A lot of water has gone under the bridge since Szasz wrote this book. But it has stood the test of time in that the 'illness' of mental illness still remains a metaphor to biological illness. Szasz thought it was an unnecessary stigma that clouded the issue. For then (and now) there was no evidence of any underlying brain disease.

A very divisive subject, but despite a massive pseudo-science of so-called mental illness, there remains little evidence today. Many studies have shown brain changes correlated with schizophrenia, or what not, but never show a causal connection. Of course if you lose control over reality, this will be expressed in the brain, but the question why remains.

The evidence from pills has been pointed to as well. If a drug helps it means it's biological. Not true. Studies have shown comparable effects of cognitive therapy on the brain as with antidepressants.

Quote from Szasz: “Although both home and mental illness are complex, modern ideas, we have fallen into the habit of using phrases such as "housing the homeless" and "treating the mentally ill" as if we knew what counts as housing a homeless person or what it means to treat mental illness. But we do not. We have deceived ourselves that having a home and being mentally healthy are our natural conditions, and that we become homeless or mentally ill as a result of "losing" our homes or our minds. The opposite is the case. We are born without a home and without reason, and have to exert ourselves and are fortunate if we succeed in building a secure home and a sound mind.”