Day 6: Diagnosing children with mental health conditions
Have you imagined a world without any mental health diagnosis?
In my daily work, we receive information about a child or young person at risk of abuse and/or neglect. One of the questions we ask as part of the risk analysis is whether a child has any mental health conditions. Interestingly, some conversations from the colleagues would change depending on whether the young person has any mental health conditions.
Sometimes later on in our intervention, when a young person is linked with professional mental health services, we then ask “are they medicated.” When a young person has seen a professional and has given some form of medications, it is when we might be able to step out, because they are relatively ‘stable’ in this point in time.
This wasn’t a problem when I first started work because I was learning. As time goes by, I now question how important is it to have a mental health diagnosis for young people. It appeared that we overdiagnose children with mental health conditions in order for them to receive some form of help and, in terms of my work, to achieve some form of stability.
Little background:
In the 20th century, mental health issues were not classified into diagnostic categories (as reflected in DSM-I and DSM-II). DSM is the Diagnostic and Statistical Manual of Mental Disorders. In those days, mental health symptoms are perceived as reflections of our ‘intrapsychic conflicts’ or some form of difficulty in life that classified as a variant of the norm. However, this was drastically changed since the introduction of DSM-III in 1980, where mental health conditions are categorised and ultimately standardised.
In the next few posts, I will talk about the strengths and criticisms of the current model of diagnosis. Lastly, I will revisit the issue of overdiagnosis of children with mental health conditions.
Some strengths of the current model of diagnosis may include the following:
a) A common language
With a diagnosis, medical professionals are able to discuss different circumstances for people suffering from mental health conditions. This would allow them to access the ‘right’ support.
b) For future research
Without clear definitions or categories to differentiate the population suffering from any mental health conditions, quality research cannot be conducted. Through categorisation, quantitative data can now be collected for future researches around the causes of mental health conditions and treatment for them. With evidence-based research, accurate and precise support can be tailored to the particular person suffering.
c) For funding and support
Funding and support can be given under a needs-based approach. This means that differentiating mild and severe mental health conditions would allow the latter to receive more support than the former.
Such an example could be seen in the National Disability Insurance Scheme (NDIS) in Australia.
d) For early interventions
With the current diagnostic system, professionals are able to provide a diagnosis to young people that could get them early interventions. With early interventions, children are able to receive help earlier on, they are better equipped with strategies to cope with the ever-changing world. In addition, the parents or extended family could better understand the children and enact changes as soon as possible.
e) For legal purposes
Some people come across the criminal system due to their mental health conditions. With the diagnosis, clinicians are able to establish to what extent is the person of interest affected by his/her mental health conditions. Ultimately, this could provide a more accurate picture for legal authorities to make decisions that impact the liberty of the person of interest.
These are just some of the strengths.
Take away reflections:
- Think about a world of no mental health conditions. How does it look like?
- Should children be diagnosed at a young age?
