Understanding Human Behaviour - Essay Example

Understanding Human Behaviour The purpose of this essay is to critically examine the notion that the massive power of psychiatric diagnosisto devastate the identity of individuals designated ill and impose lifelong limitations through prophetic labelling is something that social workers need to be mindful of when working within the field of mental health. The essay at first discusses the psychiatric diagnosis and the massive power of the psychiatrist in detail. Then it moves onto discuss certain experiences of the service users and the problems they face. The latter part of the essay ponders over the areas on which the service users need to work on in order to avoid misdiagnoses and also focuses on the ways that should be adopted by psychiatrists in order to understand the disability and mental health of the individuals. Also it discusses the problems that are faced by the health departments in the introduction of certain programmes because of the criticism of the service users. Thesis Statement and Research Methodology In this research essay I would focus on the notion that the massive power of the psychiatrists in the process of the diagnosis is something that has implications on the patients and this is something that should be given more importance. For the purpose of my research I have used many literature reviews. Psychiatric diagnosis-the massive power of the service user Psychiatric diagnosis refers to the process whereby the psychiatrist (or psychologist) is responsible for the identification and the labelling of a particular disease. One of the main purposes of this diagnosis is to help people and guide them through the entire treatment procedure. Lately, it has been felt that the diagnosis has had many different implications on the individuals concerned. According to Reich (1981) psychiatric diagnosis is a very important process because it can have varied effects on the patients. While some may be happy with the results of the diagnosis, others might not feel the same way. One implication of the procedure of the diagnosis is that the people who are diagnosed may have to suffer from unintended implications. For instance, the perceptions of the others might change towards the patient if he/she is labelled with a mental disorder. People may not want to interact with such patients. Reich (1981) argues that the main reason for this behaviour is the result of the institutionalized attitudes of the people and the society as a whole towards people who suffer from mental disorders and learning disabilities. The above mentioned effects may occur due to the attitudes of the people and the society to the mental people. There are, however, other implications that may result just because of the carelessness of the psychiatrists. A potential misdiagnosis can also have harmful and bad effects on the patients. Reich (1981) argues that a misdiagnosis on the part of the psychiatrist or any other service user does not just include the subjection to noxious and deadly treatments and procedures. It can lead to the loss of personal freedom in the patients. Other implications may include the life-long labelling of a person and thus the patient may also be subject to legal and social disadvantages. Families might not declare the patients to be responsible for things like the financial matters. According to Reich (1981) it can lead to the deprivation of life in some very extreme cases. The whole point of describing the effects and the implications on the patient is to show how important it is for the psychiatrist to carry out the diagnosis according to the standards prescribed by the government and the medical associations. The power of the psychiatrist is one of the most important reasons for the misdiagnosis of mental disorders. Mental health clinicians or service users (psychiatrists and the psychologists) are mainly the only ones responsible for the diagnosis of the mental disorders. According to Beutler and Malik (2000) the power of the diagnosis lies with the diagnostician because of three reasons. Firstly, it is because of the superior knowledge and expertise of the doctor (psychiatrist in this case), secondly because of the virtue of the doctor to help the individual and thirdly because of the patient’s faith in the doctor. Hence the role of the psychiatrists is important in the process of diagnosis and labelling because the patients have trust in them and their diagnoses. This gives the psychiatrists ultimate power over the patients. According to Lord Acton (1968), “Power tends to corrupt, absolute power corrupts absolutely” The massive power of the diagnostician is mainly responsible for the misdiagnosis of certain patients. Szasz (1994) argues that the psychiatrists are not just powerful because of their professional expertise but also due to their state laden authority. He further argues that the role of the psychiatrist is like that of a policeman or a prison guard. The responsibility of the psychiatrist here in this example is just to arrest or imprison the law breaker, irrespective of the crime committed. This way the psychiatrist is different from other physicians because of the increased power he/ she has over his/ her patients. The patients are also different from the normal patients because of their economic dependence and deviance from the normal society. The level of social deviance that the mental