The Power of Mental Health Diagnoses

(In celebration of World Mental Health Awareness Day)

Katie Lou McCusker

As behavioral health providers, we often take the practice of diagnosing mental or behavioral differences/disorders for granted. Diagnoses can make or break access to care for our clients. A diagnosis ensures healthcare funding, school supports, necessary accommodations, and more. We encourage families to get diagnoses for their children at a young age and then reassess the child’s diagnosis throughout their life. However, some people find diagnoses inaccurate or harmful. Many professionals in the medical and psychiatric communities are debating the frequency with which we diagnose. Some psychologists even advocate for the complete elimination of diagnostic labels (Timini 2014). On World Mental Health Day, I want us to think about the practice of diagnosing and consider the pros and cons of a diagnosis.

First, I want to discuss the drawbacks of an official diagnosis. Fitting the human experience into a perfect diagnostic box is nearly impossible. Some people feel that a diagnosis reduces their internal experiences. Others feel that the diagnosis does not accurately describe their personhood and find the label alienating. Diagnoses also do not capture the ebbs and flows of the human experience. For example, you do not always feel the same amount of anxiety – your mental health changes as your life experiences change. Lifespan movement can not always be captured by a diagnosis.

We cannot go much further in this discussion without mentioning cultural disparities in diagnosis. White, western men provided most of the models of mental illness and behavioral differences that exist in the Diagnostic and Statistical Manual of Mental Disorders, or DSM (Kulik, 2014). Our current diagnostic definitions do not always describe cultural experiences and practices outside of white westerners. Often, the DSM incorrectly assigns a diagnosis to a very typical cultural behavior (Washington, 2016). For example, people in some cultures regularly talk to spirits, ancestors, or god(s). In other cultures, that behavior is abnormal and makes an individual eligible for a diagnosis.

Despite the drawbacks, official diagnoses can also be positive for some individuals. Specifically, diagnosis tends to be very important for the Autistic community. Many Autistic people find that their diagnosis gives them a sense of identity. The label also provides Autistic people with a community and an explanation for why they think and act differently than their peers. Autistic author Emma Durman talks about the power that diagnosis had on their life: “There is talk of being bound by labels. Like they are some kind of trap that constrains you. This label freed me. It was everything.” (Durman, 2018).

Meanwhile, for other diagnoses, a label allows a person to separate themselves from their diagnosis. I am a little biased here – I personally found receiving a diagnosis to be incredibly freeing. I was able to lift away a layer of gunk from my personality and rediscover myself. Additionally, separating an individual from their diagnosis changes conversations about their abilities and attributes. I love the following quote from Diagnosed – The Benefits in Receiving a DSM-5 Diagnosis:

“Placing troubling behavior on a diagnosis can provide a boost in self-image and self-esteem. Instead of “Why is Sally always the bad kid and act out at school?” A DSM diagnosis label can shift the conversation to “Sally’s ODD has been really challenging lately, let’s see what else we can do to help.” Sally’s behavior is attributed to her diagnosis and she is no longer living the label as a “bad kid” which could have a big impact of her self esteem and self-image.” (Diagnosed, 2017).

I started this project hoping to find a definitive answer about diagnosis – should we or should we not diagnose? Reflecting on this work, I find that I still lean towards assigning a diagnosis. In my own life, I found an official diagnosis to be life-saving. I am grateful that I know how to adjust my environment to accommodate my needs. Diagnoses can also help people access care and understand their identities better. At the same time, others find diagnoses irrelevant to their lived experience and do not appreciate living with a label. Whether you are for or against diagnosing, receiving a diagnosis is a deeply personal experience. Every person feels differently about the presence of diagnosis in their life. In celebration of World Mental Health Day, I am challenging myself to think about what a diagnosis may (or may not!) mean to different people. I hope this piece challenges you to think about diagnosis too.

 

References

Diagnosed- the benefits in receiving a DSM-5 diagnosis. Strategic Psychology Canberra. (2017, August 1). Retrieved October 7, 2021, from https://strategicpsychology.com.au/diagnosed-benefits-receiving-dsm-5-diagnosis/.

Durman, E. (2018, March 11). 2 years ago I was diagnosed with autism. The Mighty. Retrieved October 7, 2021, from https://themighty.com/2018/03/adult-autism-diagnosis/.

Kulik, D. (2021, August 23). The pros and cons of mental health diagnosis. Dr. Dina Kulik. Retrieved October 7, 2021, from https://drdina.ca/the-pros-and-cons-of-mental-health-diagnosis/.

Timimi, S. (2014). No more psychiatric labels: Why Formal Psychiatric Diagnostic Systems should be abolished. International Journal of Clinical and Health Psychology, 14(3), 208–215. https://doi.org/10.1016/j.ijchp.2014.03.004

Washington, H. A. (2016). Microbial Culture. In Infectious madness: The surprising science of how we “Catch” mental illness (pp. 162–169). essay, Back Bay Books, Little, Brown and Company.

 

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