Diagnoses ‘neither necessary nor sufficient’
A new study, published in the Journal of Mental Health, finds psychiatric diagnoses are seldom used as entry criteria for NHS mental health services.
Despite controversy over their validity, and the damage they can do to people who receive the labels, psychiatric diagnoses are usually argued to be essential for accessing care, determining treatment options, communicating between mental health professionals, and planning services.
Psychiatric diagnoses ‘neither necessary nor sufficient’ for access to NHS care
The Diagnosis Question
Increasingly, mental health problems are labelled as an illness like any other. But can a focus on diagnoses, rather than experiences, harm as well as help?
What is Mental Health?
Despite the term’s omnipresence, there is very little consensus in terms of definition. In 2014, the WHO defined mental health as: “A state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”
The Diagnosis Question
Introducing the Power Threat Meaning Framework
A group of senior psychologists (Lucy Johnstone, Mary Boyle, John Cromby, David Harper, Peter Kinderman, David Pilgrim and John Read) and high profile service user campaigners (Jacqui Dillon and Eleanor Longden) spent five years developing the Power Threat Meaning Framework as an alternative to more traditional models based on psychiatric diagnosis. They were supported by researcher Kate Allsopp, by a consultancy group of service users/carers, and by many people who supplied examples of good practice that is not based on diagnosis.
The Power Threat Meaning Framework
MAD in the UK (MITUK)
MITUK’s mission is to serve as a catalyst for fundamentally re-thinking theory and practice in the field of mental health in the UK, and promoting positive change.
We believe that the current diagnostically-based paradigm of care has comprehensively failed, and that the future lies in non-medical alternatives which explicitly acknowledge the causal role of social and relational conflicts, abuses, adversities and injustices. MAD in the UK (MITUK)
Inner Compass Initiative
We believe that within each and every person lies an innate wisdom — an “inner compass”. This wisdom, when listened to, helps us to navigate the difficulties of being human. But the mental health industry, with its medicalised model of “mental illness” and “mental health”, its pharmaceuticalised and institutionalised standards of care, its massive promotional and public relations apparatus, its legalised authority, and its professionalisation of help, has influenced many of us to ignore and lose touch with this inner wisdom.
Inner Compass Initiative strives to contribute towards everyone reclaiming wisdom, knowledge and power, both within us as individuals and between us in our relationships and communities. We work to support individuals to engage in curious, critical, independent self-education and inner exploration, and collectively, to help develop more interconnected, empowered and resilient grassroots communities.
Inner Compass Initiative
Inner Compass Initiative
We believe that within each and every person lies an innate wisdom — an “inner compass”. This wisdom, when listened to, helps us to navigate the difficulties of being human. But the mental health industry, with its medicalised model of “mental illness” and “mental health”, its pharmaceuticalised and institutionalised standards of care, its massive promotional and public relations apparatus, its legalised authority, and its professionalisation of help, has influenced many of us to ignore and lose touch with this inner wisdom.
Inner Compass Initiative strives to contribute towards everyone reclaiming wisdom, knowledge and power, both within us as individuals and between us in our relationships and communities. We work to support individuals to engage in curious, critical, independent self-education and inner exploration, and collectively, to help develop more interconnected, empowered and resilient grassroots communities.
Inner Compass Initiative
Victim Focus
Jessica Eaton is the founder and owner of VictimFocus, the VictimFocus Blog and The Eaton Foundation. VictimFocus is her independent business providing research, consultancy, writing and speaking in forensic psychology, feminism and mental health. The VictimFocus Blog has over 30,000 readers per month and provides a lively, funny and critical perspective on CSE, victim blaming and sexual violence. The Eaton Foundation is a registered charity providing free, holistic mental health and wellbeing support to men over 18 years old and Jessica set up the first male mental health centre in the UK in 2015.
Jacqui Dillon
Dr Jacqui Dillon is a respected activist, writer and speaker, and has lectured and published worldwide on trauma, abuse, psychosis, dissociation and healing. Jacqui is the national Chair of the Hearing Voices Network in England, Honorary Lecturer in Clinical Psychology at the University of East London, Visiting Research Fellow at The Centre for Community Mental Health, Birmingham City University and a member of the Advisory Board, The Collaborating Centre for Values-Based Practice in Health and Social Care, St Catherine’s College, Oxford University. Jacqui has co-edited 3 books and has published numerous articles and papers, is on the editorial board of the journal Psychosis: Psychological, Social and Integrative Approaches and the founder of the Beck Road Alliance (BRA) which exists to support survivors of organised childhood sexual abuse on Beck Road, Hackney, and all survivors everywhere, to share their testimonies of surviving childhood sexual abuse. In 2017, Jacqui was awarded an Honorary Doctorate of Psychology by the University of East London.
