Is being ‘mentally ill’ the new normal?
Q: Everywhere I look, someone has a new diagnosis — my neighbour’s toddler, my teenage son’s classmates, even my elderly mother in aged care. Is being ‘mentally ill’ the new normal?
Dr Wright answers:
Listen up Australians. If we are to believe our former health minister, Peter Dutton (August 2014), forty six per cent of us will develop a mental illness in our life times — a staggering increase in ‘seeing’ mental illness as available to us all. This being the case, we may qualify to be in SANE, the new online support forums initiated to support us.
Not only will the near majority of us have our individual identities transformed to treatable disorders; with the publication of the Fifth Edition of the Diagnostic and Statistical Manual (DSM-V, 2013), we have a wide selection of available diagnosable ‘conditions’ from which to choose — ‘illnesses’ which in the past may have been seen as human dilemmas, rather than mental disorders.
Fast tracking socio-cultural history, our current situation may be seen as the emergence of a dominating medical framework investing in ever-expanding finer layers of distinction of human categorisation. The post-war First Edition of the Diagnostic and Statistical Manual of Mental Disorders (1952), for example, catalogued 60 different mental health disorders, and by 1994 the fourth revision listed 297 disorders and 400 specific psychiatric diagnoses. The Fifth Edition (2013) continues in the vein of further expansion of yet another kind — the definitions of ‘conditions’ are broadening in scope, thereby embracing greater inclusivity of the general population in a widening array of diagnosable disorders.
In recent decades, such expansion provoked the attention of sociologists, like Erving Goffman, who detailed the ‘career’ of the mental health patient in his 1962 book ‘Asylums’. While we celebrate the end to asylums, the phenomenon of ‘medicalisation’, first introduced in 1976 by Professor Peter Conrad, Brandeis University, Boston, highlights how the insidious process of ‘creating’ mental illness, including children’s behaviour, is expanding worldwide.
A growing number of academics and social critics are building on Conrad’s pioneering framework. I myself have been interested in the medicalisation of human dilemmas for at least a decade. The arising questions, as I see them, concern the ‘drivers’ of medicalisation and the benefactors.
How do we grapple with genuine mental illness, while depriving the big business of fashionable ‘designer labels’ applied to our infants and aged population? We boast of replacing the “putting away” of the “weird”, “troublesome” or “inattentive” as seen in Victorian-style asylums (ADHD was not available in those days) with new-found acceptance, but have we created new-age asylums of a different kind — digitally recorded mental health pedigrees, available to almost anyone and everyone?
I return to the central question as to why we feel the need to ‘diagnose’ human troubles of all kinds. We can derive a clue, if not the answer, from the example seen in school funding in many parts of the western world, including Australia. Resource-starved schools vie for additional resource dollars to support students with particular learning and behaviour needs using the most powerful and possibly the only serious currency available to them — mental health diagnoses in children. Public resources, being sought after by competing forces, are dealt out “fairly”, as described, on the strength of bona fide solid medical diagnoses. The facts are that such diagnoses are no more solid than water in a twisting stream — Dr Google often sets the course, desperate parents seek help, resource-stretched teachers are grateful — and humanitarian health professionals feel that they have ‘helped’. Forget the spurious means of obtaining diagnoses — the end justifies the means, correct?
The arising meta-themes are far too complex to deeply explore in an article of required brevity such as this — but I arrive at the provocative question as seen above: is being ‘mentally ill’ the new normal?
I close with this final thought. While we celebrate an end to asylums, as they were, let us not be so sure that new ways of social categorisation are in our best interests. How do we feel, for example, when we hear that yet another tiny Australian, perhaps just three years of age, having had no say in the matter, often in a single consultation, has been diagnosed as having a mental illness and medicated with psychotropic medication — a digitally recorded mental health label, a relieved mother in tow, and a slightly better resourced pre-school — satisfied? And what are we to think when our eighty-three-year-old grandmother, in aged care, trades her unique identity for a mental health label — gratified? And what of our pimply faced contrarian fourteen-year-old son, who now thinks he’s a ‘weirdo’ because he has a diagnosis of a mental illness — cool?
Perhaps we can join a host of well-meaning medical professionals and all be in SANE — perhaps not. Let’s talk.
Dr Gloria S Wright is an internationally recognised educator, child expert and speaker. She directly supports parents by bridging the gap between home, school and clinical reports or diagnoses. Her emphasis on education, rather than ‘medicalisation’, provides alternative ways of understanding and managing children’s learning and behaviour. For techniques and strategies for your specific situation, connect with Dr Wright.
