Or lazy? Or selfish? Or any number of personality traits and behaviors that - while undesirable, fall short of a diagnosable, treatable, and potentially compensable pathology?
Let me acknowledge off the bat that I DO NOT deny that mental and emotional illness exists and CAN BE devastating. And I’m a huge fan of subsidized health care and other government social programs. I guess this could be viewed as just one more in a long line of threads asking if mental and emotional illness is over diagnosed. Let me explain what got me thinking along these lines today.
My job involves people seeking disability benefits. Every day I review hundreds - if not thousands - of pages of medical records. But my background and expertise is law, not medicine. In RARE instances - I’d estimate fewer than 5% of individuals - examining or treating mental health professionals suggest the possibility of malingering or secondary gain. And there is the ever popular drugseeking behavior, though that is more relevant to people complaining of pain. But out of the thousands of case records I’ve reviewed, I can’t recall a psychiatrist, psychologist, counselor, or social worker ever saying, “You know, this guy just has a negative disposition.”
I’m also not opposed to providing assistance to people who are just jerks. Or who had lousy role models and upbringing. Or who made mistakes. But in my mind, helping someone develop the tools needed to function in society is distinct from diagnosing them as experiencing a pathology.
What is the purpose - within the mental health community - of widening their diagnoses? I guess my preference would be to characterize people as within the range of normal - yet entitled to assistance, rather than characterizing them as “disabled.”
There is somewhat of a circular influence occurring. I perceive that health care providers diagnose individuals, because such diagnoses and treatment is perceived necessary to entitle someone to added care and benefits. But IME gov’t programs take their cue from the medical communities, accepting - for example - the APA’s criteria in the DSM in describing what constitutes disability.