patients suffer from is the reason why they can be exploited easily by the psychiatrists and psychologists. Now that the paper has discussed the power of the service workers in the diagnosis of the mental disorders in much detail it is important to move on to discuss some of the experiences of the service users towards the procedures relating to the medical health. Different projects undertaken According to Barnes and Bowl (2001), it was in the late 1960s when it was realised that there should be something done about the process of the diagnosis and the handling of the mental and disable patients. Collective action was taken against the handlers of the patients and for the first time the rights of the disable and the mental patients were taken into consideration. Various strategies and tactics were introduced so as to ensure that the mental patients were not mistreated in any way or were subject to unkind treatment on the part of the service users that included the doctors, the nurses and the psychologists. A number of actions are still a part of the contemporary movement regarding the rights of the disable and the mentally ill according to Barnes and Bowl (2001). Some of the projects introduced for this purpose include groups that focus on different aspects of the mental well being of the patients. For example certain actions include individual advocacy where both the patients and the doctors can interact in a different range of settings as Gray and Jackson (2002) relate. Individual advocacy ensures that the patients and the doctors can have a better mutual relation based on proper care. When the doctors and the patients are provided with sufficient backing that may be economical, psychological etc, there is a lesser chance of the psychiatrists exercising their authority over the patients in the process of labelling. The projects undertaken by the contemporary movements also include different forums where the problems of the psychiatrists and the patients are discussed in detail. An example of such a forum, according to Barnes and Bowl (2001), is the Hearing Voices Forum. This forum is used by the service workers and the patients alike, in order to develop an understanding for the experiences and the problems of each other. Every person at the forum is allowed to speak out while the others listen. This way they can relate their own experiences to those of the others. For example it is likely that the doctors and the patients share same experiences. This way they can be in a better position to understand each other. The patient would develop a greater trust in the doctor and the doctor (psychiatrist) would be in a better position to diagnose the mental illness or disability properly. Usually in such forums, the black specialists and the women are also allowed to discuss their particular experiences. Since the blacks and the women are less empowered their experiences are somewhat similar to the patients who are deprived of economic independence. Such experiences make it easier for both the doctors and the patients to understand each other well. Some projects can also focus separately on the doctors and the patients. For example, counselling sessions, as Barnes and Bowl (2001) relates, can be introduced in order to make the doctors aware of their responsibilities. This way they can be bestowed with the authority to treat the patients however they can be made to realise at the same time that they have a duty towards the well being of the patients. The providing of certain grants to the doctors can also ensure that the psychiatrists do not exploit the patients just for the sake of economic benefits. Projects such as these have helped many doctors and service users. According to Barnes and Shardlow (1996), one of the doctors shared his experience stating that the projects gave him confidence and assurance and as a result he could do his job more happily. Apart from projects that focus entirely on doctors, there are some that concentrate on the well being of the patients. Examples include projects that share the experiences of the patients through arts and literature as Barnes and Bowl’s (2001) study reveals. Such projects are particularly important because they can help the patients to discuss and elaborate on things that are not easy to discuss. Such projects also include some that can relate the experiences of the individuals to the disempowerment or the reasons of the mental stress. The patients can be more open about their problems and this way their illnesses can be easy to diagnose and treat. Such projects have been helpful for many patients in the past. According to Barnes and Bowl (2001), one of the patients was reported as saying that such a project helped her attain such strength that she felt that it was highly unlikely that the professionals could take any advantage over her. Other more stringent approaches to the problem obviously would include protest actions. An example of that would be the action that was taken by the parliament against the Community Treatment Orders in 2000 as Barnes and Bowl (2001) relate. Such approaches can lead to the implementation of the policies where the authority provided to the service users can be greatly challenged. This way the government and the health department can ensure that the psychiatrists involved are given the minimum possible authority over the patients by holding the service users accountable