Psychology: Criticisms of Medicalisation of Mental Health

Medicalisation of Mental Health

• The medicalisation of mental health leads to a symptom-based perspective, where the individual is reduced to a set of symptoms, and the focus becomes symptom elimination rather than individual well-being.
• Cut-off points for diagnosis can be too rigid, such as the 1-year cut-off point for Prolonged Grief Disorder.

Limitations of Diagnosis

• Differences between abnormality and normality are of degree, not kind.
• Labelling can lead to hospitalization, which is a form of social control, and diagnosis can be a powerful tool.
• Diagnosis may not be sensitive to individual and cultural differences, leading to misdiagnosis and perpetuation of clinical stereotypes.

Clinical Prototypes

• Clinical prototypes are used to diagnose mental health conditions, assuming that members of a prototypical group display distinctive and common clinical behavior.
• The presenting clinical picture is composed of several co-varying traits and symptoms.

Advantages of Diagnosis

• Diagnosis provides hope and a sense of control over the condition.
• It reduces subjective interpretation and safeguards clients by advising against certain tasks and activities.
• All professionals arrive at a diagnosis through the same standardized procedure, using verbal shorthand to avoid diagnostic confusion.

The Medical Model vs. The Social Model

• The medical model views mental illness as a result of biological factors, e.g., "Behind every twisted mind lies a twisted molecule" (Hippocrates).
• The social model views mental illness as a result of social forces, e.g., "The cause of mental illness is the result of social forces" (Emile Durkheim).

Criticisms of the Medical Model

• The medical model can be seen as simplistic, e.g., "Men mistake medicine for magic" (Thomas Szasz).
• Madness cannot be found in a wild state, and it is not exclusive to certain conditions, such as autism or schizophrenia.

Mental Health Conditions

Anxiety Disorder

• Panic attacks or anxiety are predominant in the clinical picture.
• There are specific criteria for diagnosing anxiety disorder, including evidence from medical tests, and the disturbance must cause clinically significant distress or impairment.

Obsessive-Compulsive Disorder (OCD)

• Prevalence: 0.9% in the USA, 0.4-3.6% in other countries.
• F is twice as likely as M, and the age of onset is around 30.
• Rates of full remission are very low, and younger adults experience greater severity of symptoms than older adults.

Social Anxiety Disorder

• Most common form of anxiety disorder.
• Lifetime prevalence: 13.3%.
• Women are far more likely to develop social anxiety disorder than men.
• Age of onset: early adolescence.

Separation Anxiety Disorder

• Developmentally inappropriate and excessive fear or anxiety concerning separation from attachment figures.
• Recurrent excessive distress when anticipating or experiencing separation.
• Persistent and excessive worry about losing attachment figures or experiencing harm.

Dissociative Identity Disorder (DID)

• Rare, less than 1% of the population, with controversy regarding its existence.
• 5-9 times more common in women, with an age of onset usually in childhood but rarely diagnosed before adulthood.
• Often co-occurs with depression, anxiety, substance abuse, and self-injury.

Schizophrenia

• Hallucinations, delusions, diminished emotional expression, avolition, alogia, and anhedonia are symptoms.
• DSM criteria include two or more symptoms for one month, with social/work dysfunction, and exclusion of other disorders.
• Auditory hallucinations, delusional percept, passivity, and made affect are common symptoms.