I think it is most unfortunate that so many people suffering from acute mental health symptoms are treated with medication only. Often, there is the time and the resources to provide psychotherapy first. Some problems, are best treated with psychotherapy, and in some situations, such as anxiety disorders, psychotherapy has been identified as the treatment of choice in many cases. Medication actually interferes with the effectiveness of psychotherapy of some anxiety disorders.
Today, I tripped over an interesting article on assessing suicide potential. Psychiatric Weekly America bears witness to 30,000 deaths by suicide per year. Although clinicians have a fairly good grasp of long-term risk factors, possible short term indicators of risk have been largely overlooked. Dr. Jan Fawcett believes that, to make real headway in combating suicide, doctors need to identify patients at acute, not just chronic, risk of suicide and treat their symptoms aggressively.
Nikhil Rao in his blog OK so I’m not really a cowboy has an interesting article about the perils of taking diagnosis too seriously. He makes his point by noting that his tendancies to show schizoid and schizotypal traits is more a function of his chronic pain than a reflection of his personality. He argues that diagnosis should not be about social acceptability or conformity but should reflect an more meaningful underlying process.
Clients often see diagnosis as some sort of magical rite of passage into the mysterious world of mental health treatment. Actually, diagnosis is largely overrated. Many clinicians wouldn’t use it routinely in any formal way if insurance companies didn’t require a diagnosis for payment. Diagnosis is helpful for communicating about treatment between professionals. But as a guide that carries any stable meaning over time, it’s value is limited. People are much more complex and not amenable to fitting into catagories.