Review

Clear thinking on mental health

THE SOCIAL NATURE OF MENTAL ILLNESS
Len Bowers
Routledge, 1998, £50.00

This book is a philosophical critique of theories of mental health, focusing largely on semantics and logical inconsistencies between sociological and psychiatric accounts of the underlying causes of mental health problems.

The book often felt pedantic — but then, how a problem is defined determines the possible solutions and, overall, I found the author’s exploration of disputed issues enlightening.

Occasionally I felt he misjudged the extent to which the underlying causes of a wide range of mental health conditions are (or, realistically, can expect to be) fully understood, and the distinction drawn between the treatment of mental and physical illnesses to be more illusory than real. The arguments over the legitimacy of ‘medicalisation’ of mental health problems by psychiatry apply to a range of other conditions and clinical specialties – complex interactions of personal, cultural and social factors appear to be avoided by treatment plans which concentrate on relieving physical symptoms.

A person with mental health problems may disagree with the explanations or interpretations of his/her behaviour provided by others and resist measures proposed to ameliorate their condition. This has implications for patients’ civil and human rights, about which those without direct experience of serious mental health problems might need reminding. The book’s philosophical exploration of these issues is relevant and it will be a useful resource material for students, nurses, social workers and other professionals involved in mental health issues.