The educational challenge of mental health

This paper poses a series of fundamental educational challenges about menta l health. First, it questions whether 'mental health' is a valid concept, i n the light of debates over mind/body dualism. If the concept is valid, sho uld the absence of mental health be seen as an illness, an adaptive strateg y or simply a statistical eccentricity? Fulford's concept of 'failure of in tentional action' is commended as a philosophical basis for unravelling the se issues. Secondly, the paper considers whether diagnosis is a simple or c omplex process, and whether it can be an objective activity or one which in volves a strong subjective element. The current and potential value of mult iaxial classification systems are discussed. Thirdly, themes concerning men tal health treatment are introduced, covering problems with consent and pat ient preference, the evidential basis of interventions, and the range and l imitations of possible treatments. Finally, the paper reviews the education al processes needed to meet these challenges effectively. It recommends the develop- ment of multifaceted educational programmes, nurturing a spirit o f critical enquiry and personal awareness and, above all, the recognition a nd toleration of the uncertainty and complexity which lie at the heart of s uccessful medical practice.