Eleanor Longden Ted Talk - The voices in my head
To all appearances, Eleanor Longden was just like every other student, heading to college full of promise and without a care in the world. That was until the voices in her head started talking. Initially innocuous, these internal narrators became increasingly antagonistic and dictatorial, turning her life into a living nightmare. The voices in my head
Depression, its true nature
His own life experiences and his life as a mental health activist, medical doctor, psychotherapist and mental health author have brought him to a level of understanding of mental health that is unusual if not indeed exceptional. Depression, its true nature
Terry is the author several best selling books: Depression Delusion Volume One: The Myth of the Brain Chemical Imbalance (2015), Selfhood: A Key to the Recovery of Emotional Wellbeing, Mental Health and the Prevention of Mental Health Problems, (2011) and best-seller Beyond Prozac: Healing Mental Distress (2004).
Peter Breggin hour
Patrick D. Hahn takes us on an energetic tour of the Pharmaceutical Empire from fish exposed to Prozac and Xanax in contaminated rivers to corrupt doctors being paid off at Harvard. The Pharmaceutical Empire pollutes at every level. Patrick exemplifies how professionals outside the mental health field are appalled by what they find going on with psychiatric drugs and can make important contributions to critical psychiatry and pharmacology. Be informed and be inspired! Peter Breggin hour
Hearing Voices Network
If you hear voices HVN can help – we are committed to helping people who hear voices. Our reputation is growing as the limitations of a solely medical approach to voices become better known. Psychiatry traditionally refers to hearing voices as ‘auditory hallucinations’ but research shows that there are many explanations for hearing voices. Many people begin to hear voices as a result of extreme stress or trauma. Hearing Voices Network
Let's Talk Withdrawl
Welcome to Let’s Talk Withdrawal, a new weekly podcast discussing antidepressants and the issues surrounding them. We present real experiences of antidepressant treatment including withdrawal and tapering and experts tell us what it’s really like within the modern mental healthcare system. Come and join us to listen to stories from around the world that are sometimes shocking, sometimes inspirational but always fascinating and enlightening. Hear the real story of the drugs used to treat anxiety, depression and other mental illnesses and the brave people who struggle with them. Let’s talk withdrawl
Mad in America
Mad in America’s mission is to serve as a catalyst for rethinking psychiatric care in the United States (and abroad). We believe that the current drug-based paradigm of care has failed our society, and that scientific research, as well as the lived experience of those who have been diagnosed with a psychiatric disorder, calls for profound change. Mad in America
Rachel Waddingham - Behind the label
I ended the last century in a psychiatric hospital, diagnosed with schizophrenia and with little hope for recovery. Seen as a ‘revolving door patient’ with a severe and enduring mental illness, I lived my label – not my life. I bought into the idea that schizophrenia (and the many other illnesses I was labelled with) were life-long mental illnesses. I accepted that the best I could hope for was to manage my symptoms with life-long psychiatric medication. Life, I’m glad to say, doesn’t always turn out the way you think. Behind the label
Behaviorism and Mental Health by Philip Hickey
An alternative perspective on psychiatry’s so-called mental disorders. Behaviorism and Mental Health by Philip Hickey
Understanding Psychosis and Schizophrenia
Edited by Anne Cooke (@AnneCooke14). An overview of the current state of knowledge in the field, concluding that psychosis can be understood and treated in the same way as other psychological problems such as anxiety or shyness. This report describes a psychological approach to experiences that are commonly thought of as psychosis, or sometimes schizophrenia. It complements parallel reports on the experiences commonly thought of as bipolar disorder and depression. Understanding Psychosis and Schizophrenia
The Latest Mania: Selling Bipolar Disorder
One of the most famous direct-to-consumer television adverts for a drug begins with a vibrant woman dancing late into the night. A background voice says, “Your doctor probably never sees you when you feel like this.” The advert cuts to a shrunken and glum figure, and the voiceover now says, “This is who your doctor usually sees.” Cutting again to the woman, in active shopping mode, clutching bags with the latest brand names, we hear: “That’s why so many people with bipolar disorder are being treated for depression and not getting any better—because depression is only half the story.” The Latest Mania: Selling Bipolar Disorder
Gary Sidley, PhD - Evolution or Revolution?