to other people. This however is not a very efficient method. This is because, as Barnes and Bowl (2001) relate, the process may be a tedious one where the psychiatrists and the other service workers might also have to cooperate with the government and the health department in the designing of the policies. The reduction of the power is also likely to affect the morale of the psychiatrists and protests from the service users are also inevitable. Resisting change Although all of the above mentioned methods can be used to improve the service user/survivor relationship, it is understandable that that there are challenges associated with managing of change. This is evident by the fact that less has been done till date to improve the service user/ survivor relationship. Different projects as mentioned before have been introduced and the principles that underline the diagnosis process have been discussed in detail. However, the doctors still have a lot of authority over the mentally ill and disable patients. According to Parkes (2002), the reviewing of the service user empowerment leads to the service users losing trust and confidence in the health department. One of the service users was reported as saying that they were not allowed to exercise power because they were treated as threats. He also argued that the government and the health department wanted people who could just follow what ever the department said blindly. Many service users also argue that the funding of the user groups has increased over the years and thus there should be an increase in the number of the people involved in the project; however, that does not exist to be the case. According to the service users, as Barnes and Bowl (2001) discuss, there is limited involvement and they are usually not in control. They are not asked about the policies that are to be implemented and the involvement is usually about individual partnership so there is no point of the user involvement programme. Service users also argue that the projects introduced do not help because the sending of the committees in order to discuss the problems is not the only solution. They believe that if the problem has to be tackled it has to be done in a proper way. For them, the sending of the committees does not help because the members of the committee just listen to the problems of the people and do nothing about them. Some of the service users also argue that the involvement process does not help because some service users are not very keen on sharing their experiences. Parkes (2002) states, that talking about the experiences of the hospitals does not help many service users. This is because they are so worn out of similar experiences. In his words, “They’re just worn out with banging their head against a brick wall” Hence, the funding by the health department may be sufficient but the degree of the involvement of the service users is a critical determinant of the success of the policy. Sadly, there is less interest among the service users for the service user involvement processes. The reason is that they do not want to accept the change that can actually undermine their authority in the long run. Conclusion To conclude, the massive power that the service users possess over mentally ill and disable patients is mainly responsible for the misdiagnosis of certain patients. Because of the extreme power they have, service users are not really accountable to any one and hence can diagnose and label a patient with such a mental disorder that it can change the life of the patient greatly. Service users in working with the mental health should be mindful when coming to diagnoses and should not take advantage of their power over the patients. To tackle with the problem of the massive power of the services users, a lot of projects have been introduced that help to develop a better relation between the doctor and the patients. Also, they ensure that the experiences of both the service users and the patients are given importance and consideration. These projects, however, have failed to achieve the desired objectives. The resistance on the part of the service users to the change is one reason for the failure of these programmes. It is important that this problem is given more consideration and the service users are allowed to express their opinions too. This way they would take more part in the programmes and in the long run it would ensure that their power is not misused. References   Balloch, S. and Taylor, M. (2001). Partnership working: policy and practice. Bristol. Policy Press.   Barnes, C. and Mercer, G. (2006). Independent futures: creating user-led disability services in a disabling society. Bristol. Policy Press.   Barnes, M. and Bowl, R. (2001). Taking over the Asylum: Empowerment and Mental Health. Basingstoke. Palgrave. Beutler,L. and Malik, M. (2000). Alternatives to the DSM. USA. APA.   Cambridge, P. and Carnaby, S. (2005) Person centred planning and care management with people with learning disabilities. London. Jessica Kingsley.  Care Services Improvement Partnership. (2006). 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Department of Health.   National Institute of Mental Health for England. (2004). The Social Work Contribution to Mental Health: The Future Direction. London. NIMHE. Szasz, T. (1994) .Psychiatric Diagnosis, Psychiatric Power and Psychiatric Abuse. Russia. BMJ Publishing Group. Read More