Mental Health and Mental Health Treatment are topics that we take seriously at Father's Little Helper.
We have chosen Psychiatry as our careers because we recognize the treatment of mental illness is important and rewarding work. While we joke about some mental health issues, we take our jobs very seriously. We would like to offer our assessment on a few issues regarding mental health important to Fathers and Children.
Issue #1 - DIAGNOSTIC LABELS
The realities of mental health treatment demand professionals establish labels. Psychiatrists and other mental health professionals must define terms. Our labels, the diagnosis, identify patterns of dysfunctional behaviors, thoughts and emotions.
However, the cost of diagnostic labels is not to be over-looked. Yet the state of the science is evolving. Current categories will change as the knowledge base improves. Even at its best, the label (diagnosis) will oversimplify complicated sets of behaviors, thoughts and emotions. This is true even when we are considering clearly valid labels such as Autism, Schizophrenia and mental retardation.
Trade-offs regarding labeling a person "mentally ill" includes the possibility they may be seen primarily through the prism of their disorder. The patient's strengths, individuality and humanity can be lost. Also, a psychiatric diagnosis may change self perception in negative ways.
If the diagnosis overstates and over-simplifies the problem, the label of "disorder" may create new problems. Diagnosis or a "disorder" may create unrealistic expectations to "treat" inescapable realities of human existence, or social or economic problems beyond the scope of the realm of psychiatry.
When mental health professionals diagnostically "creep" into less and less severe "disorders", they enter realms where they are less and less the experts. Societies, families and individuals have varied approaches to respond to the complex behavioral and emotional problems human being face.
Mental health providers ought to remain humble about their relative expertise compared to "traditional" and non-mental health related interventions. "We" have the most research and special expertise with more severe mental illness. If you want parenting advice, ask a grandma, not a PhD.
Mental health professionals ought to be careful about labels. The difficult question regarding the risks and benefits of diagnosing a child mentally ill can only be answered on an individual basis.
Issue #2 - BEHAVIOR PROBLEMS
Labels (see above) have been created to define children's behavior problems. Psychiatrists use labels such as the "Behavioral Disorders": Oppositional Defiant Disorder, Conduct Disorder and Attention Deficient Disorder. The document which defines these diagnoses and their criteria is the Diagnostic and Statistical Manual (DSM-IV, currently in the 4th edition) published by the American Psychiatric Association. A committee decided the criteria for each disorder. Thus the "Behavioral Disorders" reflect research, clinical practice, along with political and social philosophies.
A troubling aspect of the current framework is the diagnosis of oppositional behavior as a "mental illness". Is rule breaking or talking back a "disorder" in the same way as Schizophrenia, Autism, Major Depression or Obsessive Compulsive Disorder? Are psychiatrist and other mental health professional really the experts when it comes to children to behave? Is "behaving" always in their interest? To what degree do parents and society need "treatment"?
Issue #3 - ANGER
Anger is a primary human emotion. Yet anger hardly gets mentioned in the DSM-IV. The lack of mention in the official diagnostic manual is despite the fact that issues surrounding anger and violence are the focus of a large part of treatment of children and adolescents (and parents).
Anger is not pathological. Anger is an important and useful human emotion. The appropriate expression of anger effectively communicates displeasure and motivates individuals to act. Inappropriate anger is a common human problem. Of course anger problems affecting both children and adults. Parental anger disrupts good parenting. Childhood anger problems interfere with social and academic functioning.
Young children let their emotions flow freely, including anger. This is normal, but if allowed to develop into a pattern it will cause problems. Many teenagers are angry: angry about school, angry at their peers, angry at their parents. When this anger is inappropriate and destructive they might benefit from treatment.
Mental health professionals do not have language that clarifies inappropriate and appropriate anger. For example, we use "sad" to describe "normal" unhappiness and "Major Depression" to describe dysfunctional severe and pervasive sadness with accompanying physical signs and symptoms. Psychiatry has not similarly defined appropriate anger and dysfunctional anger. Here we actually need more labels!
Don't get upset: many bright researchers are working to better define behavior problems, including anger. Good research on anger does exist. Unfortunately the prevailing psychological, political and social philosophies often ignore the facts.
If you want to hear more:
We have put together short audio and audiovisual presentations on some common parenting and mental health issues. But please, don't just take our word for it.
Check our
Heroes list for a reference to people we consider experts and places to find more information.
We think you will find that science does meet common sense!
