Week 1: Mental Illness and its Critics

Question 1

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.

Answer 1

Mental Illness

Question 2

What was Eliot Slater’s (1954) quote on Mental Illness?

Answer 2

‘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.’

Question 3

What was Peter Tyrer’s (1998) quote on Mental Illness?

Answer 3

‘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.’

Question 4

The process of identifying a specific mental health condition based on a set of symptoms and criteria.

Answer 4

Psychiatric Diagnosis

Question 5

Other medical conditions that might mimic the symptoms of an initial diagnosis.

Answer 5

Medical Differential

Question 6

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.

Answer 6

International Classification of Diseases (ICD) vs Diagnostic and Statistical Manual of Mental Disorders (DSM-V)

Question 7

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.

Answer 7

Grassroots

Question 8

A grassroots movement that promotes recovery from mental illness through self-advocacy, peer support, and community-based services.

Answer 8

The Recovery Movement

Question 9

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.

Answer 9

Postpsychiatry

Question 10

What did Thomas Szasz write in his ‘Myth of Mental Illness’ (1998)?

Answer 10

‘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.’

Question 11

What did R.D. Laing publish in his work, ‘The Politics of Experience’ (1967) about Mental Illness?

Answer 11

‘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.

Question 12

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.

Answer 12

Critical Psychiatry

Question 13

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.

Answer 13

Antipsychiatry

Question 14

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.

Answer 14

Psychopharmacology

Question 15

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.

Answer 15

Construct Validity

Question 16

Is influenced by philosophy, particularly hermeneutics.

Emphasizes the importance of context and the idea that human reality is open and full of potential.

Answer 16

Postpsychiatry

Question 17

Provides a framework for understanding human experiences and relationships, emphasizing the importance of context, understanding, and interpretation.

Answer 17

Hermeneutics

Question 18

Can be illustrated by the emphasis on understanding individual experiences and narratives.

Answer 18

Hermeneutics in Postpsychiatry

Question 18

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.

Answer 18

Big Pharma (Pharmaceutical Industry)

Question 19

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.

Answer 19

Psychiatry

Question 20

Psychiatry VS Pharma

Answer 20

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.

Question 21

What was Peter Kinderman’s )2014) take on psychiatric care?

Answer 21

‘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.’

Question 22

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.

Answer 22

Formulation-based Psychological Therapy

Question 23

Diagnostic-based Approaches VS Formulation-based Therapy

Answer 23

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.

Question 24

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.

Answer 24

Formulation-based Therapy

Question 25

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.

Answer 25

Diagnostic-based Approach

Question 26

Key points in reclaiming mental illness

Answer 26

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.

Question 27

A method of describing and categorizing abnormal experiences as reported by the patient and observed by the clinician.

Answer 27

Descriptive Psychopathology

Question 28

Is the study of mental disorders.

It involves the classification, diagnosis, and understanding of abnormal thoughts, feelings, and behaviors.

Answer 28

Psychopathology

Question 29

Is the classification of diseases.

In the context of mental health, it refers to the system used to categorize and diagnose different mental disorders.

Answer 29

Nosology

Question 30

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.

Question 31

A valuable tool for exploring constructs like personality disorder, learning disabilities, and cognitive impairment.

Answer 31

Psychometric Testing

Question 32

Specific assessment tools exist for various diagnoses, such as autism.

Answer 32

Structured Assessments

Question 33

While not always diagnostic, it can be useful in the context of neuropsychiatric disorders.

Answer 33

Neuroimaging Techniques

Question 34

Forensic practice relies heavily on these assessments to understand problematic behaviors and plan care.

Answer 34

Structured Risk Assessments

Question 35

A biopsychosocial approach that incorporates biological, psychological, and social factors is often necessary for effective mental health care.

Answer 35

Eclectic Approach