various ideas or visions or
values of what anyone considers to be mentally healthy can be promoted and
cultivated the way that ethical and spiritual values can be promoted and
cultivated. To attempt to universalize such criteria and judge others according to
them is to impose hegemony of certain beliefs and values over others, and most
importantly to create a hierarchy of those who are in a position to authoritatively
proclaim the hegemony of these beliefs and values, and to judge others according to
how well they meet the criteria.
2. For me, mental health is a sense of internal well-being and congruence with one’s
own beliefs and values. This is an internal reference, my personal idea of what I
would envision, or abstract from what it means to me to see some habit or pattern as
mentally healthy or unhealthy. Nevertheless, it is not for anyone else to take that
from me and judge me according to whether they think I am fulfilling this in my own
life.
3. There can be dialogue and interchange about what we consider to be mentally
healthy, just as we can exchange views about ethics and spiritual beliefs and values.
Such interchange is worthwhile but will never amount to, or should aim to create, an
objective universal standard. In other words mental health is an aspirational personal
value that can be meaningful in individuals’ lives. When used as a yardstick for one
person to measure another, it is the enactment of a power inequality and hierarchy,
contrary to the values that underlie CRPD Article 12, in particular what I have
referred to as the incommensurability of persons, or the impossibility for one person
to ‘assess the inner-workings of the human mind, and when the person does not
pass the assessment, to deny him or her a core human right.’ (CRPD General
Comment No. 1 para 15).
4. In my view, giving any hegemonic weight to such assessment in law or social
practice is enough to deny the person the human right to be treated as a member of
his or her community of equal worth and dignity as others. I consider that the logical
implication of Article 12 is a radical mutuality and respect for worldview as developed
by Shery Mead in the framework of Intentional Peer Support. See Mead’s papers
and other materials on intentionalpeersupport.org, and my papers CRPD and
Transformative Equality, Rethinking Criminal Responsibility, Alternative to Functional
Capacity, and Norms and Implementation of CRPD Article 12 on academia.edu, and
blog posts ‘Decision-making and moral injury’ on madinamerica.com and ‘Guiderails
and reparation’ on tastethespring.wordpress.com. These values underlie the work
that has been done since the 1970s on peer support as a practice of sharing,
exploration and co-creation of knowledge by and for people who have been labeled
by others as mentally unhealthy and denied our human rights on that basis. To
embrace the idea that mental health is individual and subjective, an aspirational
value akin to spiritual and ethical values, reasserts our ownership of policy as well as
legal norms in an area that has deeply affected us and that we have contemplated
and studied to remedy the injustices that have been done.
*
adapted from https://tastethespring.wordpress.com/2017/05/29/on-defining-mental-health/.