Does ‘mental illness’ exist? I have taken as my title one of my least favourite questions. Although often posed to critics of psychiatric practice like myself, it actually makes very little sense. In unpicking it, I hope to show that we have better ways forward than the current, largely unchallenged understandings of emotional distress which do not reflect reality – either in terms of the evidence, or in terms of people’s lives. The question really needs re-phrasing in two parts. If we framed the first part as ‘Do people really experience extreme forms of distress such as suicidal despair, hearing hostile voices, crippling anxiety and mood swings?’ then of course…