HIPAA is in conflict with Form 4473, (as well as Form 4's and Form 1's), and relies on honesty and self-awareness (Ask a racist if they're racist, for example...).
Aside from that, the mental status of many people (can) change on a day to day, moment to moment basis.
Then you have a wide continuum of skills and insight in the MH clinical world, where perceptions of reality and humanity can range from the perceptions of those who went to school on mommy's and daddy's dime, and have never scraped their knees hard in real life, and those who have been on the path of more harsh real-world survival and its lessons, and you have many wide-ranging perceptions of who and what is imbalanced or balanced, mentally well-adjusted or not, all relying on a cook book of thought disorders and personality disorders put together by what is typically a (fairly large) group of (often) Ivory Tower-dwelling, well-credentialed 'leaders' in the field, with an equally varying perception of what degree of prevalence or symptom is problematic or not..
(Edit: Nearly all symptoms contained in the DSM's over the years are somewhat natural or normal human experiences or occurrences. The question is often one of prevalence, and what degree of dysfunction is caused by the symptoms or diagnoses. I could give a hundred examples if necessary)
And the added fact that 'personality disorders' (Axis II) are not typically perceived as 'mental illness', in the same way that 'thought disorders', or Axis I diagnoses are.
Having worked in that field for a long while, and knowing some of the inherent weaknesses therein, I shy away from any exposure to them.. I found that some of my colleagues were at least as fucked up as the majority of my clients.
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