What is the difference between being schizophrenic and having the "opinion" that Satan speaks to you through your neighbor's cat?
Mental illness is defined by what a person feels and believes.
What you feel and believe is subjective but you can objectively establish that a particular cluster of subjective feelings and beliefs is abnormal vis-a-vis a populate.
Then when you ask people the same questions and their cluster of responses fits the abnormal definition you can objectively say that they have a mental illness.
The objectivity does not come from the doctor observations or patient self-survey, it comes from the study that created the questions and proved that a certain score or cluster of responses is statistically abnormal.