Between Natural Kinds and Non-Kinds: A Review of Current Psychiatric Stakeholders’ Views on Mental Illness and Treatment

Historical and current mental health practice show a variety of illness concept being utilized by users, professionals and other people involved (e.g., carers). For several decades, a dominant concept such as psychoanalysis, social psychiatry or biomedicine has shaped the view on mental health and illness. While biomedicine currently remains a strong perspective predominantly in academia, a diversity of new illness concepts have evolved.

This contribution seeks to identify current theoretical and practical perspectives that inform today’s discussions. The concepts that are being reviewed range from ‘Natural kinds – biomedicine’ over ‘Harmful dysfunction’, ‘Practical kinds – biopsychosocial psychiatry’, ‘Recovery’, ‘Neurodiversity’ to ‘Non kinds – denial of illness existence’. For each perspective, the leading stakeholder groups will be identified. By identifying relevant stakeholders, it will become clearer that the current diversity of illness concepts is one of the main causes of conflicts that we can see within the mental health care system. While these conflicts traditionally have happened mainly between users and professionals, today we see further splits of perspectives within mental health professionals or within the user community.

Finally, this contribution will explore the consequences of this ‘postmodern’ state of illness concepts. A strong unified and universally acknowledged mental illness concept seems to be out of reach. On the contrary, we can expect the treatment institutions to be confronted with an increasing diversity of views, enriched, for example, by non-western cultural attitudes on mental health and illness.