Diagnosis Future

11 04 2011

Well hello there, and are we having fun today kiddies? Causing terror, fear, and panic wherever you go? If the answer is yes then way to go! If the answer is no then meh, something to aim for.

Sho Mr Bond… guess I oughta get that diagnosis future out the way.A little while back, not long ago, not in a distant galaxy (despite various peoples wishes), Channel 4 in the UK gave Scientologists (see, there was a reason for all the space stuff) a little air time to discuss a few things. Naturally mental health was one topic and, whilst I may not be a fan of L Ron Hubbard, they came up with a good point. At this time there is no physical test for any mental health diagnosis, of course the scientologist went on to say something along the lines of doubting psychiatry as a whole but then nobody’s perfect.

For me, the future of psychiatry will be led by a diagnosis system based on a physical test. Why? Because it’s the only way to get a concrete diagnosis. This is important as without a concrete diagnosis then all the research, all the work done, is tainted by poor work elsewhere. This would certainly bring it within the realm of medicine as practised by the physical side.

Psychiatrists are, and should be, top of the tree in this field. My experience of psychiatrists means either I’m a difficult patient or that they aren’t as well versed in their patients as they should be. Yes, I’ve experienced what I consider good psychiatrists which makes the practise of the rest more infuriating. Perhaps they would all be improved if the task of diagnosis was simplified as above? The way I see things is that psychiatrists should lead the treatment, but they should work more hand in hand with psychologists and others to provide a more holistic approach.

Meds will always have a part in treatment but then it should only be relatively short term and for helping people achieve a stable platform to work from. The phrase ‘How is the medication working for you?’ should be amongst the first few sentences out of psychiatrists mouth. Doses should be kept as small as possible whilst still having an effect. And the patient must be kept fully informed and reminded that this is a platform to work from, so they are more likely to continue to comply with the regimen (hey, we’ve all done the stopping meds too soon routine).

Patients want, and need, the therapy which can help them overcome the more stressful parts of any condition. Remember that a mental health diagnosis is not a mental health problem unless it’s actually a problem for the person. If you arm a person with the skills to cope then you lower dependancy on meds and the wole mental heath system.

Yes some people will require life long medication, I’m not debating this point, but there are many who don’t yet are on them for the long term. Perhaps it’s because meds are a fast and initially cheap solution. Either way, therapy and coping skills are initially more expensive but usually cheaper in the long run so a move towards this makes economic sense.

How am I doing so far? Yeah for some this is going to be a ‘No $#%& Sherock’ moment but the thing is that whilst it may be obvious this should be the way… why isn’t it being done? Ho hum, we shall see how the future holds up to scrutiny of hindsight, but at least we can examine the past with the same.

If you talk to the older/retired psychiatrists it appears that what I’m saying is how things were done, at least to a degree. It also appears that they were onto something. Apart from the profit margin, what was wrong with this approach?



One response

12 04 2011

A whole hearted me too on this. Although I would say it *does my head in* that psychiatrists have the same kudos as other medical doctors when they won’t acknowledge the epistemological bias inherent in their field. Most of the DSM is theoretical, and the inconsistency in diagnosis experiments (when done blind) is simply doesn’t happen in the same way when detecting say, cancer cells. (Sorry, being v. lazy on sources at the moment… but eg if you can cope with pop psychology as evidence Mainly Blue posted a few weeks back about the Channel 4 documentary doing this.)

Oh, but can I call you on older psychs being better? That was a generation that ECTed, lobotomized, depersonalized, etc. Modern medicine has been doing pretty shit things for the past 100 years, but the brain doctors have been more than a little bit brutal. (And even the ‘good’ bits of scientific psychology are rooted in the nastiness of post WW2 studies of mass control -eg Erikson did pretty shit work with soldiers, as I recall, but again brai too fuzzy for referencing..)

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