ABSTRACT

T o THE intelligent, sympathetic observer, intent onreaching a balanced and informed understanding of its content and its possibilities, the present fragmented state of psychiatry presents a formidable picture. The concept of mental illness appears to permit a bewildering number of interpretations. Is it a label for socially unacceptable behaviour behind which the deviant is permitted to take refuge and thereby evade the consequences of his antisocial activities? Is it an arbitrary concept which only serves to mislead people, by virtue of its medical connotations, into believing in 'mental sickness' when, more often than not, what it describes consists of disordered, interpersonal relationships wherein one person is scapegoated to carry the responsibility for the disturbances of the group? Is it merely a political expedient which enables those who hold power within society to devalue and degrade the dissenter and, by defining him as mentally ill, to violate his freedom and destroy his dignity? Or is it a concept, analogous to physical illness, which is applied to a patient who manifests not physical pathology but 'psychopathology', who experiences psychic rather than physical suffering, exhibits disturbances in his psychological rather than his physical functioning, and who, in some instances at least, suffers a serious

impairment of his judgemental capabilities and his personal responsibility?