{
  "abstract": "In his 1987 book ‘Insanity: the idea and its consequences’, Thomas Szasz analyses in Part 4 the practical advantages of receiving a psychiatric diagnosis. In particular, he lists four uses of the concept of ‘mental illness’. It serves - he says - at the same time and/or in different occasions 1) as a strategy, 2) as a justification, 3) as a legal fiction, 4) as explanation. Re-reading those words today, in the time of the ‘epidemics’ of fibromyalgia, Adult-ADHD, subthreshold BD, BPD, ASD, is both illuminating and relieving for psychiatrists that do not agree with the trends of contemporary ‘mental health’ narrative. It interrogates us today by deeply scrutinizing the logical and ethical grounds of the concepts of diagnosis vs. illness, excuse vs. responsibility, freedom of will vs. psychic determinism. The problem - and the reason why Szasz’s arguments are often dismissed today as ‘of simply historical interest’ or ‘antipsychiatry’- is that the logical conclusion of those words are the complete disappearance of some so far fortunate fields of psychiatric practice, i.e. most parts of forensic psychiatry, suicide prevention, civil committment practices, substance prescription, work-related benefits and pensions for psychiatric diagnoses. A good clinical psychiatry is not attacked by Szasz’s libertarian approach, hence his refusal of the ‘antipsychiatry’ label. Only, according to Szasz, psychiatrists should be considered by institutions and should consider themselves as mere agents of their private clients. They should reject any disclosures or interventions onto the ‘external’ world. This would not only prevent overdiagnosis, it would make psychiatric diagnoses largely unnecessary and, in the long term, definitely unpopular.Objectives Learning objectives will be answering the following questions:Can Szasz’s views about the four uses of ‘mental illness’ modify our daily practice?Can such an approach limit the use of psychiatric diagnoses?Who are the institutions that should be involved in such a radical change of perspective?Is there room today on the media for pointing out the logico-ethical fallacies in the concept of psychiatric disorders as medical issues?Method A synthesis of Szasz’s Part 4 of his book ‘Insanity: the Idea and its consequences’ (with reading of text excerpts) will be presented. Interactive discussion on the four topics will be stimulated: mental illness as 1) strategy, as 2) justification, as 3) legal fiction, as 4) explanation.",
  "authors": [
    {
      "affiliations": [
        "Critical Psychiatry Network, Verona, Italy",
        "Court of Law, Verona, Italy"
      ],
      "name": "Giovanni Perini"
    }
  ],
  "title": "005 The four practical uses of psychiatric diagnoses in Thomas Szasz’s analysis",
  "uid": "2bc96225-09f8-54aa-be94-25a298f55496"
}