Five years ago, when I worked as a clinical psychologist within the UK’s psychiatric system, a senior colleague urged me to be patient. After hearing me – again – express my frustrations at the speed of change, and the stubborn endurance of bio-medical approaches to human suffering, he would urge me to aim for modest, incremental improvements in the existing system, to not expect too much too quickly, and to strive for ‘evolution not revolution.’ But how realistic is it to expect that the biological skew of Western psychiatry can be sustain-ably changed one small step at a time? Evolution or Revolution?
Division of Clinical Psychology publications
Gives open access to Division of Clinical Psychology publications, including DCP 2011 Good Practice Guidelines on the use of Psychological Formulation, Clinical Psychology Forum Nov 2015 special edition on Team Formulation, and accessible leaflets on ‘Understanding diagnosis in adult mental health’ and ‘Understanding formulation.’ Division of Clinical Psychology publications
Paula J. Caplan, Ph.D - On Trump and Psychiatry
Once you know a crucial fact about what gets called “mental illness”, the debate about whether or not President Donald J. Trump is “mentally ill” disappears, and what is left is what really matters. What really matters is that President Trump apparently has no desire to change behaviour that has been described as totally self-absorbed, self-referential, misogynist, racist, xenophobic, and otherwise abusive. It’s ironic that the arguments on both sides of the debate about whether or not Trump is “mentally ill” are based on the one “alternative fact”: that deciding who is “mentally ill” is a science. That could not be farther from the truth. On Trump and Psychiatry
Paula Caplan’s websites:
Ending Harm from Psychiatric Diagnosis
Paula Joan Caplan
Dr Lucy Johnsone - interview with Peter Breggin
Lucy Johnstone, PhD is a marvelous British psychologist on the cutting edge of what’s good in the field. She promotes”psychological formulation,” including the patient’s input, to replace psychiatric diagnosis. Yes, replace it!
Dorothy Rowe
Dorothy Rowe is a clinical psychologist and writer who is renowned for her work on how we create meaning, and how the meanings we create determine what we do. Her application of this understanding to the problems of depression and of fear has changed many people’s lives for the better, and has caused many mental health professionals to think more carefully about how they deal with people who are suffering great mental distress. She writes regularly for newspapers and magazines, appears frequently in the media, and is the author of over 15 books. www.dorothyrowe.com.au/
There Are No Rules About Psychiatric Diagnosis
Paula J. Caplan, PhD, discusses the unscientific nature of psychiatric diagnoses and how much harm they cause. She also reveals that psychiatrist Allen Frances, who for years has claimed that he could not possibly have foreseen the epidemics in psychiatric diagnosing of children — which emerged from the editions of the diagnostic manual that he helmed — and who has blamed Big Pharma as largely responsible for those epidemics and the resulting heavy psychiatric drugging of children was actually paid handsomely to promote Risperdal, which is the neuroleptic most used in children. [watch video]
The Power Threat Meaning Framework
The Power Threat Meaning Framework is a new perspective on why people sometimes experience a whole range of forms of distress, confusion, fear, despair, and troubled or troubling behaviour. It is an alternative to the more traditional models based on psychiatric diagnosis. It applies not just to people who have been in contact with the mental health or criminal justice systems,but to all of us.The Framework summarises and integrates a great deal of evidence about the role of various kinds of power in people’s lives;the kinds of threat that misuses of power-pose to us;and the ways we have learned as human beings to respond to threat.In traditional mental health practice, these threat responses are sometimes called ‘symptoms’. The Framework also looks at how we make sense of these difficult experiences, and how messages from wider society can increase our feelings of shame, self-blame, isolation, fear and guilt. [download]
Guidelines On Language in Relation To Functional Psychiatric Diagnosis
This document is intended to support clinical psychologists in the development of documents using language consistent with the Division of Clinical Psychology (DCP) position on functional psychiatric diagnoses.
Also see: Resources, Links, Reading, Videos, Trauma informed