One possible interpretation of the social aetiology of mental illness is the expression of a socially constitutive view of illness. That is, facts about illness or illness status are constituted by social factors in the way that professional roles, capital city status or, initially less obviously, country borders are.
But discussion suggested a possible connection between this version of a constitutive or constructionist view and a more general constructionist view of truth itself. Let us call the opposite of that ‘realism’. The question it prompts is what, if any, is the relation?
One reason to suspect that the connection is not so close is this. One might take a realist view of socially constructed statuses. Evidence can be given in courts as to marital status or bank balance just as to matters of natural fact. There is no reason to think that the truth of such claims is not as well behaved as the realist will claim even if the facts reported have complex social underpinnings.
Equally constructionist views of truth are applied to natural facts as much as social facts. That is what makes radical aspects of the social study of natural science so radical: physics reduces to sociology rather than, as is more commonly thought, the other ways round.
Constructionist views of truth also face the question of what is used as the basic materials for the construction. From what are truths constructed? The problem is that these will have to be intelligible independently of the world view they are used to construct. That is non-too easy.
Bruno Latour’s thoughts on this are worth notice.
And the basic motivation for not being a fan of truth are also an issue.
In all cases of constructionism, the question of what the basic materials are from which the constructed things are constructed is pressing. If mental illness diagnoses are constructed is there anything mental or psychiatric in the constructing facts? One possibility is that symptoms are real and diagnoses are misleadingly constructed from these. In the case of transcultural psychiatry, it is an interesting question whether symptoms might really be basic and real. An alternative is something deeper and more theoretical such as a ‘failure of biological function’.