I was happy to see The Observer address mental health on Friday, in its editorial and a column. I agree that we should be talking more about mental health. I am worried, though, about some of the ways that it currently is talked about, even in your sympathetic editorial. Psychiatrists would have us believe that mental illnesses are caused by chemical imbalances, which might be cured with the right set of drugs. That’s no accident; pharmaceutical companies have aggressively lobbied for standard diagnostic criteria (the DSM), and the medicated solutions that go along with them.
I am not writing to vilify medication, which I know is helpful for many. But I do find it problematic when difficult mental states are described as simply being the result of chemical imbalances. I recently reconnected with my old therapist in England over Skype. I was happy to find out that Aetna will cover our sessions, but they want a diagnosis and the corresponding code. My therapist and I talked about this (he has never given me a diagnosis before) and he recognized that in the UK mental health care professionals are more reluctant to give diagnoses, because they can be part of the problem, leading people to identify with an illness that then becomes intractable.
Receiving a diagnosis is probably better than being in denial, but I think we should question the supposed matter-of-factness that says chemical imbalances create mental illnesses, and are readily treated with pills.
Joel Duncan
Ph.D. candidate in English
