Abstract

What is it to be mentally healthy? In the ongoing movement to promote mental health at work and in schools, to reduce stigma and to establish parity between mental and physical health, there is a clear enthusiasm about the central concept and a recognition of it as a central value in human life.

However, it is much less clear what mental health means in all these efforts and whether there even is a single concept underlying them. Sometimes the initiatives for the sake of mental health are aimed just at reducing mental illness, thus implicitly identifying mental health with the absence of diagnosable psychiatric disease. More ambitiously, there are also prominent initiatives in public health and policy that adopt positive definitions identifying mental health with psychic or even overall well-being. But those looking for an explicit agreed upon definition will be disappointed.

To make progress we first identify a definition of mental health that is clearly too thin and undemanding – mental health as absence of mental illness – and a definition that is too ambitious and too demanding – mental health as the state of general well-being across all aspects of social and personal life.

There are compelling reasons to reject both: the first one ties mental health too closely to the controversial concepts and methods of psychiatry, while the second one threatens to set up an impossible ideal, to medicalise unhappiness, and to make controversial philosophical judgments about the good life look falsely scientific. We then sketch out a middle position. On this view mental health is a primary good, that is the psychological preconditions of pursuing any conception of the good life, including well-being.