Mental illnesses have always been treated with a raised eye, a societal taboo that has been judged in a million different ways, all of them more wrong than the one before. In the face of the technological innovations and progressive modernization, mental illnesses are still treated as an abomination rather than being just a health disorder in need of proper treatment (Schildkrout & Frankel, 2016). Medical sciences however has done a lot to improve the treatment availabilities and care for the unfortunates dealing with any kind of mental disorders, however there still are many inadequacies left behind for their treatment.
In any kind of health related disorder the journey of treatment begins with a prognosis, it is vital for your medical practitioner to diagnose your health care concern based on the abnormalities or symptoms so that he or she can progress with your treatment to address those concerns (Schildkrout & Frankel, 2016). Mental disorders are no exception to that, a logical, precise and clinically reasonable diagnostic procedure is the pivotal pedestal. However the question is whether the diagnostic procedures meant to help the individuals dealing with mental disorders are really concerned with helping out the mentally disabled or are they just another tool for stigmatizing the unfortunates. This essay will attempt to criticize the existing psychiatric disorders and their efficacy in actually helping the patients of mental disability rather than addng to the social labelling and stigmatizing (John & Saeed, 2016).
A diagnosis can be defined as the initial step towards delivering medical treatment and has a number of different purposes; it provides the clinical practioner with the relevant information about the patients and allows the prognosis to develop scientifically according to the needs of the patient (John & Saeed, 2016). It has to be considered that each patient has varying needs irrespective of the labelling of disorders. However the diagnostic procedures for the different mental disorders are heavily lacking in modern techniques and advancements and are no longer viable for the scientific treatment procedure.
Various studies suggest that there are various gaps and loose relationships between diagnosis and treatment in psychiatry. Lucy Johnstone in her book titled critical issues in mental health has explained how the labels used in psychiatry are vague and vastly misleading (Johnstone, 2000). She has explained how the medical sciences are yet to discover any biochemical abnormalities in the brain tissues that can relate to any particular mental disease, nor is the genetic predisposition very clear to the medical sciences (Campinha-Bacote, 2017). In such a condition a diagnosis on one hand can provide the label that the patient will need to seek the medical regime but on the other hand that label is vague and stigmatizing in the society. Moreover the different diagnostic procedures vary vastly across different regions hence the diagnostic labels are misleading as well (Johnstone, 2000).
The inadequacy of the formal psychiatric diagnostic procedures is also supported by Sami Tamimi in his article on viability of the age old formal psychiatric diagnostic measures in The face of modern and technologically advanced medical science (Timimi, 2014). The author in his article has beautifully explained how the invalid and inadequate age old conventional diagnostic procedures have only aided in escalating the stigmatizing and discrimination in the society rather than aiding in the treatment procedure of the mentally ill patients (Anderson, Nordstrom, Wilson, & Peltzer-Jones, 2017). The author suggests that despite all the technological advances and improvisations to the medical science have not made any modifications to the rusty old diagnostic modules for psychiatry. The diagnostic manual still lacks any physical tests or biological markers that can be correlated to the pathophysiological subjective assessment based on which he will construct the prognosis (Timimi, 2014). It has to be considered that there still have not been any discoveries of biological or psychological markers that identify different mental disorders and can characterize them, unlike the rest of the disciplines that have diagnostic procedures that are heavily linked to pathophysiology and etiological findings (John & Saeed, 2016). The author has further commented on how popular diagnostic manual like that are used abundantly in the psychiatry cannot provide any link between the diagnostic procedures with etiological processes (Timimi, 2014).
Moreover the validity of the diagnostic procedures concerned with the psychiatric procedures is questionable. The validity and viability of a diagnostic procedure is based on how effectively it can explain and characterize a naturally occurring abnormality though substantial data that can be standardized (Wigney & Parker, 2010). In case of psychiatric diagnoses, the lack of any physical tests utilizing any biochemical or physiological markers eliminates any chance for it to be viable or valid. This phenomenon can be further established by discussing about the number of diagnoses a mental patient generally receives (Anderson, Nordstrom, Wilson, & Peltzer-Jones, 2017).
