The phrase “manufactured mental illness” is not a standard psychiatric diagnosis or a formal clinical term.
It is better understood as a question:
Can social pressures, institutional practices, inaccurate assumptions, coercion, or misuse of psychiatric authority cause a person to be labeled as mentally ill when the evidence does not justify that conclusion?
History shows that, in some circumstances, the answer has been yes.
There are documented examples of psychiatric diagnoses being used to stigmatize groups, justify discrimination, suppress dissent, or facilitate coercion.
There are also well-established examples of institutional practices themselves causing harm, including trauma associated with coercive treatment, prolonged institutionalization, isolation, restraint, and loss of autonomy.
At the same time, none of this means that mental illnesses are imaginary or that psychiatry as a whole is fraudulent.
Mental disorders are real health conditions, and psychological and psychiatric treatment can help many people.
The serious issue is more specific:
A medical diagnosis is an exercise of power as well as an exercise of clinical judgment.
That power has to be used carefully, transparently, and with respect for evidence and human rights.
“Manufactured” Is Not the Same as “Imaginary”
This distinction is essential.
When people hear the expression “manufactured mental illness,” they may interpret it as meaning that mental illness does not exist.
That is not what the historical evidence demonstrates.
Depression, schizophrenia, bipolar disorder, post-traumatic stress disorder, obsessive-compulsive disorder and many other conditions involve real patterns of psychological, behavioral and functional disturbance.
But diagnosis is not identical to the underlying phenomenon.
A diagnosis is a clinical classification used to describe a person’s symptoms and functioning.
It is therefore possible for: a real illness to be diagnosed accurately; a real illness to be diagnosed inaccurately; a non-illness to be incorrectly classified as illness; or a legitimate clinical concept to be defined too broadly or too narrowly.
That is one reason the scientific validity of psychiatric diagnoses matters.
The American Psychiatric Association itself has discussed the distinction between reliability and validity in psychiatric diagnosis: clinicians can agree on how to apply a category without necessarily proving that the category accurately represents a distinct illness.
Diagnoses Can Change Because Science Changes
The history of psychiatry contains many examples of changing categories.
Some diagnoses have been removed.
Others have been revised.
Some have been divided into different conditions.
Others have had their criteria substantially altered.
This does not demonstrate that psychiatry is useless.
It demonstrates that psychiatric classification is a developing scientific discipline.
The same is true in other areas of medicine.
Medicine once attributed many illnesses to theories later abandoned.
Treatments once considered standard later became unacceptable.
Scientific knowledge changes because evidence changes.
The appropriate response is not to reject medicine.
It is to demand that medicine remain capable of correcting itself.
The Most Extreme Example: Political Abuse of Psychiatry
The clearest documented example of intentionally or politically manipulated psychiatric diagnosis occurred in the Soviet Union.
For decades, Soviet psychiatric institutions were used to imprison political dissidents.
Researchers and historians have documented cases in which people were diagnosed with mental disorders because of their political beliefs, religious convictions, or opposition to the government. (ncbi.nlm.nih.gov)
One particularly notorious concept was “sluggish schizophrenia.”
The diagnosis was broad enough to be applied to people who could otherwise appear socially functional.
Behaviors such as persistent political activism, demands for reform, or what Soviet psychiatrists interpreted as pathological “struggle for the truth” could be incorporated into a psychiatric framework. (ncbi.nlm.nih.gov)
This was not simply a theoretical problem.
People were hospitalized.
They could be involuntarily treated.
They could lose their freedom.
And the psychiatric label could itself become justification for continued confinement.
Academic reviews conclude that political abuse of psychiatry was systematic in the Soviet Union and involved thousands of dissidents. (pubmed.ncbi.nlm.nih.gov)
Why This Was So Powerful
A political accusation can be challenged as a political accusation.
A psychiatric diagnosis creates a different kind of authority.
Instead of saying:
“You disagree with the government.”
the institution can effectively say:
“Your disagreement is evidence that something is wrong with you.”
That changes the argument completely.
The dissident is no longer treated as somebody expressing a political position.
They become a patient.
The political disagreement becomes a symptom.
Opposition becomes pathology.
That is an extraordinarily powerful mechanism of social control because it medicalizes dissent.
The Psychiatric Institution as an Instrument of Power
Psychiatric institutions historically possessed powers that ordinary social institutions did not.
