Sunday 28 May 2017

Mental Illness And Labels: Helpful Or a Hindrance?

Mental Illness And Labels: Helpful Or a Hindrance?  mental health wellbeing support help OCD psychology depression anxiety time to change mind blogger UK

This isn't something I've really given much thought of before. That was until we studied, Rosenhan's study; on being sane in insane places (1973), in my psychology class. Rosenhan conducted two experiments. In the first one, he gave confederates, acting as pseudopatients the task of getting into a psychiatric hospital. They complained of hearing voices. In particular, hearing three words ' Hallow' 'empty' 'Thud', they reported no other symptoms. All eight of the patients were given the diagnosis of schizophrenia and admitted to hospital although this symptom alone is not enough for someone to be diagnosed with schizophrenia

Once the patients were in the hospital, they started to act as normal. They said they were fine and reported no symptoms. Yet on average, the number of days someone stayed was 19, with the most being 52 and the least being seven. While in the hospitals they took detailed notes about what they were observing and their experiences. Firstly in secret, but once they realised no one was fused, they did it in public. However, the nurses in the hospital saw this behaviour as a symptom of their disorder calling it excessive writing. They also believed queuing for lunch was unusual and another symptom of their disorder.

In the second experiment, Rosenhan said he was going to send pseudopatients to the hospitals, and they should look out for them. 193 were reported as fake by at least one member of staff. Yet, Rosenhan sent no pseudopatients. In experiment one they made a type one error; diagnosing healthy people as sick and in study two a type two error; diagnosing ill people as healthy. You may be wondering what on earth has this got to do with mental illness and labels, but let me explain.

From these studies, Rosenhan developed the theory of 'stickiness of labels'. He believed that once someone is given a label if they keep referring to that person with that label, all their subsequent behaviour will be seen as an element of their illness, whether it is or isn't. Which is why perfectly healthy people in the study found themselves stuck in psychiatric hospitals and those who were genuinely ill couldn't get the help they needed.

If you think about it, nothing has really changed. When you are given a label, it can be really hard to shake that label off. For example, I have OCD. Although my OCD has nothing to do with me being neat, organised and tidy. Yet because all my teachers know that I have OCD, they think the reason why I prefer to type my work, why I always hand it in a plastic wallet and why I take my time over everything is all because I have OCD. They couldn't be further from the truth. However, you could argue that this is a result of the misconceptions around OCD. I personally feel that it's a mix of both.

But take depression or anxiety for example, if someone knows you have depression. They may assume that every bad day is because you are ' depressed' or if you have anxiety, every time your nervous is because you have an anxiety disorder. When actually we all have bad days, it's just part of being human. You don't have to have depression. Likewise, we all get nervous. Exams and job interviews make us all nervous at the best of times. It doesn't mean you have a diagnosable anxiety disorder.

Mental Illness And Labels: Helpful Or a Hindrance?  OCD depression anxiety help support time to change mind NHS mental health wellbeing CBT

Taking this into account, mental health labels can be seen as a hindrance. If once you have a label, it sticks. This can be particularly hard if you start to recover from your illness and change your behaviour, but people still know you by your label. What if you were misdiagnosed? The label you were given wasn't even accurate, like the Confederates used in Rosenhan's study? Think of how devastating that must be for the individuals who are given this label which they definitely know isn't true.

This is why doctors and professionals often over-diagnose. They think it's better to be safe and sorry. They don't want to make a type two error like in the second experiment of Rosenhan's study. Although in theory, this may sound better, is it really? Is it fair for individuals to think they are sick when they aren't? How much of an impact will that have on their life? Labels can often be a self-fulfilling prophecy. Once you are given a label, you can start to believe this label and start acting in a way that confirms it. In these instances, labels appear to be a hindrance. Is it better to over or under diagnose? Or are they as equally bad as each other?

However, if we didn't have any labels, what would we use to diagnose people, to ensure they got the correct treatment needed for a successful recovery? Doctors and medical professionals use the DSM-5 to diagnose individuals with mental illnesses. The DSM-5 is basically one big fat book which lists every possible mental illness within our current understanding. In theory, this should help diagnose and decide on the appropriate treatment for the individual.

In these instances, labels are very helpful. You can't give someone with depression antipsychotics; likewise, you can't give someone with schizophrenia antidepressants. It's not going to make them better. If anything it will make them worse. If we just had a blanket term of ' mentally ill' would that be any better? Would anyone really get better? You wouldn't be able to treat every physical illness with the same prescription of antibiotics, so surely you can't do the same for mental illness.

That leads me to conclude that we need something in the middle. We need labels to provide a common language for mental illness to allow medical professionals to communicate with each other but also with their patients to ensure they can get the best treatment to help them on the road to recovery but with labels comes misunderstanding. People will always use labels incorrectly, claiming they have an illness when they don't. I think it's important for individuals and charities to continue to spread awareness and educate people about what the labels they chuck about without thinking, really mean. I also believe that it's the media's job to take more responsibility with how they talk about mental illness and being more considerate about the language they use to describe it.

So I guess, long story short, we need to find a middle way between the two. 

I hope you enjoyed this post. It's something a bit different from the usual, as I don't usually include elements of what I've learnt in psychology, but I'm definitely considering doing it more often if you like.

I would love to know your thoughts on the topic in the comments below. Do you think mental health labels are helpful or a hindrance? Let me know 

Thanks for reading, as always X 

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