In case of any health care related emergency a single precise diagnosis is enough to determine and construct the prognosis in case of the rest of the medical disciplines. However, in case of psychiatric disorders the mental patients receive multiple diagnoses in the majority of the cases which seriously questions the viability of the each of them in the first place (Timimi, 2014). More often than not the reliability of the diagnostic procedures associated with the psychiatry varies among different practitioners. Studies suggest that most of the common diagnostic procedures associated with the primary mental disorders are invalid due to the immense amount of disagreements in different psychiatrists over the key symptoms. Hence the diagnostic procedures along with being highly backward and nonviable are not reliable as well (Lakeman & Cutcliffe, 2016).
With so many misgivings of a medical diagnostic procedure one might raise a question as to whether the psychiatric diagnoses are even scientific or not. A wonderful article by Jose de Leon questions the scientific basis of psychiatry in intricate details, incorporating facts and data that provide valid information negating the age old notion of psychiatry being as connected to science (De Leon, 2013). The author very clearly questions the lack of statistical data backing the psychiatric medical practice and has deemed psychiatry to be scientific only if we consider the limitations of science largely. The major controversies around the scientific basis of psychiatry arose with the emergence of DSM5 established by the high and mighty American Psychiatric Association (De Leon, 2013). Many of the researchers have declared psychiatry to be completely out of scientific context due to the vast lack of validity and relative connection between the diagnosis and treatment outcome. However, here the author guides the readers to find the intersection between psychiatry, science and medicine before declaring psychiatry to be completely unscientific (De Leon, 2013).
Jose here explained psychiatry to e a hybrid discipline of science which is vastly run by the methodologies of medical science and concepts of social science it has to be considered that the history of psychiatry has seen multiple changes in the human society and living and the impact of all those changes have structured the human psyche of today and has great implications to the psychiatric theories (Sidhu, 2016). He has clearly articulated the problems that are prevalent in the realm of psychiatry that restricts it to be as compatible to science and statistics as the rest of the medical disciplines. The author suggests that human mind is complex and it does not play by the hard and fast rules, every individual is different and their disorders have different stories and triggers behind them, and this differential data often does not fit to the medical models (De Leon, 2013).
It has to be understood that the a psychiatrist may need to use the scientific procedures along with the social and personal understanding of the situation of the patient before they can decide what prognosis fits them bet n accordance to the mental disorder they are dealing with (Brodwin, 2014). Hence in the world where science is treated as the ultimate source of truth, psychiatry has a lot of restrictions to fall through the yes or no model of the rest of the medical sciences (Gruber, 2008).
Now one might raise a question that psychiatry being a medical science can it not modify itself to a more scientific and statistical grounds of practice. The author has answered this question by listing the limitations of the current scientific approach within psychiatry. In the light of the a lack of any biological marker that can link psychiatric diagnosis to treatment outcome, the first and foremost cause behind this inadequacy that comes to mind is the lack of proper technology (Van Os, 2010). However there are a lot more confounding factors, the author has declared the inadequacy and restrictions of the psychiatric language to be the major reason behind the limitations of the current psychiatric practice. It has to be considered that application of scientific methodology to psychoanalysis presents a conundrum, and that delimits the scope of psychiatry in general (Wigney & Parker, 2010).
Various studies have agreed to the view of Jose that the limitations of the psychiatric language is a major reason why the psychiatry could not align itself to the scientific models that the rest of the medical disciplines so accurately do (Campinha-Bacote, 2017). However there are other limitations as well, it should not escape notice that the science of psychiatry has to deal with the differential complexities of human minds, most of which is still a mystery to the scientific biomedical researches (Wand, 2013). As mentioned above the different individuals have different mind sets and the mental disorders one faces can due to triggers that are completely different from another one. And if we consider medical science to be a phenomenon of cause and effect, how can psychiatry follow the strict and unbending models of medical sciences with so many confounding variables to consider (Goldfried, 2013).
