Week 1: Mental Illness and its Critics Flashcards
A term used by psychiatrists to describe conditions that affect a person’s thoughts, feelings, and behaviors.
It implies a problem that is fundamentally different from normal functioning.
Mental Illness
What was Eliot Slater’s (1954) quote on Mental Illness?
‘The main claim of the physical approach, that is the assumption that mental disorders are dependent on physiological changes, is that it is a useful working hypothesis. It has made great advances and looks like making more.’
What was Peter Tyrer’s (1998) quote on Mental Illness?
‘The name “mental illness” implies disease. An illness suggests something wrong that is fundamentally different from normal function and is not just a variation in degree.’
The process of identifying a specific mental health condition based on a set of symptoms and criteria.
Psychiatric Diagnosis
Other medical conditions that might mimic the symptoms of an initial diagnosis.
Medical Differential
Both ICD and DSM-5 are used for classifying diseases and health conditions.
ICD has a broader scope and is used globally for various purposes, while DSM-5 is specifically focused on mental health disorders and is primarily used by mental health professionals.
International Classification of Diseases (ICD) vs Diagnostic and Statistical Manual of Mental Disorders (DSM-V)
Refers to something that originates from or is organized by ordinary people, rather than by governments or large organizations.
It often implies a bottom-up approach, where ideas and initiatives come from the people themselves.
Grassroots
A grassroots movement that promotes recovery from mental illness through self-advocacy, peer support, and community-based services.
The Recovery Movement
A more recent approach to mental health which often emphasizes the subjective experiences of individuals with mental health conditions and the importance of self-determination.
They might advocate for a more collaborative approach to mental health treatment, involving individuals with mental health conditions as partners in their care.
Postpsychiatry
What did Thomas Szasz write in his ‘Myth of Mental Illness’ (1998)?
‘mental illness is a metaphor (metaphorical disease).
The word ‘disease’ denotes a demonstrable biological process that affects the bodies of living organisms (plants, animals, and humans). The term ‘mental illness’ refers to the undesirable thoughts, feelings, and behaviors of persons. Classifying thoughts, feelings, and behaviors as diseases is a logical and semantic error, like classifying a whale as a fish. As the whale is not a
fish, mental illness is not a disease. Individuals with brain diseases (bad brains) or kidney diseases (bad kidneys) are literally sick. Individuals with mental diseases (bad behaviors) like societies
with economic diseases (bad fiscal policies) are metaphorically sick. The classification of (mis) behavior as illness provides an ideological justification of state-sponsored social control as medical treatment.’
What did R.D. Laing publish in his work, ‘The Politics of Experience’ (1967) about Mental Illness?
‘Madness need not be all breakdown. It may also be break-through. It is potential liberation and renewal
as well as enslavement and existential death.’
This suggested that madness could be a way of breaking free from societal expectations and limitations, leading to personal growth and liberation.
A well-organized movement that critiques the reliance on diagnostic classification and psychopharmacology in psychiatric practice.
It also emphasizes the importance of understanding individual experiences and relationships in developing effective treatments.
It is interested in examining the social, cultural, and political factors that influence mental health.
Critical Psychiatry
Primarily concerned with challenging the concept of mental illness itself and the use of psychiatric treatments.
Often adopts a libertarian or existentialist perspective, emphasizing individual freedom and autonomy.
Antipsychiatry
Is the study of the effects of drugs on the mind and behavior. It involves the development, use, and study of medications to treat mental health conditions.
Psychopharmacology
It refers to the extent to which a test or measure accurately measures the underlying construct or theoretical concept that it is intended to assess.
In the context of psychiatric diagnoses, it refers to the question of whether the criteria used to diagnose a mental health condition accurately reflect the underlying psychological processes or experiences that the condition represents.
Construct Validity
Is influenced by philosophy, particularly hermeneutics.
Emphasizes the importance of context and the idea that human reality is open and full of potential.
Postpsychiatry
Provides a framework for understanding human experiences and relationships, emphasizing the importance of context, understanding, and interpretation.
Hermeneutics
Can be illustrated by the emphasis on understanding individual experiences and narratives.
