Essay Sample on Critical Review for Behavioural Perspectives of Mental Well-being

Mental disorders have been a significant problem affecting a larger population in the world. Mental disorders involve a variety of mental health illnesses, such as bipolar, depression, and addictive behaviors, that affect the behavior, thinking, and mood of an individual. Despite the significant progress made over the years to understand the aspects of the illnesses, they remain a mystery. Even so, researchers, clinicians, and patients have made major steps in diagnosing and treating mental disorders (Gary, 2018). In the meantime, psychiatric diagnoses use diagnostic classification approaches including the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 (mostly used in the U.S.) and the International Classification of Diseases (ICD)-11 (used internationally) to provide clinicians, patients, and researchers a structured approach for mental health diagnosis (Timimi, 2014). Although these classification systems are useful and necessary for diagnosing and treating mental disorders, there are significant concerns relating to their reliability, validity, exclusion of social contexts, and stigmatization.One great concern relating to mental disorders diagnosis approaches is they tend to be subjective. The diagnosis labels lack psychopathological biomarkers, even for schizophrenia, as there are no blood tests, brain scans, lab tests, or other related tests to establish the existence of a mental health disorder (Deacon, 2013). Thus, subjectivity is inevitable in the diagnosis. On a large extent, clinicians, while examining mental disorders, depend on self-reports of the patients regarding their symptoms, which tend to be subjective and unreliable. When describing mental disorders, experts try to define conditions that may not be existing in the pure form nature, and they do not state a clear line for the distinction between the abnormal and the normal (Johnstone, 2018). Irrespective of mental disorders diagnoses being slightly subjective, that is the current science and the state-of-the-art of psychodiagnosis. With more scientific research being conducted on the physiological correlates and aetiology of mental disorders, the diagnosis labels will outright develop to be more objective. However, given that some mental disorders are attributed by functional instead of organic impairment, the mental disorder diagnoses of some conditions will certainly stand foreseeable in the predictable future.

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Besides, psychiatric disorder diagnosis labels are established on symptoms and not risk factors. The psychiatric classification systems facilitate a checklist of the symptoms of different disorders, yet little information is provided on what leads to the disorders. There arises the question if what causes mental disorders is unknown, how can they be treated? Certainly, the diagnosis labels are developed on symptoms and not causes simply because, mostly, the risk factors are unknown. Thus, the treatment, including psychotherapy and medications, is an attempt to manage unknown causes through known symptoms. Psychological treatments have worked so hard to prove that there is practically no need to know the cause of a disorder to treat it. Medications assist many mental disorder patients, even though they do not usually know how they work (Gary, 2018). However, Steine et al. (2013) argued that the situation in counselling and psychology is nothing distinct from the medical treatment of physical disorders, considering that the risk factors for many physical disorders are unidentified, sometimes physicians just try various medications, consistently with the hope that one works and in most cases, they succeed. Similarly, they claimed that psychologists should not be questioned for seeking a new approach after their primary treatment did not deliver the desired results.

Diagnostic labels in psychiatric diagnoses are powerful and can hurt people due to stigmatization. Classification systems have a great possibility of causing stigmatization (Australian Psychology Society, 2018). However, classification approaches may not necessarily result in a negative effect as some people may feel better when their disorder is diagnosed. For instance, if someone has severe, stressful psychological symptoms and seeks help from a clinician, it is likely a great reprieve to learn that their condition is known and that they are not the only people suffering it, and there is a treatment to help. Thus, the potential stigma associated with being diagnosed with a disorder can be offset by the positive outcomes of getting a diagnosis and treatment (Clark et al., 2017). Conversely, labels can have powerful stigmatization issues. If a person presents the abnormal behaviours identified in the classification manuals, they might start being perceived differently, which makes many people withdrawn and can sink deeper into depression. The classified behavioural perspective limits confidentiality of medical and psychological diagnoses. Sohrabi et al. (2019) suggested that people having mental disorders experience stigma suggests that people experience stigma because of their diagnostic label as it influences how the people around them think about them.

Psychiatric classification systems continuously raise the reliability of diagnostic criteria since they make it possible to over-diagnose healthy individuals. Through the revision of the existing diagnostic approaches, so many behavioural perspectives have resulted in the pathologizing of normality. Behavioural perspectives that are not valid should not be comprised of the diagnostic approaches. Usually, clinicians are not able to critic the reliability of the behavioural perspectives, despite being able to acquire the original research to facilitate their decision making concerning a specific criterion (Keeley et al., 2016). Given that the classification approaches, DSM-5, and ICD-11 are widely accepted as reliable, and no other systems have emerged to be more valid, clinicians are naturally obligated to accept and implement it. Therefore, there is a need for clinicians to undergo quality clinical training to be able to avoid over-diagnosing individuals on symptoms that do not substantially fulfill the classification system of mental disorder. Conditions should specifically be defined as mental disorders if they fulfill accepted reliability standards and can cause an individual critical impairment and distress (Reed et al., 2016).

