Monthly Archives: May 2017

On defining mental health

Further reflections on defining ‘mental health’

This is written in dialogue with, and in partial response to the WHO Quality Rights training modules, version released in March 2017, in particular module 5 on ‘Realizing recovery and the right to health in mental health and related services.’ I am taking part in a review of these materials.  It is also written with appreciation to Sarah Knutson for our dialogues on mental health and  human rights.

  1. Mental health, like recovery, is individual and subjective. It cannot be judged externally or with reference to any universal criteria.   Various ideas or visions or values of what anyone considers to be mentally healthy can be promoted and cultivated the way that ethical and spiritual values can be promoted and cultivated.   To attempt to universalize such criteria and judge others according to them is to impose hegemony of certain beliefs and values over others, and most importantly to create a hierarchy of those who are in a position to authoritatively proclaim the hegemony of these beliefs and values, and to judge others according to how well they meet the criteria.


  1. For me, mental health is a sense of internal well-being and congruence with one’s own beliefs and values. This is an internal reference, my personal idea of what I would envision, or abstract from what it means to me to see some habit or pattern as mentally healthy or unhealthy.   Nevertheless, it is not for anyone else to take that from me and judge me according to whether they think I am fulfilling this in my own life.


  1. There can be dialogue and interchange about what we consider to be mentally healthy, just as we can exchange views about ethics and spiritual beliefs and values. Such interchange is worthwhile but will never amount to, or should aim to create, an objective universal standard. In other words mental health is an aspirational personal value that can be meaningful in individuals’ lives. When used as a yardstick for one person to measure another, it is the enactment of a power inequality and hierarchy, contrary to the values that underlie CRPD Article 12, in particular what I have referred to as the incommensurability of persons or impossibility for one person to ‘assess the inner-workings of the human mind, and when the person does not pass the assessment, to deny him or her a core human right.’ (CRPD General Comment No. 1 para 15).


  1. In my view, giving any hegemonic weight to such assessment in law or social practice is enough to deny the person the human right to be treated as a member of his or her community of equal worth and dignity as others. I consider that the logical implication of Article 12 is a radical mutuality and respect for worldview as developed by Shery Mead in the framework of Intentional Peer Support.   See Mead’s papers and other materials on, and my papers CRPD and Transformative Equality, Rethinking Criminal Responsibility, Alternative to Functional Capacity, and Norms and Implementation of CRPD Article 12 on, and blog posts ‘Decision-making and moral injury’ on and ‘Guiderails and reparation’ on   These values underlie the work that has been done since the 1970s on peer support as a practice of sharing, exploration and co-creation of knowledge by and for people who have been labeled by others as mentally unhealthy and denied our human rights on that basis.   To embrace the idea that mental health is individual and subjective, an aspirational value akin to spiritual and ethical values, reasserts our ownership of policy as well as legal norms in an area that has deeply affected us and that we have contemplated and studied to remedy the injustices that have been done.


you are not our kind of person
you have wild hair
you don’t shave
you smell
you are too short, too fat, you don’t wear a bra
you wear t-shirts with things on them i don’t understand
you sit with your feet up in meetings
you talk loud
you argue
you shake your fingers in the air and it makes me afraid

you are not our kind
my children will be frightened
their father was like that
i don’t want you to be around us

you are not our kind
you are not our
we bar the door against you
chutz lilit

i nod my head, understand
this has happened before

people don’t want their illogic exposed
their little penis
their little ego
their little world that
is guarded against breaking

they don’t want to know what broken looks like and surviving without denial
without comfort or affirmation
breaking through the water unexpected and triumphant and scaring the bejeezus out of everybody

they want perfection or obedience, especially in a woman
even women want this

i have been the chutz lilt also maybe, i can’t remember
we aren’t separate

your world might scare me


ass trailing reluctant acknowledgement of rejection
turning out of a room
leaving where she’s not wanted

waking up
echoes of my own snares

when is desire fertile
when is it cold blooded eggs seeping from a crevice
making lizards
or pearls
of dew and spiders

when does it make dragons

when is a woman not a woman
when she is not a man

do you find something here?
looking under the pillow
what never was

adam v/chava chutz lilit chutz lilit adam always the power behind the throne
even if a woman makes the incantation

is there no place
for fertile dragon eggs

no place for eyes
that swim up from the bottom

wanting as much as you do
the warmth of fire
making the fire with my own sticks
my own dry skin

on the dry skin of others like me
tinder and flesh
setting the leaves to flame

(c) Tina Minkowitz 2017

(lilit/lilith is part of jewish mythology and ancient sumerian mythology, a demonized goddess. ‘adam v/chava, chutz lilt’ = adam and eve, out lilith. not even going to try and explain that, lot of material out there. in my world lilith is a lesbian and this poem ends her up there, female connection and female autonomy.)