The ERNI Declaration: Making Sense of Distress Without âDiseaseâ 244 The ERNI (Emotions aRe Not Illnesses) declaration is based on the idea that distress does not equate to disease, dysfunction, dysregulation, or chemical imbalance. Signatories believe that there needs to be a shift from illness and diagnosis ideas to personal narratives and understandings. The declaration was created with the appreciation that there are many like-minded people out there who share opinion, research, ideas, and experiences with others within many contexts but are frustrated by subsequent lack of action or change within mental health and other related systems. The Disease Model The disease model for understanding emotional distress has been the primary paradigm in Western cultures for a hundred years, with roots that stretch back even further.