Diagnostic classification approaches have significant validity issues due to the lack of scientific evidence. While there is a need for diagnosis labels to be more evidence-based than they are, the rebuttal is that the mental disorder diagnosis is efficiently scientific. For instance, Allsopp et al. (2019) argued that the changes in the DSM-IV-TR to DSM-5 were greatly influenced by scientific research done in 2013 before the approach was published, and there is ongoing research to keep on revising the manual with the increase of knowledge on mental disorders. However, based on how the manuals are developed, there is a significant concern on the scientific validity of the manuals since they are developed by committees of experts. The members of the committee are assumed to base their input on scientific research and individual clinical wisdom; nonetheless, inevitably, opinions are mixed up. Considering the unavailability of specific mental disorders biomarkers, subjectivity is inevitable, and there is always a possibility of legitimate disagreement regarding the validity of mental disorders’ criteria for diagnosis.

Furthermore, the psychiatric diagnostic classification approaches are developed on the medical model and suppose that mental health disorders are medical illnesses. Thereby, there raises the question: why would counsellors and psychologists apply a manual developed majorly by and for psychiatrists? Some psychologists oppose the prevalence of the medical model in psychiatry, which is the basis of psychiatric diagnosis approaches (Bentall, 1992). They would prefer to gain some payment for facilitating psychotherapy to patients having issues in living, including vocational problems, marital problems, etc. The diagnostic labels have also become a diagnostic reference book for various economic, political, and scientific reasons (Jacob, 2016). For instance, the American Psychiatric Association has transformed to have more power compared to the American Psychological Association. However, some psychologists propose that the diagnosis labels are not established under the medical model; their research has not acquired much relevance. For psychologists and counsellors who believe that diagnostic labels are harmful and invalid to people should not apply them, considering that doing so would be unethical (Whooley, 2018). Many counsellors and psychologists possibly commemorate with the psychiatrists that mental disorders exist, and the classification system plays a critical role in identifying and describing them. It would be weird for psychologists to complain, conversely, that the increase of new disorders to psychiatric diagnosis approach inflation while still complain that they cannot acquire payment for treating people for problems of daily living (Jablensky, 2016).

In my practice as a professional registered nurse, I anticipate providing quality and reliable health service to all patients without causing any significant issues that can affect their psychological and physical well-being during and after my interventions. Patients with mental disorders need critical interventions, as the approach used in diagnosing and treating them can ultimately have dire consequences not only on their psychological well-being but also on their social life. Bearing in mind the ineffectiveness affiliated with the existing psychiatric diagnostic classification systems, due to their validity, reliability, stigmatization, and treatment, registered nurses must pay critical attention to how they manage critical conditions. Therefore, I will seek adequate knowledge and experience to improve on how I manage psychiatric patients through a step by step examination of individual behavior to limit generalization and misinformed treatment. For the system of diagnosis to establish itself usefully scientifically, its categories should enable it to be evidence-based, and for it to be clinically useful, it should demonstrate that the application of diagnostic labels helps supports the treatment decisions in a manner that influences the overall outcomes. As discussed, there is minimal evidence to support either side. But there is great evidence to propose that instead, they can lead to substantial harm. Therefore, the only evidence-based conclusion is that psychiatric diagnostic systems, including DSM and ICD, should be abolished as they are not fit for purpose.

References

Allsopp, K., Read, J., Corcoran, R., & Kinderman, P. (2019). Heterogeneity in psychiatric diagnostic classification. Psychiatry Research, 279, 15-22. https://doi.org/10.1016/j.psychres.2019.07.005

Australian Psychology Society (Executive Producer). (11 October 2018-28 October 2018). How Mad are You? [TV Series]. SBS Company. https://www.sbs.com.au/ondemand/video/1330848323779/how-mad-are-you

Bentall, R. P. (1992). A proposal to classify happiness as a psychiatric disorder. Journal of Medical Ethics, 18(2), 94-98. http://dx.doi.org/10.1016/j.ijchp.2014.03.004 1

Clark, L. A., Cuthbert, B., Lewis-Fernández, R., Narrow, W. E., & Reed, G. M. (2017). Three approaches to understanding and classifying mental disorders: ICD-11, DSM-5, and the National Institute of Mental Health’s Research Domain Criteria (RDoC). Psychologi...