Because psychiatric diagnoses are based on the subjective interpretation of behaviour by third parties. A psychiatrist may be highly trained but their diagnosis is still subjective.
How often do they get it wrong? Unlike in most other areas of medicine, where misdiagnosis is taken seriously, nobody knows very much about the extent of it in psychiatry. It has been very poorly studied.
McGorry’s Delorean continues on it’s trip back to the future in Australia, it’s new passenger, Prof Ian Hickie.
I say new, Hickie has been around for years.
Judging by an article in today’s Australian Telegraph, there seems to be questions being asked regarding the number of Australian children being prescribed antidepressant medication.
“Mental health experts ask: Will anyone be normal?” So read the title of a July 27 Reuters report. The “experts” warned that the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), scheduled for publication in 2013, “could mean that soon no-one will be classed as normal. . . . [M]any people previously seen as perfectly healthy could in future be told they are ill.”
This is not news. More than 200 hundred years ago Johann Wolfgang von Goethe (1749–1832) warned: “I believe that in the end humanitarianism will triumph, but I fear that, at the same time, the world will become a big hospital, each person acting as the other’s humane nurse.”
As the recent New York Times story confirms, most psychiatrists don’t even do psychotherapy anymore; they simply diagnose and drug. As I first described in Toxic Psychiatry, medically-oriented mental health professionals have become remote from their patients whom they now seek to manipulate chemically rather than to know personally.
In the field we call mental health, the rampant diagnosing, drugging, and incarcerating of those we seek to help must be replaced by practices that encourage responsibility and freedom rather than compliance and docility. By working directly in the field of ethical human services and sciences, we can become a leading part in the grassroots movement we call the Empathic Transformation.
All over the world, those of us who practice the healing arts–physical, psychological and spiritual–are seeing the need to join together to further humanity’s empathic transformation–to transform the old ways into something better and even grander, into practices embedded in and imbued with empathy.
The world is changing and we need to lead the movement in our fields toward a view of human beings that never demeans and always empowers, that never forces but always encourages, and that recognizes that human beings are not ultimately driven by their instincts and their biochemical but by their ideals and principles.
A 2005 government survey found that just 11 percent of psychiatrists provided talk therapy to all patients, a share that had been falling for years and has most likely fallen more since. Psychiatric hospitals that once offered patients months of talk therapy now discharge them within days with only pills.
Recent studies suggest that talk therapy may be as good as or better than drugs in the treatment of depression, but fewer than half of depressed patients now get such therapy compared with the vast majority 20 years ago. Insurance company reimbursement rates and policies that discourage talk therapy are part of the reason. A psychiatrist can earn $150 for three 15-minute medication visits compared with $90 for a 45-minute talk therapy session.
Competition from psychologists and social workers — who unlike psychiatrists do not attend medical school, so they can often afford to charge less — is the reason that talk therapy is priced at a lower rate. There is no evidence that psychiatrists provide higher quality talk therapy than psychologists or social workers.