However, the question remains whether the psychiatric diagnoses are scientifically valid or not, the answer to that could be tricky. It is undoubtedly true that the methods of the age old diagnostic manuals are more stigmatizing to the patients rather than being very helpful, but they are not completely useless as well (Campinha-Bacote, 2017). In my opinion what the science of psychiatry n is discretion and modifications that can drag psychiatry towards a more positive health paradigm (Wyatt, 2009). The diagnostic methods for the psychiatry need to be more inclined towards labels that aid in the treatment outcomes and simplified decision making. The psychiatric diagnoses need to be reorganized keeping the current needs and complexities of the patient in mind so that the psychiatrists can engage the patient in the best biological treatment that is in accordance with the needs of the patient (Gruber, 2008).
On a concluding note it can be said that the science of psychiatry is as different as the minds of humans it deals with are. Different humans have different thinking, different perception and have gone through varying experiences and grief. There can be no standard that can quantify the degree to which a traumatic experience can affect the mental sanity of an individual. Different situation affects different people with varying magnitude; hence there cannot be strict quantifiable data or benchmarks for psychiatry unlike the rest of medical sciences.
On a similar note, Jose in his article has stated that if an individual judge the basics of psychiatry with the rules and regulations of natural sciences will not find it to be very scientific. It has to be considered that psychiatry is a discipline 150 years behind the so called science of medicine and has had to deal with mental and behavioural issues that can be more easily explained by social sciences rather than natural sciences. However if the psychiatric practitioners change their methods and tactics in a more patient centred way that can address the needs for different patient in a manner more receptive for that patient, psychiatry will come out of the dead end that it has approached.
Anderson, E. L., Nordstrom, K., Wilson, M. P., & Peltzer-Jones, J. M. (2017). American Association for Emergency Psychiatry Task Force on Medical Clearance of Adults Part I: Introduction, Review and Evidence-Based Guidelines. Western Journal Of Emergency Medicine: Integrating Emergency Care With Population Health, 235-242.
Brodwin, P. (2014). The Ethics of Ambivalence and the Practice of Constraint in US Psychiatry. Culture, Medicine & Psychiatry.
Campinha-Bacote, J. (2017). Cultural considerations in forensic psychiatry: The issue of forced medication. International Journal Of Law & Psychiatry, 501-508.
De Leon, J. (2013). Is psychiatry scientific? A letter to a 21st century psychiatry resident. Psychiatry investigation, 205-217.
Goldfried, M. R. (2013). What should we expect from psychotherapy? Clinical psychology review, .
Gruber, H. (2008). Diagnostic inadequacies in the nursing home. Diagnostic Inadequacies in the Nursing Home, . 103.
John, N. J., & Saeed, S. A. (2016). Key Studies That Inform Clinical Practice: Child and Adolescent Psychiatry. Psychiatric Times, 33.
Johnstone, L. (2000). Users and abusers of psychiatry: A critical look at psychiatric practice. Psychology Press.
Lakeman, R., & Cutcliffe, J. (2016). Diagnostic Sedition: Re-Considering the Ascension and Hegemony of Contemporary Psychiatric Diagnosis. Issues In Mental Health Nursing.
Schildkrout, B., & Frankel, M. (2016). Neuropsychiatry: Toward Solving the Mysteries That Animate Psychiatry. Psychiatric Times.
Sidhu, N. &. (2016). Ethics and Medical Practice: Why Psychiatry is Unique. Indian Journal Of Psychiatry.
Timimi, S. (2014). No more psychiatric labels: Why formal psychiatric diagnostic systems should be abolished. nternational Journal of Clinical and Health Psychology.
Van Os, J. (2010). Are psychiatric diagnoses of psychosis scientific and useful? The case of schizophrenia. Journal Of Mental Health,, 305-317.
Wand, T. (2013). Positioning mental health nursing practice within a positive health paradigm. International journal of mental health nursing, 116-124.
Wigney, T., & Parker, G. (2010). Medical student observations on a career in psychiatry. Australian & New Zealand Journal Of Psychiatry, 730.
Wyatt, W. J. (2009). Behavior analysis in the era of medicalization: The state of the science and recommendations for practitioners. Behavior analysis in practice, 49-57.
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