Saturday, February 08, 2014
Overemphasis on the importance of psychiatric diagnosis
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Craddock & Mynors-Wallis make the case for psychiatric diagnosis in a BJPsych editorial, although I'm not sure why they think its importance is increasing rather than decreasing. I don't want to overemphasise the difference between psychiatric and medical diagnosis, but, despite what they say, there is a difference. I know they're waiting for specific tests "to confirm or refute diagnoses based on clinical assessment" but this is pie in the sky. See my article The overemphasis on biomedical diagnosis in psychiatry.
Moving from an outdated physical disease model of mental illness to a more relational mental health practice
2 comments:
Unfortunately I can't get access to this editorial and can't afford to pay to see it, being an unpaid carers, picking up the pieces after traumatic psychiatric treatment.
However I have an opinion about psychiatric diagnoses/labels since all of my family have received these and they've stuck like glue in "medical" notes despite their inaccuracy and the fact that many of us have completely recovered, by going against the advice of psychiatrists.
I see no point in labelling people in mental distress with stigmatising psychiatric terminology that I am told, by psychiatrists, are purely a way of categorising symptoms and behaviours. That may well be so but in my opinion they need to reflect on the impact of their labels in the long term. The damage done. The difficulties in escaping such a disabling diagnosis.
And as for the "severe and enduring mental illness" tag well that is unforgiveable. They gave it to me and mine, in different Scottish health board areas, putting us in cul-de-sacs or dead end streets where we couldn't even access CBT or any talking therapy that would help us recover. We had to do it ourselves if we had the strength.
Which is why I'm now a mental health writer, survivor activist and human rights campaigner. Up to my neck in it, I had no choice but to resist and stand firm.
Duncan thanks for sending me the editorial by Nick Craddock and Laurence Mynors-Wallis. Although the piece is confidently written I'm not convinced by the arguments or the clever (being ironic) linking of diagnosis and formulation "Diagnosis should be part of a formulation that brings together aetiology, severity and functioning and should lead to a management plan." The management plan worries me and sounds more like it could lead to a CTO and lifelong mental illness.
I'm concerned about the "biomarkers for mental illness" crusade and the fate of the sacrificed transgenic mice. Recently I saw them side by side with patients on slides at two events run by the Scottish Mental Health Research Network, in Glasgow and Edinburgh:
http://www.gprn.gla.ac.uk/conference.php
http://www.smhrn.org.uk/News/asm.asp
It felt dehumanising to be compared to the unfortunate mice. It didn't inspire me with hope.
"We can certainly expect that over the coming generation
psychiatry will move towards a classification that is better
informed by understanding of the normal and abnormal workings
of the brain." I have no such expectation, rather it fills me with horror that there might more NMD/brain surgery for mental illness going on at Ninewells Hospital under the auspices of the Advanced Interventions Service where they write in their reports of an "unmet need".
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