This article brings together considerations from philosophical work on standpoint epistemology, feminist philosophy of science, and epistemic injustice to examine a particular problem facing contemporary psychiatry: the conflict between the conceptual resources of psychiatric medicine and alternative conceptualizations like those of the neurodiversity movement and psychiatric abolitionism. I argue that resistance to fully considering such alternative conceptualizations in processes such as the revision of the Diagnostic and Statistical Manual of Mental Disorders emerges in part from a particular form of epistemic injustice (hermeneutical ignorance) leveled against a particular social group (which I call the "psychopathologized"). Further, insofar as the objectivity which psychiatry should aspire to is a kind of "social objectivity" which requires incorporation of various normative perspectives, this particular form of epistemic injustice threatens to undermine its scientific objectivity. Although many questions regarding implementation remain, this implies that psychiatry must grapple substantively with radical reconceptualizations of its domain if it is to achieve legitimate scientific objectivity.

This paper draws on Kukla’s “Institutional Definition of Health” to provide a definition of “psychiatric condition” that delineates the proper bounds of psychiatry. I argue that this definition must include requirements that psychiatrization of a condition benefit the well-being of 1) the society as a collective, and 2) the individual whose condition is in question. I then suggest that psychiatry understand individual well-being in terms of the subjective values of individuals. Finally, I propose that psychiatry’s understanding of collective well-being should be the result of a “socially objective” process, and give certain desiderata for this understanding.

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