"Mental illness is like any other medical illness": a critical examination of the statement and its impact on patient care and society.

The nature of mental illness has been the subject of passionate discussion throughout history. In ancient Greece Plato,1,2 promoting a mentalist definition of mental illness, was the first to coin the term “mental health,” which was conceived as reason aided by temper and ruling over passion. At around the same time, Hippocrates,3 taking a more physicalist approach, defined different mental conditions as a variety of imbalances between different kinds of “humours.” Griesinger4,5 almost 2 centuries ago was the first to state that “mental illness is brain illness,” an expression that has provided a strong impetus to the more recent medical conception of mental illness. The substantial progress accomplished in genomics and brain imaging in the last few decades made biological psychiatry stronger than ever and contributed to the reification of mental disorders as illnesses of the brain. The almost exclusively biogenetic conceptual framework for understanding mental illness has acquired a hegemony that has influenced mental health practitioners while also influencing campaigns designed to improve public attitudes toward the mentally ill. As a result, the statement “mental illness is like any other illness” has become almost axiomatic and, therefore, by definition it embodies an accepted truth not in need of a proof. This view of mental illness is presented for better acceptance of the mentally ill by the public and of treatment by those experiencing mental illness and is indeed based on accumulated, albeit limited, knowledge in the neurobiology of mental disorders. However, anything that reaches axiomatic proportions needs a serious examination. In this editorial we examine the reasons underlying this perspective, its consequences and the evidence to support or refute its continued justification. We then present a position that we believe best fits the current state of knowledge and is closest to clinical realities and public perceptions of mental illnesses. What does the statement actually imply?