Brad Delp's Suicide and the Reality of Mental Illness:

This is sad. Brad Delp seemed like he was in really good shape for a guy in his mid-50s, so I wondered how he died. Like Richard Jeni, it was suicide.

These two recent suicides bring to mind something that disturbs me about the thesis which some libertarians accept, most notably put forth by Thomas Szasz, that mental illness doesn't exist. Though, I note he's done some great work in the profession and I'm with him to some extent. I just can't accept the entirety of his argument. If I understand the argument, if the brain is not "sick" with a virus or cancer or something along those lines -- in other words, if a physiological test reveals a "healthy" brain like a healthy heart and set of lungs, there is no mental illness. And all categorizations have been somewhat arbitrary exercises of power (which thesis was pushed hard by the likes of Foucault).

Perhaps my problem with Szasz is just semantics. Things like schizophrenia and severe depression which causes otherwise healthy people to take their own lives are real things, real problems, regardless of whether we call them "illnesses" or not. If we accept that they are real problems which ought to be recognized as such and treated to the best of our ability, that's all I care about. Often that treatment involves drugs like antidepressants. And Szasz has done Yeoman's work as an advocate for drug legalization. So I don't think he'd have a problem with a shrink recommending a certain amount of an antidepressant. Indeed he'd probably liberalize the requirement for a prescription and allow anyone to avail themselves of these drugs as well as illegal drugs.

Where Foucault, Szasz et al. have a kernel of truth (what I accept in their argument) is that the mental health industry has and continues to try to unjustifiably medicalize social norms or conventional morality. Just as things like masturbation and homosexuality were "illnesses" of the past, things like racism and homophobia, according to some practitioners, are present day "mental illnesses." Indeed, in the Soviet Union, those who questioned the party line could be institutionalized for mental illness.

My solution which both recognizes mental illness but tries to act as a check against the use of such categorization to enforce social norms is to decouple the notion of mental illnesses and social norms. Having a mental illness, even if it doesn't involve physiological sickness like being infected with a virus, ought to be understood as analogous to physical sickness. Finding out someone is mentally ill ought to be like finding out they have high cholesterol or diabetes. Such says nothing about a person's character or social norms.

If anything, because of the unchosen element of mental illnesses and given that they are presumptively covered under disabilities related civil rights laws, if a particular condition qualifies as a real mental illness, such ought to weigh in favor, not of its social stigma, but its socially neutral status.

Of course certain behaviors -- stealing, killing, hurting other people, and perhaps hurting oneself -- are almost always wrong no matter what the cause. But, if they do in fact result from a mental illness, such behaviors are wrong, not because of but in spite of that fact. And, in criminal law and in social morality, behavior which results from mental illness often acts a "mitigating" factor. Someone who chooses to do a bad act with a clear mind and a cold heart is more immoral and criminally culpable than someone who had an impulse, couldn't "help" himself and then felt terribly guilty about it afterwards. And if the resultant behavior is not harmful or immoral -- like for instance jumping over the cracks of a sidewalk (as people with OCD do), or yelping in class (as someone with tourettes syndrome does -- though I can understand how this might distract professors!) then there is nothing socially or morally wrong with either the condition or the behavior of the person and discriminating against or thinking less of a person because of their harmless eccentricities which might result from an underlying neurosis is morally wrong and ought to be frowned upon. (And while professors have no duty to accommodate a yelper without tourettes, if a student yelps because she has tourettes, otherwise inexcusable behavior must be accommodated to the extent that it is "reasonable" to do so).

As I noted before, Madison, Jefferson and Lincoln all likely suffered from moderate to serious mental illnesses of the depression and anxiety variety. Finding this out about them should be like discovering that some founding father had male pattern baldness under his whig. Contrast that with finding out that Lincoln might have been homosexual. Whatever we think of the morality of homosexuality, such ought to have nothing to do with whether homosexuality is a mental illness which would presumptively make that condition more like having high cholesterol, or an even closer analogy -- tourettes -- and demand its inclusion in various disabilities related civil rights legislation and "reasonable accommodations" for the underyling conduct which results from the illness.