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I am not entirely ready to completely divorce the medical model of health/illness from mental health. I don't think we can accept that the brain is something special and should not be treated in the same way the body is treated. If my arm is broken a doctor fixes it, if my stomach cells can't create a certain enzyme that is need for digestion then a doctor gives me a pill to supplement the enzyme, if my brain is missing an enzyme that keeps me from remembering what happened 5 minutes ago then my doctor should give me a pill too. If something is broken, it should be recognized as such. This does not mean that everything needs to be fixed just because we know that it is broken. Health is just one of many goods in human life that must be ordered and subordinated to one another. 

 If I had a mutation that gave me an extra arm, I would have to acknowledge that the mutation is abnormal. But I would not need to say it is necessarily a bad thing that needed to be fixed. The arm might enable me to do a lot of new and useful things, but it would also result in my alienation from much of society because having 3 arms is abnormal. I think this is the line of reasoning that is being used to suggest that we should not think of mental illness as an illness at all.

 I agree with that assessment on some level. But, there comes a time when these "differences" will effect wether or not someone can live a distinctively human life and I think this is the case more often than not with mental differences. If, through some difference in brain composition and function, a person looses the potency to: engage in community, to acknowledge and try to improve their own understanding of reality, or any other activity that is distinctly human then I think there is reason for saying that person is broken. Having three arms doesn't prevent me from living a human life but being unable to engage reality does.  

Side note on reality:  I agree entirely with what Grobstein said about human knowledge being partial and perspectival, but the fact that we say we try to get things less wrong implies (correctly I believe) that there is some objective reality to which we are all trying to conform our conceptions to. Each cultural norm is imply the sum of the most popular understandings of reality in a given place. That is why people are so fond of saying that one is not better than the other, simply because it is difficult to tell which one is better than the other. However, rest assured that one understanding of reality is better than another, although I don't know for sure which one it is. I do think it (the best approximation of reality) is mine, and you do think it is yours or else we wouldn't think what we do!

Prof, Grobstein could you elaborate what you mean by a capacity to create meaning?