Values in the definition of mental disorder

Abstract

There has been rapidly increasing interest in the concept of mental disorder in the last few years. One of the main forces behind this has been the increasing importance and sophistication of diagnostic manuals such as DSM-IV and ICD-10, alongside continuing discontent about psychiatric diagnosis (e.g. Kutchins and Kirk, 1997). Critiques of the medical model have charged it with being a means by which individuals or groups are, among other things, disqualified, stigmatized and socially excluded, and these concerns continue to be pressed by patients and their advocates. We have seen concerns about community care, the beginnings of compulsory community treatment orders, uncertainty about response to dangerousness associated with ‘personality disorder’, as well as the growing influence of the service user movement. Further, advances in the sciences – biological, psychological and social – modify our concept of mind, its biological and social basis, and hence our ways of understanding mental disorder. The arguments and perspectives on mental disorder move in and around these themes: the medical model, social values and the sciences.