They could: restrict movement; isolate individuals; administer medication; impose institutional routines; control communication; and, under certain legal systems, facilitate involuntary detention.
The WHO and OHCHR now explicitly recognize that mental-health systems can create serious human-rights risks and have called for reforms that place autonomy, informed consent, dignity, and community-based care at the center of mental-health law and practice. (who.int)
The historical record of institutional abuse is therefore not controversial.
Coercion Can Cause Harm Even Without Political Abuse
Psychiatric abuse does not have to be politically motivated to cause harm.
The WHO identifies involuntary detention, forced treatment, seclusion and restraints as coercive practices that can violate rights and negatively affect physical and mental health. (who.int)
This is important because it expands the discussion.
A system does not need to be deliberately “manufacturing” illness to produce harmful outcomes.
A person may enter treatment already distressed and leave feeling: humiliated; powerless; traumatized; distrustful; stigmatized; or alienated from the people who were supposed to help them.
That does not prove malicious intent.
It does demonstrate why the method of care matters.
Institutionalization Has a History
For much of modern history, long-term psychiatric hospitals were a dominant model of mental-health care.
Some institutions provided useful care.
Others became environments of neglect, isolation and abuse.
The WHO notes that human-rights violations and poor treatment have been extensively documented in long-stay psychiatric institutions and supports the movement toward community-based mental-health services. (who.int)
This historical transition is important.
A modern rights-based approach increasingly asks:
Can people receive treatment while remaining part of their communities?
Can support be provided without unnecessary confinement?
Can coercion be reduced?
Can patients participate in their own treatment decisions?
Can services focus on recovery rather than permanent institutionalization?
These are not anti-psychiatry questions.
They are questions of better psychiatry and better human-rights practice.
The Power of Labels
A psychiatric diagnosis is not simply a word.
It can affect how other people interpret everything a person subsequently says or does.
Once somebody has been diagnosed, future behavior may be interpreted through the diagnosis.
A complaint can become evidence of “paranoia.”
A disagreement can become evidence of “poor insight.”
A refusal of treatment can become evidence that treatment is necessary.
A strong emotional response can be interpreted as a symptom.
Sometimes these interpretations may be clinically appropriate.
But sometimes they can create a self-reinforcing loop.
The diagnosis influences how behavior is interpreted.
The interpretation appears to confirm the diagnosis.
The diagnosis then influences future decisions.
This is one reason transparent assessment and independent review are so important.
The Problem of Circular Reasoning
Consider a hypothetical example.
A patient says:
“I disagree with this diagnosis.”
A clinician responds:
“Your insistence that the diagnosis is wrong demonstrates poor insight.”
The patient says:
“I disagree with that too.”
The disagreement is then interpreted as further evidence of poor insight.
That creates a potentially circular structure.
Of course, a real clinical assessment is much more complicated than this example.
But the example demonstrates why diagnostic reasoning needs to be based on specific symptoms, functional impairment, clinical history and evidence, rather than simply treating disagreement with the clinician as proof of pathology.
Cultural Context Matters
Human behavior cannot be understood independently of culture.
What is considered abnormal in one society may be ordinary in another.
The WHO’s human-rights guidance emphasizes person-centred care and recognition of social and structural determinants of mental health rather than reducing every difficulty to an isolated medical problem. (who.int)
A good mental-health assessment therefore has to consider: culture; language; family circumstances; trauma; social environment; economic conditions; religion and values; physical health; medications and substances; and the person’s own understanding of their situation.
Ignoring context can lead to inaccurate conclusions.
Social Problems Are Not Automatically Mental Illness
This is another important distinction.
Poverty is not a psychiatric diagnosis.
Unemployment is not a psychiatric diagnosis.
Political disagreement is not a psychiatric diagnosis.
Relationship conflict is not a psychiatric diagnosis.
Being angry about unfair treatment is not automatically a psychiatric diagnosis.
Grief is not automatically a psychiatric disorder.
Fear during a genuinely dangerous situation is not automatically evidence of pathology.
Of course, each of these experiences can contribute to mental illness in some circumstances.
But the existence of distress does not automatically tell us its cause.
A clinician has to ask whether the person’s experiences meet appropriate clinical criteria and whether alternative explanations have been considered.
