“Mental illness” is one of the central fields in the sociology of deviance. Yet, it has only gained little attention in the past years and decades. Partially, this is due to the fierce attacks on psychiatry by sociologists. The present paper wishes to move beyond these attacks and offer a sociological analysis that no longer insists on a sociological explanation that opposes the psychiatric discourse but that asks about the achievements of the latter. This objective is pursued by building on a pragmatist and definitional perspective that overcomes the antagonisms about the “truth” of a description and rather asks about its practical consequences. The question if mental illness “really” exists is beside the point, even empty, in an analysis such as the one offered here.