I’ve just started listening to the latest episode of the BBC’s Moral Maze podcast (which I highly recommend). The topic for discussion is mental illness and unhappiness: where do we draw the line between the two, and what are the implications for moral responsibility?
It seems to me that the dichotomy between unhappiness and mental illness is based on a false underlying premise, namely that unhappiness has to do with some sort of nonphysical, emotional realm under the control of our free will, while mental illness is about physical pathologies of the brain that are beyond our control.
If this premise were true then the question posed by the Moral Maze episode would make sense: We could ask how it is possible to distinguish between normal emotional states (for which a person is responsible) and actual illnesses (which a person has no control over).
Under the naturalist worldview, though, the above premise is clearly false. “Normal” emotions like unhappiness are just as much a product of brain function as mental illness. Unhappiness and mental illness therefore lie on the same “landscape” of mental states. This landscape may have several dimensions (such as intensity, cause, etc.), but it is still one landscape – the landscape of possible mental states.
There are a few consequences of this paradigm:
1. It makes it possible to link mental health to morality, as I argue in my essay on morality (see the section on Morality and Mental Health here).
2. It shifts attention away from the labels we use to describe undesirable mental conditions, and helps us focus on what should be done about them. Instead of asking where the boundary between unhappiness and mental illness is, we should be asking what parts of the mental landscape warrant which sorts of intervention or therapy.
3. It helps us to avoid playing the “blame game”, which really doesn’t help anyone. Instead, the focus is on the condition as a problem to be solved, rather than a moral failing to be reprimanded.
It seems there is still a tremendous hurdle in public opinion when it comes to mental health. Many people consider mental illness to be some sort of well-defined and rare phenomenon when in reality, it is a sliding scale that joins the happiest, most rational people with those who are severely disabled. I can only hope that public perceptions will change.