Abstract
<jats:title>Abstract</jats:title> <jats:p>We explore how mental health professionals enact or “do” mental health through their everyday clinical practices in psychotherapy. While “mental illness” is defined in the Diagnostic and Statistical Manual (DSM), mental health professionals have not articulated nor critically examined “mental health” to the same extent. Though the elimination of illness was traditionally seen as the central goal of medicine, several scholars have challenged this view, arguing that patients, healthcare professionals, and governments increasingly equate health with the optimization of well-being. Using an interactionist and grounded theory approach, this paper builds on these theoretical frameworks, examining whether enactments of mental health in psychotherapy have also reoriented toward optimization. We conducted semistructured interviews with clinical psychologists (CPs) and General Practitioner (GP) psychotherapists, looking at practitioners’ (1) goal setting, (2) therapeutic interventions, and (3) clinical assessments. We find that practitioners flexibly enact four models of health, which we label “stabilization,” “restoration,” “management,” and “enhancement.” We argue that practitioners are best thought of as possessing ambivalent attitudes toward health, alternatively endorsing and criticizing each approach depending on the patient and situation at hand. Given that enactments of mental health in psychotherapy are complex, produced through interactions, and context specific—differing across professional sites as well as over time with the same practitioner and the same patient—we propose that “mental health” cannot be adequately captured through a single, universal definition. Instead, mental health should be understood through a pluralistic approach, recognizing the different interactional needs of practitioners and patients that vary across both place and time.</jats:p>