How Does a Psychiatrist or Psychologist Go about Establishing Whether a Person Is Mentally Ill or Not - Coursework Example

How does a psychiatrist or psychologist go about establishing whether a person is “mentally ill” or not? Full February 11, 2009 It has become more and more apparent that the meaning of mental illness is not at all precise and is dependent on interpretation. These difficulties have led some to assert that psychiatry is remotely distant from being an exact science. The following essay investigates some of the difficulties in precisely defining mental illness. Why Mental Illness is difficult to define The main reason that contributes to making it difficult to differentiate normal mental health and abnormal mental health is that there is no simple test to ascertain mental illness. There is no blood sample for delusional malady, no ultrasound for schizophrenia and no X-ray for post traumatic stress disorder, for example. That does not mean that mental illnesses are not biologically based. On the contrary, majority of mental health doctors maintain that some mental illnesses are connected to chemical changes within the brain, and new methods allow mapping these changes visually using imaging tools (Elster, 1999). Presently, however, there exists no physiological diagnostic test for mental illness. Societal and Cultural Differences The standards set by society are broadly subjective and often connected to moral rules which change over time as social attitudes alter. This approach to standards is the cause of many serious abuses of human rights. An example of a cultural difference in definition is suicide.  In many nations, such as those in the West, a person who commits suicide or attempts to do so is regarded as mentally ill. Another example is the former Soviet Union who regarded those who differed from the Communist Party line as being diagnosed with schizophrenia (Hacking,1998). On the other hand, in the United States, people who objected to the Vietnam War were at times considered to be mentally ill. Furthermore, not all people who are mentally ill may be aware of their weaknesses. For instance, Schizophrenics often reject that something is wrong with them. Hence, the meaning of disorder is subjective and varies upon culture and social context (Hacking, 1998). A further issue in diagnosis is that doctors specializing in mental health may diagnose symptoms basing on their individual or cultural prejudices, thus diagnosing different results. A research studied this effect videotaping three hundred American and British psychiatrists interviewing eight patients with mental disorders (Culver, 1982). Even though the doctors’ diagnoses essentially were similar for patients with theoretical cases of schizophrenia, their diagnoses differed broadly for patients who had symptoms of both schizophrenia and other mental illnesses, varying on whether the doctor was American or European. Thus, the danger of incorrect diagnosis is even larger when the doctor and the patient are from different cultural backgrounds. For this reason, unequivocal assertions about what is normal or abnormal cannot be made. Hacking (1998), writing on race, culture and ethnicity, maintains that psychiatric illnesses which are seen in Western (white, Caucasian) societies are almost completely different from those seen in non-Western (non-white) societies. Mental health experts thus are inclined to think similarly, and would diagnose symptoms in the West with basic textbook methods and see those occurring in other countries as unique from the accepted Western treatment. Biological and Medical Model New medical findings and research can likewise lead to changes in meanings of healthy normal mental state. A major method to psychiatric categorization is the medical model. This method maintains that psychiatric categorization is able to be systematic and unbiased (Boorse, 1976). The counterpart thinking is that psychiatric categorization relies mainly on the impulse or values of those performing the categorizing, that it could not be objective. Furthermore, this thinking maintains that there are no facts regarding what is normal. These subjective models are in general suggested with the purpose of criticizing or destabilizing psychiatry, and adhere to the opinion that there is really no such thing as mental illness; hence there could not be a valid objective categorization of various types of mental illness. In most cases, the opinion that is attached to these views is that categorization methods are constructed to fit the needs of those in control. This opinion has not been debated extensively yet but is implied in the work of Szasz, and it may several sociological theorists. As for its acceptability, the opinion that the categorization is totally biased or arbitrary hinges on the denial of objective reality in mental illness, although it has not received considerable support (Culver, 1976). Most arguments on categorization have been between various interpretations of combined models, and with certain arguments between combined models and of the biological model. The medical model says that to determine whether a particular condition is normal or abnormal is determined by science (Hacking, 