Hermeneutics in Postpsychiatry
Role: Develops, manufactures, and distributes medications for various conditions, including mental health disorders.
Focus: Profit-driven, aiming to create new treatments for profitable markets.
Potential Concerns: Can be influenced by commercial interests, which may lead to over-promotion of certain medications or suppression of negative research findings.
Big Pharma (Pharmaceutical Industry)
Role: Medical field specializing in the diagnosis, treatment, and prevention of mental health disorders.
Focus: Patient-centered, aiming to provide effective and compassionate care for individuals with mental health conditions.
Potential Concerns: Can be influenced by the availability and promotion of pharmaceutical treatments, leading to over-reliance on medication or under-utilization of other therapeutic approaches.
Psychiatry
Psychiatry VS Pharma
Benefits: Pharmaceutical advancements have led to the development of effective medications for many mental health conditions, improving the lives of countless individuals.
Challenges: The commercial interests of the pharmaceutical industry can sometimes influence psychiatric practice, leading to concerns about over-medication, overdiagnosis, and the suppression of negative research findings.
What was Peter Kinderman’s )2014) take on psychiatric care?
‘One that truly offers care rather than coercion, therapy rather than medication, and a return to the common sense appreciation that distress is usually an understandable reaction to life’s challenges.’
Is a therapeutic approach that focuses on understanding the individual’s unique experiences and developing a personalized treatment plan based on that understanding.
It is often used in cognitive-behavioral therapy (CBT) and other psychological therapies.
Formulation-based Psychological Therapy
Diagnostic-based Approaches VS Formulation-based Therapy
Focus: Diagnostic-based approaches focus on identifying specific diagnoses, while formulation-based therapy focuses on understanding the individual’s unique experiences.
Treatment: Diagnostic-based approaches often involve standardized treatments, while formulation-based therapy involves personalized treatment plans.
Flexibility: Formulation-based therapy is generally more flexible and adaptable than diagnostic-based approaches.
Focus: Emphasizes understanding the individual’s unique experiences and developing a personalized treatment plan based on that understanding.
Treatment: Tailored to the individual’s specific needs and challenges, often involving a combination of therapeutic techniques.
Advantages: Can be more flexible and adaptable to individual differences, leading to more effective and personalized treatment.
Formulation-based Therapy
Focus: Relies primarily on identifying specific diagnoses based on standardized criteria (e.g., DSM-5).
Treatment: Often involves prescribing medications or using standardized therapeutic techniques that are thought to be effective for the diagnosed condition.
Limitations: Can be overly rigid and may not fully capture the individual’s unique experiences and needs.
Diagnostic-based Approach
Key points in reclaiming mental illness
1) Mental illness language seems highly appropriate to some forms of mental disorder
2) Differences between mental and physical illnesses have been exaggerated
3) Diagnosis can serve as an ‘agenda for action’, providing a framework for understanding and addressing mental health problems.
4) Diagnosis is not a complete description of the person but rather a statement that their presentation meets certain criteria.
A method of describing and categorizing abnormal experiences as reported by the patient and observed by the clinician.
Descriptive Psychopathology
Is the study of mental disorders.
It involves the classification, diagnosis, and understanding of abnormal thoughts, feelings, and behaviors.
Psychopathology
Is the classification of diseases.
In the context of mental health, it refers to the system used to categorize and diagnose different mental disorders.
Nosology
Is a philosophical approach that focuses on the study of experience and consciousness.
It emphasizes the subjective nature of human experience and the importance of understanding things from the perspective of the person experiencing them.
A valuable tool for exploring constructs like personality disorder, learning disabilities, and cognitive impairment.
Psychometric Testing
Specific assessment tools exist for various diagnoses, such as autism.
Structured Assessments
While not always diagnostic, it can be useful in the context of neuropsychiatric disorders.
Neuroimaging Techniques
Forensic practice relies heavily on these assessments to understand problematic behaviors and plan care.
Structured Risk Assessments
A biopsychosocial approach that incorporates biological, psychological, and social factors is often necessary for effective mental health care.
Eclectic Approach
