An inability-based account of psychiatric harm

Analytical and conceptual engineering approaches converge in showing that harm should be a necessary component of the general concept of mental disorder, particularly within the Diagnostic and Statistical Manual of Mental Disorders (DSM). Nevertheless, the notion of harm in this and similar manuals remains vague and insufficiently defined. Using conceptual engineering, which refines or constructs concepts to better serve theoretical and practical aims, I develop an explication of psychiatric harm. Psychiatric harm arises when psychological inabilities obstruct the formation or pursuit of admissible conceptions of the good life. I reject definitions grounded in uncritical social consensus, rationalist exclusions, or essentialist ideals of human flourishing, and instead propose standards rooted in normative pluralism and democratic values that respect individual diversity. Finally, I indicate that this framework could be operationalised through methodologies exemplified by the World Health Organization's International Classification of Functioning, Disability and Health (ICF).