1998). It does not ignore the fact that science has supplied many of the answers and it may agree that there is a huge amount of research to be done. It may even surrender that people will never be able to gather enough proof to evaluate whether a certain condition is abnormal or not. This argument would then conclude in such a situation that people cannot know the truth. The biological (medical) model started during the end of the nineteenth century with the discovery that brain damage could cause thought and mood disturbances and weird behavior (Mele, 1996). This conception of abnormal behavior as an illness was an improvement on previous opinions, which considered abnormal behavior to be caused by the possession of supernatural beings or immorality. However, some segments of society still argue and believe in the older view even until today. The more modern opinion resulted in more compassionate treatment, because persons were not held accountable for their actions. Patients were sent to hospitals instead of being sent to prison or killed as witches. The improvement of the medical model was regarded to supply psychiatry with a tool of functioning outside the sanctuary and to construct a certain professional structure. The significant assumption of the biological (medical) model is that abnormal behavior may be compared to an illness (Elster, 1999). Thus, the mental illness is regarded as illness due to a chemical disparity. The theory likens physical illnesses to that of mental illness. In medicine, every physical disease is usually defined by a particular set of symptoms. A doctor trying to assist an ill patient will usually strive to obtain a diagnosis by comparing the patients specific symptoms to the description of different illnesses. Diagnosis Mental health professionals identify and determine mental disorders by signs, symptoms and functional defects (Elster, 1999). Signs are what unbiased analysts can observe, such as very fast breathing. Symptoms are more qualitative, or what one feels, such as extreme joy or depression. Functional defects are being incapable of performing some routine or simple daily tasks, such as taking a bath or commuting to work. For the majority of the cases, psychiatrists define the existence of mental illness in a person by conducting an interview with the purpose of revealing symptoms of abnormal behavior (Hacking, 1998). Specifically, the mental health doctor questions the patient questions about his or her mental condition: “Are you hearing voices of people who are not with you?” “Do you experience times when you feel so depressed or lost interest in most activities that you are doing?” “Have you undergone a considerable increase or decrease in your appetite?” “Do you sleep less than normal?” “Do you feel that your attention is distracted often?” The answers to these questions may create other questions. Ultimately, the doctor will feel that he or she has adequate information to define whether the patient is undergoing mental illness and, if possible, to make a diagnosis. However, the process of diagnosis is not as simple as it may appear. Patients have, on many occasions, problems recalling symptoms or feel hesitant to speak to others about their dreams, sexual activity, or use of drugs and alcohol. Certain patients experience more than one disorder at a time. For instance, depression and abnormal fear, or schizophrenia and delusion and establishing which symptoms involve the main problem is complicated. Additionally, symptoms may not be particular to mental diseases. For instance, brain tumors and infections of the central nervous system can create symptoms that copy those of psychotic disorders (Culver, 1982). Conclusion Oftentimes, distinguishing between mental health and mental disease is not as clearly delineated. For instance, if one is afraid of giving a speech in public, does it mean that he has a disease or obviously an ordinary fear for speaking in public? If one feels sad and depressed, is he only experiencing a low period, or is it an urgent case of depression needing medication? Scientists, researchers and psychiatrists have debated this topic for hundreds of years, and even to the present, the delineation between normal and abnormal is often unclear. This is why the areas of psychiatry and psychology are oftentimes controversial. There exists a wide definition of what is normal. What is normal is often dependent on who is defining it. Sanity is ambiguous and often connected to opinion especially to a particular culture or society. Even among cultures that are the same, ideas of healthy mental state may change over time if society’s values or expectations change. Word count: 1,500 References Boorse, C. (1976). What a Theory of Mental Health Should Be. Journal of the Theory of Social Behavior, 6 (1976): 61-84. Culver, C. (1982). Philosophy in Medicine. New York: Oxford University Press. Elster, J. (1999). Strong Feelings: Emotion, Addiction, and Human Behavior. Cambridge, MA: MIT Press. Hacking, I. (1998). Mad Travelers: Reflections on the Reality of Transient Mental Illnesses. Charlottesville: University Press of Virginia. Mele, A. (1996). Addiction and Self-Control. Behavior and Philosophy, 24, 99-117. Read More