This matters

This is not just an academic issue. 'Diagnoses' send an inappropriate message about the nature of mental health problems. It is inappropriate to suggest that a 'disease' called 'depression' is responsible for the low mood someone is experiencing. It is inappropriate philosophically, because it confuses a label with an explanation. It doesn't help to say that the label that we give to the experience of low mood is the cause of the low mood. It doesn't help us understand why a person is hearing voices to suggest that the cause of the voices is a disorder called 'schizophrenia'. 'Schizophrenia' is again merely a label we give to a variety of problems, including hallucinations. This is inappropriate because it's lazy thinking, and it's inappropriate because it pretends to offer an explanation, but fails so to do. This is probably most worrying when parents need to understand why their child has problems with attention or emotion regulation. To say: ' ... he is having problems concentrating at school because he has ADHD ... ' is so circular, so misleading, that it is genuinely counter-productive.

I have previously mentioned how diagnoses, in the area of mental health, can also have very serious implications for people. Diagnosis is stigmatising, but the labels can also have significant practical consequences for people. I have had personal experience, through my professional activity, of people whose careers have been threatened by psychiatric diagnoses offered during childhood. In the majority of cases, these diagnoses had been used speculatively - with possible diagnoses recorded in medical records without a great deal of confidence in their accuracy or the likely consequences. In most cases, medication was either recommended or prescribed, but the clients rarely took the medication regularly. However, later in their lives, when applying for responsible jobs, the previous 'psychiatric diagnoses' tended to have very serious consequences - it is sometimes very bad news, in a competitive and risk-averse world, to have 'mental illness' in your medical history. Writer Fay Thomas, 'diagnosed' with bipolar disorder, has argued eloquently that we should treat psychiatric diagnoses as potentially defamatory.21

But perhaps the most important negative consequence of a psychiatric diagnosis is what happens next. After we have been diagnosed with a 'mental disorder', it's a near-certainty that we'll be prescribed medication. The diagnosis of depression is intimately associated with the prescription of 'antidepressants'. The diagnosis of 'ADHD' leads inexorably to a prescription for Ritalin. The diagnosis of 'schizophrenia' leads to a prescription for 'antipsychotic' medication. And I absolutely don't think drugs are the answer.

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