Increasingly, mental health problems are labelled as an illness like any other. But can a focus on diagnoses, rather than experiences, harm as well as help?by Eleanor Morgan / October 16, 2019 / Leave a comment
What is mental health?
Despite the term’s omnipresence, there is very little consensus in terms of definition. In 2014, the WHO defined mental health as: “A state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”
The definition has been criticised by prominent clinicians for painting a prescriptive utopia. In reality, most people will not know what such a state of things looks like. Feeling pain, sadness and fear is a part of life. When any kind of pain is extreme, we need intervention to help us regain hope, self-worth and a sense of self. But can it really be that we are ‘ill’ if we don’t necessarily feel we are in a state of well-being at all times?
With this in mind, various studies have found that people are dissatisfied with current definitions that often focusing on a disease model; positioning distress as something ‘other’ that infiltrates our minds and changes how we function.
If we imagine a spectrum between ‘health’ and ‘illness’ and agree that the threshold lies towards the ‘ill’ end, the knotty issue of exactly where one draws the line remains. The criteria of ‘diagnosable’ psychiatric disorders in The Diagnostic and Statistical Manual of Mental Disorders (DSM) was developed with global data and structured interviews, but the reliability of psychiatric diagnosis remains controversial. No objective biological test exists to say someone is ‘depressed’, ‘anxious’ or ‘bipolar’; categorisation relies on subjective judgement.
The arbitrary nature of psychiatric diagnoses and how they are capitalised on by politicians and Big Pharma has long been questioned. However, when important research and planning of health services so often hinges on clearly-defined problems—diagnoses—the power of our governing systems and the language we seemingly must use to navigate them can feel intractable.
As someone who has experienced what I will call, as I always have, ‘anxiety’ for most of my adult life, there were times where the word ‘disorder’ made some sense to me. This inner, malevolent force, this thing that detonated my guts and…