> What is controversial, however, is how much we should lament the fact that more people don't ask for help (take drugs seek therapy) when we have decided that they have a mental illness.

The 'we' in this context is referring to professionals. The professionals who are willing to state such things as 'one in four people are suffering from mental illness' and 'mental illness is high in immigrant populations' and such things as 'they often seek help from spiritual leaders instead of realising that their problem is medical and seeking professional psychological / psychiatric interventions'. They are also willing to lament the current situation in third world countries where many people who they regard to be suffering from mental illness have no access (or desire to access) pscyhiatric help. Even when those people are regarded as 'different' or 'positively revered' in their home town. The idea is that mental illness is far more prevalent than people have supposed and that it is a tragic state of play indeed that more people aren't asking for psychiatric / psychological help for their condition - and where those people are instead turning to spiritual leaders and / or their family for supports.

Perhaps you aren't aware that people are doing this... They are, however. I have participated in a few threads over at the 'Student Doctor Network' where people training to be psychiatrists (and the psychiatrists over there) consider that a person who hears voices has a psychiatric condition (and should be medicated) and that it is a sad state when they aren't receiving psychiatric medication for (what they regard to be) a mental / medical disorder EVEN when the person, the persons family, and the persons society doesn't consider it problematic at all that that person reports hearing voices.

'We' decide that one in four people have experienced what we regard to be 'mental illness' because 'we' are determined that mental illness will be an 'epidemic' (a leading health issue) in the next few years. This is supposed to (somehow, in a way that is obscure to me) result in it being more likely that the american government will aprove parity between treatment for physical conditions (e.g., obesity - which of course looks rather ridiculous compared with cancer and AIDS) and mental health conditions (notably - at this point - depression (which again looks rather ridiculous compared with cancer and AIDS).

> We don't pass laws that people have to get better in any particular way (therapy or meds) either, anymore than we pass laws insisting that people have to buy health insurance.

We pass laws that say that people can be detained in an institution against their will under the 'mental health act'. Similarly, a person can be treated against their will (with medication most typically, though also with therapy, I guess) under the mental health act.

> People DO have a negative emotional response to rape! It is the suppression of that negative emotion that is non-optimal

Not according to the DSM definition of 'optimal' psychological, social, and occupational functioning (looking at the difference between the top and second top category here). Looks to me... That the 'optimal' category is based on a rather outdated theory that it is better to not have emotional responses at all. No appreciation of the importance of emotions and emotional expression seems to be noted...

> if you are out on a date and get date-raped, the "environment" doesn't have anything to do about it.

The issue is whether a negative response to rape constitutes a problem with the individual who has been raped (they have an internal malfunction that is responsible for their negative response therefore they have a mental disorder) or whether a negative response to rape constitutes an understandable response to an environmental event (so they aren't considered to have a mental disorder because their negative response doesn't imply that they have an inner dysfunction - it doesn't imply that something is wrong within them).

Because... That is meant to be the distinction between 'mental disorder' and 'problems in living'.

Wakefield gives us the following example: Two people meet criteria for 'reading disorder' in precisely the same way. We then learn that the first individual wasn't ever taught how to read. We then consider his inability to read to be a limitation of his environment. Hence, his inability to read doesn't mean that there is a dysfunction within him. Hence, he doesn't have a mental disorder. The second individual was given as much instruction as most people get but he still never managed to learn. We then consider his inability to read to be due to a limitation / deficiency within him. Hence, his inability to read does mean that there is a dysfunction within him. Hence, he does have a mental disorder.

My thought was... Does rape or childhood neglect that results in someone meeting criteria for something or other... Constitute an environmental limitation (like never having been taught how to read) or does it constitute a malfunction within the individual (hence a mental disorder)

?

The problem is... That 'we' (drug companies, psychiatrists, psychologists) attempt to say that people 'should' seek psychiatric / psychological help WHETHER THEY THINK THEY NEED IT OR NOT. And my issue is: What gives them that authority?

The public are subjected to advertising which (conveniently enough) makes us DESIRE that kind of intervention. For the places where people haven't been affected by advertising people are reluctant to seek psychiatric / psychological help, however. We think that OBJECTIVELY they have a psychiatric / psychological condition and they SHOULD be receiving help (we will slap a treatment order on them if necessary and jolly well make them).

So...

What gives them that authority?

And... Should we rethink our views with respect to seeking that kind of help?????

Perhaps...