Mental Illness/ Diagnostic Approach: Relevance to Clinical Psychology - Essay Example

Introduction

Mental health is critical to the wellbeing of a person as there is a link between the mental health of an individual and their physical health. A mental illness is a diagnosable condition that manifests largely in the behavior of a person. Mental illness includes the broad variety of the conditions of the mental health that has an effect on how a person thinks, behaves and their mood (Foucault & Dreyfus, 2008). The term mental illness is synonymous with the term psychological disorder or mental disorder. In the broad field of psychology, the examination or assessment and treatment of mental illnesses is covered in the branch known as clinical psychology. As such, this essay will underscore the concept of mental illness and its relevance to clinical psychology. Further, the essay will focus on the history and the present aspects of the diagnostic approach to mental health.

The Concept of Mental Illness

Mental illness, a clinically diagnosable disease, interferes with a person’s emotional, cognitive and social abilities. The diagnostic approach to mental illness is carried out with accordance to the taxonomy made by the Diagnostic and Statistical Manual of Mental Disorders (DSM). Goldberg & Huxley (2003) stated that the major conditions that are categorized under mental illnesses consist of eating disorders, personality disorders, psychotic disorders like schizophrenia. Mood disorders that include bipolar disorders, depression, and anxiety, are also the main mental illnesses that affect the mental health of a person. Mental problems affect the culture and the society as a whole as it causes suffering and disability to those affected while their families endure significant distress. Thus, there have been calls for assessment and treatment of the mental conditions. International bodies such as the World Health Organization champion the clinical psychology to be at par with the approaches to physical illnesses.

The common symptoms of mental illnesses are identified so as to facilitate management of the conditions in terms of assessment and treatment. The common feelings, behaviors and symptoms of mental illnesses include panic attacks, self-harm, and suicidal feelings. Panic attacks are the intense frightening symptoms that make a person experience difficulties in breathing, chest pain, and choking sensations. Mental disorders are also manifested through the self-harm or self-destructive behaviors that an individual portrays as a way of expressing deep distress (De Silva, et al., 2005). Self-harm include cutting, maiming of the body by an individual which may lead to suicidal acts.

After examining the conventional symptoms of mental illnesses, it is imperative to determine the causes. The causes of mental problems or disorders include a wide range of causes such as unemployment, discrimination, death, child abuse, poverty, trauma, physical causes such as head injuries and genetic factors. A person may inherit a gene from the family bloodline which means that they will also experience mental problems such as epilepsy. The mental health problems are diagnosed by looking at the distinctive symptoms. For instance, a symptom such as having low interests in usual activities for a fortnight is an outward indication that the person is having a mental problem (Kessler et al., 2003).

A doctor may administer a questionnaire to the patient where issues such as depression, anxiety, dietary schedules are covered. Specialists are only involved in fewer cases of mental illnesses as many diagnoses have similar symptoms. Insomnia is a symptom associated with anxiety and depression. All these symptoms are significant in clinical psychology as the symptoms are used to identify the specific mental illness which will help in its management. Brewin (2013) stated that clinical psychology uses the symptoms to assess the mental state of a person and administer the right treatment to the person so as to relieve the psychological distress.

The Diagnostic Approach

There has been considerable research on the diagnostic approach to mental health and its relevance to clinical psychology. Studies have illustrated on the notion of the diagnostic approach together with its challenges and the alternative approaches that can be used for better practices in clinical psychology. The limitations of the diagnostic approach are relevant in the treatment of mental illnesses. Clinical officers in the field of psychology have employed various methods such as the use of questionnaires, interviewing and diagnostic testing (Keyes & Lopez, 2002). In clinical psychology, the diagnostic approach has different diagnostic models. The two primary methods include the diagnostic biopsychosocial and diagnostic medical model.

The Diagnostic Medical Model

The diagnostic approach to mental health posits that diagnosis involves the process of establishing if a specific problem that affects a person meets all criterions for a mental illness. American Psychiatric Association (2013) noted that the diagnostic medical model has its basis on the array of customs that views abnormal behaviors in an identical framework as physical problems or illnesses. Evaluations in the medical models comprise of behavioral testing and assessments, interviewing and conducting the intelligence tests. In the medical diagnosis, the Diagnostic and Statistical Manual (DSM) was developed to aid in the formulation of correct, accurate clear and reliable diagnosis. The latest DSM-IV came out to even increase the accuracy and improve on the knowledge of mental illnesses.

