Mental Health Diagnosis – Friend or Foe?

This week’s EBN Twitter Chat on Wednesday 3rd February between 8-9 pm (UK time) will focus on whether mental health diagnosis are a friend or a foe. The Twitter Chat will be hosted by Neil Withnell (‪@neilwithnell‪ ) who is a Senior Lecturer/Associate Dean Academic Enhancement at the University of Salford.

To participate in the chat you need a Twitter account; if you do not already have one you can create an account at www.twitter.com. Once you have an account contributing is straightforward, You can follow the discussion by searching links to #ebnjc or contribute by creating and sending a tweet to @EBNursingBMJ and add #ebnjc (the EBN chat hash tag) at the end of your tweet.

I remember starting my mental health nurse training over 30 years ago and the teacher explaining that nurses don’t label individuals, like doctors do. The teacher continued to explain to the six of us (yes that was the size of our group) that a label did not help as no two people were the same and symptoms varied across individuals, so we were trained to treat and respond to symptoms. I immediately knew I had made the right career choice as I wanted to work with individuals with mental health difficulties, and to challenge the stigma that this brings.

During my nurse training I continued to question the value of diagnosis with my medical colleagues. I recognised the importance of medication in treating people symptomatically but the diagnosis often seemed to serve no purpose other than labelling or putting people into boxes.

The formal diagnosis of mental illness has been around since 1900 with the introduction of the International Classification of Diseases (ICD) by the World Health Organisation. This covers all illnesses, not just mental health, and is in its 10th iteration, ICD11 is expected out in 2018.

In 1952 we saw the introduction of the Diagnostic and statistical Manual of Mental Disorders (American Psychiatric Association). This is in its 5th iteration (2013), the latest edition causing the most discussion and debate as to the value of diagnosis. Part of the debate centres around the disease model of mental illness, which tends to underpin mental health care. Diagnosis can certainly help people understand behaviour and symptoms which otherwise may be judged negatively or unfairly. On the flip side diagnosis can be a part way of pathologising personality and individual differences. People are individual, overzealous diagnosis could mean that a little over 64 million people in the UK alone could have a mental disorder!

The #ebnjc twitter chat will explore the role of diagnosis. Is it helpful? Is it necessary? Does diagnosis hinder the therapeutic relationship? Would you want to have a diagnosis?

We hope you can join us on Wednesday 3rd February 2016, 2000 UK time to further explore this topic…

Neil Withnell, Senior Lecturer/Associate Dean Academic Enhancement, University of Salford

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