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I've just finished Jeanette Winterson's novel, Lighthousekeeping, which gives another perspective on the question of whether mental health can be measured in terms of an "awareness of reality":

The psychiatrist…asked me why I had not sought help sooner.
“I don’t need help…I can dress myself, make toast, make love, make money, make sense”….
“Do you keep a diary?”
“I have a collection of silver notebooks.”
“Are they consistent?…do you keep one record of your life, or several? Do you feel you have more than one life perhaps?”
“Of course I do. I would be impossible to tell one single story.”
“Perhaps you should try.”

[and then, from a later session:]

“An obsession with meaning, at the expense of the ordinary shape of life,
might be understood as psychosis….”
“I do not accept that life has an ordinary shape….How would you define psychosis?”
"...out of touch with reality."
Since then, I have been trying to find out what reality is, so that I can touch it.