7 Jul 2018

Simon Keller - Philosopher assesses claims about mental health

From Saturday Morning, 9:05 am on 7 July 2018

The modern definition of mental health as being something positive to aspire to should be viewed with suspicion, according to philosopher Simon Keller.   

Keller is a professor of philosophy at Victoria University of Wellington.

“What I think is dangerous is the way we’ve come to start talking about a positive conception of mental health and in particular the way in which it’s being presented as a sort of quasi-scientific medical notion.

Professor Simon Keller

Professor Simon Keller Photo: supplied

“So people will say things like 'in order to improve your mental health you can do things like write gratitudes or engage in mindfulness or change your diet'.”

He says from a philosophical point of view talking about positive mental health is “replicating a whole lot of ancient important and difficult moral debates about how we ought to feel when confronted with life’s difficulties.”

“People are pushing that notion of mental health that pretends to be neutral and scientific but is actually quite ideological.”

He says, for example, the World Health Organisation’s (WHO) definition of mental health is very broad.

“It turns out everyone is mentally unhealthy if you have a look at the definition.”

The notion of wellbeing has also come to replace words such as happy or flourishing, he says.

“We throw it around a lot but we haven’t really decided what it means.

“The word wellbeing is quite a recent one in the English language, 100 years ago people talked about happiness or flourishing or a good life, the word wellbeing came into being to cover up some of the difficult notions that are raised when we use those words.”

When economists and philosophers talk about wellbeing they are talking about whether a person’s life is going well, he says,

“Who gets to decide that? At that point the conversation becomes a little more difficult.”

It is untrue, he says, that our natural state is one of happiness.

“There are lots of things we face in life that are worth being depressed about or that lead to anxiety.

“Genuine depression can be best understood as a response to the circumstances that somebody is facing. That’s of course not to say that it’s good, it ought to be treated in whatever way we can.”

And people with mental illnesses such as depression or bipolar disorder or addiction can be mentally healthy and have wellbeing if their condition is managed.

“They are often able to live with their mental disorders and to flourish in many ways. It’s like if someone with diabetes has proper treatment and is able to take their insulin.

“Somebody who suffers from a mental illness can say ‘yes I suffer from a mental illness but my mental health is great.”

The ubiquitous concept of mindfulness is also problematic, he says.

"What counts as mindfulness? It’s a bit like wellbeing it’s one of those words that’s grown to envelope a huge amount of very disparate phenomena.

“There’s a real clash between on the one hand being mindful is to be non-judgemental about your mental state just accept them as they come to you and on the other some very prescriptive claims about what those mental states should be.”

The notion too that personal attitude is the key to mental health is also flawed.

“That is another dangerous aspect of the mental health discourse when we start think of mental health interventions and we start thinking of them as very individualised.”

He says focusing purely on the individual can cause us to overlook deep social factors such as poverty that can make people mentally unwell.

Victoria University of Wellington is hosting the joint Australasian Association of Philosophy and New Zealand Association of Philosophy annual conference this month.

Simon Keller will be giving the New Zealand Association of Philosophers presidential address - Putting Mental Health in its Place.