Thomas Szasz, March, 1998
Mental illness is a metaphor (metaphorical disease). The word "disease" denotes a demonstrable biological process that affects the bodies of living organisms (plants, animals, and humans). The term "mental illness" refers to the undesirable thoughts, feelings, and behaviors of persons. Classifying thoughts, feelings, and behaviors as diseases is a logical and semantic error, like classifying the whale as a fish. As the whale is not a fish, mental illness is not a disease. Individuals with brain diseases (bad brains) or kidney diseases (bad kidneys) are literally sick. Individuals with mental diseases (bad behaviors), like societies with economic diseases (bad fiscal policies), are metaphorically sick. The classification of (mis)behavior as illness provides an ideological justification for State-sponsored social control as medical treatment.
If we recognize that "mental illness" is a metaphor for disapproved thoughts, feelings, and behaviors, we are compelled to recognize as well that the primary function of Psychiatry is to control thought, mood, and behavior. Hence, like Church and State, Psychiatry and the State ought to be separated by a "wall." At the same time, the State ought not to interfere with mental health practices between consenting adults. The role of psychiatrists and mental health experts with regard to law, the school system, and other organizations ought to be similar to the role of clergymen in those situations.
Because being accused of mental illness is similar to being accused of crime, we ought to presume that psychiatric "defendants" are mentally competent, just as we presume that criminal defendants are legally innocent. Individuals charged with criminal, civil, or interpersonal offenses ought never to be treated as incompetent solely on the basis of the opinion of mental health experts. Incompetence ought to be a judicial determination and the "accused" ought to have access to legal representation and a right to trial by jury.
Involuntary mental hospitalization is imprisonment under the guise of treatment; it is a covert form of social control that subverts the rule of law. No one ought to be deprived of liberty except for a criminal offense, after a trial by jury guided by legal rules of evidence. No one ought to be detained against his will in a building called "hospital," or in any other medical institution, or on the basis of expert opinion. Medicine ought to be clearly distinguished and separated from penology, treatment from punishment, the hospital from the prison. No person ought to be detained involuntarily for a purpose other than punishment or in an institution other than one formally defined as a part of the State's criminal justice system.
Insanity is a legal concept involving the courtroom determination that a person is not capable of forming conscious intent and, therefore, cannot be held responsible for an otherwise criminal act. The opinions of experts about the "mental state" of defendants ought to be inadmissible in court, exactly as the opinions of experts about the "religious state" of defendants are inadmissible. No one ought to be excused of lawbreaking or any other offense on the basis of so-called expert opinion rendered by psychiatric or mental health experts. Excusing a person of responsibility for an otherwise criminal act on the basis of inability to form conscious intent is an act of legal mercy masquerading as an act of medical science. Being merciful or merciless toward lawbreakers is a moral and legal matter, unrelated to the actual or alleged expertise of medical and mental health professionals.
In 1798, Americans were confronted with the task of abolishing slavery, peacefully and without violating the rights of others. They refused to face that daunting task and we are still paying the price of their refusal. In 1998, we Americans are faced with the task of abolishing psychiatric slavery, peacefully and without violating the rights of others. We accept that task and are committed to working for its successful resolution. As Americans before us have eventually replaced involuntary servitude (chattel slavery) with contractual relations between employers and employees, we seek to replace involuntary psychiatry (psychiatric slavery) with contractual relations between care givers and clients.
Note *: Thomas Szasz, author of this manifesto, is Professor of Psychiatry Emeritus at the State
University of New York Health Science Center in Syracuse, New York. His classic The Myth of Mental Illness (Szasz, 1961) made him a renowned international figure. I have included this small manifesto for its importance in the context of a humanism that recognizes, more and more each day, mental illnesses as neurological disorders. Taken from Thomas S. Szasz, M.D. Cybercenter for Liberty and Responsibility, Internet site.