The Difference Between Iatrogenic Harm and Manufactured Illness
There is another useful concept here: iatrogenic harm.
Iatrogenic means harm caused by medical intervention itself.
This can happen without malicious intent.
A medication can have side effects.
A treatment can cause complications.
A hospital experience can be traumatic.
A diagnosis can carry stigma.
A coercive intervention can worsen someone’s psychological state.
These are genuine medical risks.
But they should not automatically be described as evidence that someone deliberately manufactured a disease.
That distinction is extremely important.
Unintended harm is not the same thing as intentional fabrication.
Misdiagnosis Is Real
Psychiatric diagnosis is based substantially on clinical assessment rather than a single laboratory test that confirms every disorder.
That makes clinical skill, history-taking, differential diagnosis and context particularly important.
A person can be misdiagnosed.
A diagnosis can be incomplete.
Two clinicians can disagree.
A diagnosis can change over time as more information becomes available.
None of these facts makes psychiatric medicine inherently fraudulent.
It means that psychiatric diagnosis, like many areas of medicine, contains uncertainty.
Good clinical systems should therefore include ways to revisit diagnoses.
Second Opinions Matter
One of the simplest safeguards is independent review.
If a diagnosis is having major consequences, asking another qualified clinician to assess the situation can be reasonable.
That is especially important when the diagnosis: is disputed; was made during an emergency; was based on limited information; has major legal consequences; or is being used to justify coercive treatment.
A second opinion is not automatically proof that the first clinician was wrong.
It is another opportunity for evidence to be examined.
Records Matter
Medical records can be crucial when a diagnosis is disputed.
A patient has an interest in understanding: what diagnosis was given; what symptoms were recorded; what evidence was considered; what treatment was recommended; what alternatives were considered; and why particular interventions were chosen.
Transparency helps protect both sides.
It protects patients from arbitrary decisions.
It also protects clinicians by creating a record showing how decisions were reached.
Consent and Autonomy
The WHO and OHCHR’s joint guidance emphasizes autonomy and informed consent as central principles of mental-health law and care. (who.int)
This represents a major shift from older institutional models.
The patient is not merely an object of treatment.
The patient is a person with rights.
Where decision-making capacity exists, people should be involved meaningfully in decisions about their healthcare.
Where coercive intervention is legally permitted because of serious risks, it should still be subject to safeguards, proportionality and review.
The Modern Direction of Mental Health Care
The international direction of reform is increasingly toward: community-based care; person-centred treatment; recovery-oriented approaches; informed consent; reduction of coercion; anti-discrimination; and participation of people with lived experience.
WHO’s 2025 policy reform guidance argues that many mental-health systems remain overly dependent on biomedical and institutional models and calls for stronger accountability, community services, person-centred assessment, and action on social and structural determinants. (who.int)
This is significant.
The international mental-health debate is no longer simply about building more psychiatric hospitals.
It is increasingly about how to provide support while protecting autonomy and dignity.
Croatia Is Part of This Debate
This is relevant in Croatia as well.
A 2024 report presented in the European Journal of Public Health described Croatia’s mental-health system as still substantially hospital-based and identified involuntary hospitalization, coercive measures, and deprivation of legal capacity as areas requiring attention. The authors highlighted the importance of mental-health literacy and knowledge of the rights of people with mental disorders and noted the use of WHO QualityRights training in Croatian counties. (academic.oup.com)
That provides a constructive way to discuss the subject.
The question isn’t whether psychiatry should exist.
It is how mental-health services can become more rights-respecting, transparent and patient-centered.
What About Political Activism Today?
History teaches us to be alert to the possibility of psychiatric systems being abused politically.
The Soviet case demonstrates that this can happen.
But history does not justify automatically assuming that a current diagnosis is politically motivated.
A person can be an activist and genuinely have a mental-health condition.
A person can be an activist and be misdiagnosed.
A person can be an activist with no mental disorder at all.
The only responsible way to distinguish those possibilities is through evidence and independent clinical assessment.
That is a much stronger principle than assuming either that psychiatry is always correct or that every psychiatric diagnosis is an instrument of repression.
What Should Raise Legitimate Concern?
There are circumstances where scrutiny is reasonable.
For example:
A diagnosis appears unsupported by documented symptoms.
