Szasz (2011) The myth of mental illness: 50 years later


Szasz (2011)- Theories on which study is based/Bac

The idea of mental illness may be closely related to the social values of individual societies.

In the West it is generally believed that the changes in descriptions and treatments of mental illness are as a result of increasing knowledge and understanding. 

Szasz believed there was no such thing as mental illness.- 'disease means bodily disease', and given that the mind is not part if tge body, disease is a concept that shouldn't be applied to the mind. 

Szasz' aim was to challenge the medical character of the concept of mental illness and to reject the moral legitimacy of the involuntary psychiatric interventions it justifies. 

He proposed that 'psychoses', a phenomena it was formally known as, is now known as 'mental illness'- we should reject the image of the patients as the helpless victims of pathological events outside their control; and withdraw from participating in coercive psychiatric practices as incompatible with the moral ideals of free societies.

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Szasz (2011)- Research method

The article critiques changes in the beliefs and concepts surrounding mental health and changes in mental healthcare in the USA over the 50 years since 1960. 

Main 4 sections:

1) 50 years of change in US mental healthcare

2) Mental illness- medical or legal concept?

3) 'Mental illness' is a metaphor

4) Revisiting 'The myth of mental illness'

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Szasz (2011)- Outline of article: Section 1

Fifty years of change in US mental healthcare 

In 1950s the notion that the responsability for the healthcare of the American people should lie with the federal government had not yet entered national consciousness.

Most pwoplw called 'mental patients' incurable.

The physicians who cared for them were employees of the state governments. 

Since that time, the formerly sharp distinction between medical hospitals and mental hospitals, voluntary and involuntary patients, private and public psychiatry have blurred. 

Now, mental health care is the responsability of the government and is paid for by public money. 

Everyone defined as a mental health professional is now legallt responsible for preventing their patient from being 'dangerous to himself or others'.

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Szasz (2011)- Outline of article: Section 2

Old diseases such as homosexuality disappeared.

Bill Clinton: 'Mental illness can be accurately diagnosed, successfully treated, just as physical illness' 

Szasz thinks illness is a structural/functional alteration of cells, tissues and organs. Metaphor

Mental hospitals are like prisons, imprisonment 

psychiatrists like judges and jailers- not physicians or healers. 

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Szasz (2011)- Outline of article: Section 3

if all the conditions now called mental illnesses proved to be brain disease, there would be no need for the notion of mental illness 

mental diseases are the resulyt of products of medicalisation of disturbed behaviours.

diseases of the body have consequences, such as nutritional deficiencies or infectious agents

people with mental illnesses have reasons for their actions that must be understood 

they can't be treated by drugs, may be helped by people who respect them, understand their predicament and help them to help themselves. 

a patient should be free to seek, accept or reject diagnosis and treatment. 

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Szasz (2011)- Conclusion

According to Szasz: 

psychiatry is a pseudoscience 

mental illness is ficticious, is a metaphor 

mental illness is a legal concept rather than a medical concept

it is wrong to treat individuals called mentall ill as sick patientd needing treatment, regardless of whether they seek or reject such help. 

should have freewill. 

in last 50 years, psychiatry has become medicalised and politicised


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Szasz (2011)- Outline of article: Section 4

his book is a radical effort to recast mental illness from a medical problem into a linguistic-rhetorical phenomenon. 

curing/healing souls by conversation and coercing/controlling people by force, authorised and mandated by the state. 

Bleuler (1911)- people are being forced to continue to live a life that has become unbearable for them for valid reasons. Psychiatrists shouldn't deprive people of liberty

In Szasz's view, Bleuler's plea to resist 'obeying the cruel views of society' have been ignored by psychiatrists. 

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