A Welfarist Account of Mental Disorder

Abstract

My project explains the current literature and questions surrounding accounts of mental disorder. I argue that naturalist (value-free) accounts of mental disorder are untenable and propose a normative account in which the relevant value judgments are clearly defined. My account of mental disorder relies on a value fulfillment account of well-being based on the following observations: (1) An individual’s life will go well or poorly for them based on the fulfillment of certain appropriate values, and (2) mental disorders are clusters of symptoms that significantly lower welfare, as they severely limit or interfere with an individual’s ability to pursue and fulfill their values. After fleshing out this account, I discuss the practical implications of such an account on both diagnosis and treatment. Key to the diagnosis of disorder is establishing a boundary between disorder and non-disorder, which is the threshold problem in psychiatry. I propose significance requirements which link mental symptoms to substantial reductions in welfare on a value fulfillment theory. Then I discuss the application of this account to treatment for mental disorders, considering and responding to concerns about an evaluative conception of disorder in this context.