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The field of "mental health" is large and covers many different symptoms and degrees of said state.
From one side you have conditions such as sleep problems, depression, phobias, OCD and many others, working through to the deeper aspects of psychosis. This is usually defined by a person acting in a way very outside what we class as "normal" behaviour and loosing contact with reality. It is often accompanied by the belief one is being guided into certain actions by an external source, such as hearing voices.
In Anders Breiviks case I believe the first doctors thought he was psychotic but when the prison doctor examined him she disagreed with this.
I think it is safe to say Breiviks actions were not normal. No matter how you try to say "what would we think normal"..murdering other people is not normal.
To class Alzeimers and those suffering it with psychotic actions is ridiculous in the extreme.
No, believing in fairies cannot be treated as a mental health issue (unless you start laying a place at the table for them!)
As for Breivik claiming he knows what he did is one thing, however it seems clear that whilst he may be aware of his actions he seems to have no empathy to the tragedy or depth of his actions.