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Szasz and the "Myth of Mental Illness"

At least one prominent theorist argued since the 1960s that the concept of mental illness was a myth and that society should abandon the effort to judge people as sane or insane. Thomas Szasz (1961) claimed that there was no real evidence for biological causes of mental illness, so a person who was labeled mentally ill was essentially the victim of a political act. Such a person was perceived as threatening to society, and that (according to Szasz) was the real reason the person was likely to be locked away in a mental hospital, with no rights and few freedoms. Szasz argued strongly that it was dishonest to label such a person mentally ill and wrong to use illness as an excuse to deprive people of their rights.

What was the famous theoretical position of Thomas Szasz? In what sense was Szasz's position "not simply lenient and forgiving"?

Szasz believed that so-called mentally ill people should have the same rights and responsibilities as everybody else. His position was not simply lenient and forgiving, however, because he also felt that in exchange for having the same freedom as every other citizen, an "insane" person should also have the same responsibilities as every other citizen and should not be exempted from moral or legal blame for deviant behavior. Therefore Szasz was against the insanity defense in our legal system, with its implication that people who fall into a special category (insane) should be exempted from punishment for illegal behavior. Instead (Szasz argued) such an individual should be treated just like everybody else. If the person's behavior endangered other people, the person should be arrested and sent to jail. If the person did not endanger other people, the person should be left alone.

What happened in the United States that moved laws closer to Szasz's position?

Szasz's position was very radical when he first put it forward, but a lot of people agreed with the essence of his argument about freedom and responsibility. Eventually, the laws in the United States changed to resemble Szasz's recommendations. Many states passed legislation making it illegal to put people in mental hospitals against their will, unless they presented a danger to others. In modern day America, people are no longer locked up just for acting crazy. They are allowed to remain free unless they endanger the property or personal safety of other people. If they do pose a danger, they are more likely to be put in a prison than in a mental hospital. That has caused problems for the prison system and mentally ill people who end up there. (See the next page, on deinstitutionalization.)

How did Kety respond to Szasz's statements about the "myth of mental illness"?

Ironically, while Szasz's political position (that people should not be locked up just for being different) prevailed, his theoretical position (that there is no such thing as mental illness) was rejected by many in the psychological and psychiatric professions. For example, Kety (1974), responding to Szasz's statement that mental illness is a myth, collected all the evidence for genetic influences on schizophrenia. He concluded, "If schizophrenia is a myth, it is a myth with a strong genetic component" (p.961).

How can it be argued, still, that mental illness is a myth, in an era when many abnormalities can be related to brain diseases?

As already noted, biological explanations of abnormal behaviors (whether called mental illnesses or harmful dysfunctions) are increasingly common. Brains scanning technologies, genetic analysis, and knowledge about neurotransmitters (the chemicals around neurons) have all led to an increasingly biological emphasis in the diagnosis and treatment of severe psychiatric disorders. However, Szasz might respond that an identifiable biological illness is just that—a body or biological illness. He would say "mental" illness is still a myth because "minds" do not get sick. What is labeled mental illness is behavior—specifically, behavior which is harmful to others or disapproved by society. We do not label people with brain diseases "mentally ill" if they act normal. So the label should be recognized as a political or moral judgment, not a medical judgment.

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