Clinical records contradict the diagnosis.
A diagnosis changes immediately after a political or interpersonal dispute without an evident clinical basis.
The person is denied meaningful access to their records.
Independent clinicians strongly disagree.
Coercive treatment is used without adequate legal safeguards.
The individual is prevented from obtaining an independent assessment.
A diagnosis is repeatedly used to dismiss every complaint without addressing the underlying facts.
None of these automatically proves malicious intent.
They are reasons to request clarification, documentation, review, and where appropriate, independent oversight.
What Should Not Be Assumed
A person having a psychiatric diagnosis does not mean their testimony is automatically false.
A person disagreeing with a diagnosis does not mean they are automatically correct.
A psychiatric medication does not prove that somebody is being controlled for political reasons.
A hospitalization does not prove abuse.
A clinician making a mistake does not prove conspiracy.
And psychiatric terminology should not be used as a weapon against people we dislike.
The Opposite Danger: Rejecting Genuine Mental Illness
There is another side to this discussion that should never be forgotten.
People genuinely experience severe psychiatric disorders.
They can suffer terribly.
Some conditions can affect perception, mood, thinking, memory, behavior, relationships and the ability to function.
People experiencing these conditions deserve treatment without stigma.
A critique of psychiatric abuse should never become a denial of mental illness.
That would replace one harmful simplification with another.
Psychiatry Needs Criticism to Improve
Every medical profession benefits from scrutiny.
Psychiatry should be no different.
Criticism can expose: bad practices; outdated assumptions; coercion; conflicts of interest; poor-quality treatment; diagnostic errors; discrimination; and institutional failures.
The historical removal of homosexuality from psychiatric diagnosis is a good example of how criticism, activism, scientific research and professional reassessment can produce major change. (psychiatry.org)
The lesson is not:
“Psychiatry cannot be trusted.”
It is:
“Psychiatric medicine must remain accountable to evidence, ethics and human rights.”
The Meaning of “Manufactured”
So what can the phrase manufactured mental illness reasonably mean?
At its most defensible, it can refer to several different phenomena that should be kept separate:
Pathologizing normal human variation.
Historical psychiatric classifications sometimes treated socially disfavored characteristics as disorders.
Misdiagnosis.
A person can be incorrectly classified because of incomplete information, bias, or clinical error.
Iatrogenic harm.
Medical interventions themselves can cause psychological or physical harm.
Institutional effects.
Long-term institutionalization and coercive practices can worsen a person’s situation.
Political abuse.
History provides documented examples of psychiatric diagnosis and confinement being deliberately used for repression.
Diagnostic expansion or boundary disputes.
A society can legitimately debate where normal distress ends and mental disorder begins.
These are real subjects of study.
They do not require the claim that every psychiatric diagnosis is manufactured.
A Better Goal Than “Anti-Psychiatry”
The most constructive position is neither blind trust nor blanket rejection.
It is critical psychiatry with evidence and human rights at the center.
That means:
Take mental illness seriously.
Take patients seriously.
Take scientific evidence seriously.
Take clinicians seriously.
Take mistakes seriously.
Take coercion seriously.
Take historical abuses seriously.
And take the possibility of institutional bias seriously.
No system deserves immunity from examination.
Conclusion
Mental illness is real.
But the history of psychiatry also demonstrates that psychiatric categories can be wrong, diagnoses can be misapplied, institutions can cause harm, and psychiatric authority can be abused.
The Soviet Union provides a serious historical example, where psychiatric diagnosis and hospitalization were systematically used against political dissidents. (ncbi.nlm.nih.gov)
And today, international health and human-rights institutions continue to document problems involving coercion, institutionalization, stigma, discrimination and failures to respect autonomy. (who.int)
The appropriate conclusion is not that psychiatry is inherently fraudulent.
It is that medical power must remain accountable.
A diagnosis should be based on evidence.
A patient should be treated with dignity.
A disputed diagnosis should be open to review.
Coercion should be minimized and legally safeguarded.
Political disagreement should not be confused with mental illness.
And people should never lose their fundamental rights simply because a medical label has been placed on them.
The most important safeguard is ultimately the same one that protects every other area of medicine: evidence, transparency, independent review, professional ethics and respect for the person behind the diagnosis.
That is how mental-health care becomes not weaker, but more trustworthy.