Kessler et al. (2004) stated that the DSM-IV also presents a framework used in clinical psychology where it enables the classification of mental illnesses. Mental health professionals use the framework to share information and diagnoses with their patients and colleagues. The DSM-IV, therefore, smoothes the distribution and recording of records amongst the stakeholders in mental health care. Besides, the DSM helps the mental practitioners to foresee the usual course of an illness and the patient’s symptoms, to sustain the advancement of treatment plans. Additionally, it categorizes the mental health illnesses to ensure all members if a group are uniform and mutually exclusive in cases of the different classes.

However, it is imperative to recognize that several mental illnesses are not unique and thus will manifest with others. For instance, depression appears with other mental disorders while the lack of sleep may be a symptom of another illness. Bernstein & Nash (2006) stated that due to the judicial and legislative requirements, the DSM-IV is critical in the formal taxonomy of mental health disorders. To illustrate this, a child may be given financial aid by the government only after it is determined that he/she suffers from a mental health illness that is classified under the DSM-IV framework. Insurance firms, governmental institutions, and medical agencies have all accepted the DSM-IV hence the diagnostic approach is relevant in clinical psychology.

Challenges of the Medical Model

Despite the positive contributions of the medical diagnostic model, there are limitations associated with the method. According to Barlow & Durand, (2008), The DSM-IV framework is not universally applicable to all cultures or nations since it is based on conditions and mental illnesses present mainly in the Western and first world countries. The medical model majorly focuses on the categorization of the illnesses and hence a person with psychological problems may develop adverse perceptions about the model. The model also places an emphasis on a particular client and ignores the significance of his/her societal background and family relations, aspects that also contribute to mental disorders.

Moreover, the other drawback of the model is based on the notion that chemical compounds treat the body and mind of an individual and mechanically replacing and repairing body parts. Consequently, it omits the spiritual and psychological aspect of clinical psychology where the biological well-being is prioritized over the cultural, social and psychological well-being.

The Biopsychosocial Model

The alternative models, forwarded by scholars such as George Engel, provide a solution to the challenges posed by the medical diagnostic model. Engel suggested an inclusive model that incorporates psychological and socio-cultural aspects in addition to the biological considerations (Engel, 1980). To really understand the mental problem experienced by a person, the social and psychological factors are considered in this model. The model encourages mental health practitioners to holistically assess the reciprocal impacts of the genetics, behavior, and the environment of a client. The model is not only used to diagnose a disorder, but also facilitates the collection of an individual’s data regarding their environment which is fundamental to achieving successful treatment.

Personal resolve and other unquantifiable aspects are considered in the treatment of the mental illness where the treatment can be customized to an individual depending on their particular condition. The mood, behavior and how a person thinks all affect the effectiveness of a treatment arrangement. Some of the unquantifiable factors to be considered include emotional stability, social roles, and scholarly ability. The biopsychosocial model, hence, is appropriate in helping an individual as a whole, instead of concentrating on a particular illness. The major limitation of the biopsychosocial model is that it is highly personalized hence it is difficult for organizations to use the model because of the number and diversity of employees (Borrell-Carrió, Suchman, & Epstein, 2004).

The biopsychosocial model is also associated with more costs to the mental health specialist and would, therefore, be a problem for NGOs and governmental agencies. Still, the model remains a better model than the medical model as it offers better end-results in the treatment plan. The two models are employed after the users undergo training, and although the medical model is cheap, the biopsychosocial model should be preferred as it produces better and long-lasting results (Engel, 1977).

Clinical psychology also involves assessment of the mental illness and the diagnostic approach is just as relevant as in the treatment. After, assessment and diagnosis, the biopsychosocial model provides information and material to mental health employees and their clients. The information is used to help people have a meaningful life. Generally, the diagnostic approach has numerous benefits, and the personality disorder will be used to underline its relevance in clinical psychology. The personality disorder, the Borderline personality disorder (BPD) that makes a person have instability in terms of impulsivity and interpersonal relationships (Pauncz, 2012).

In the 19th century, the diagnostic approach was systematized and in 1980, the DSM-III was used in BPD. The personality disorders at that time were less recognized due to the fact that the disorders had symptoms synonymous to schizophrenia. It has been established that the diagnostic approach has a benefit to psychology as it offers a standardized system of classification by providing an array of precise diagnostic criteria. Kecmanovic (2012) pointed out that the relevance here in clinical psychology is that the clear guidelines are that mental health clinicians are able to achieve consistency in the understanding of the mental illnesses. A better understanding of the mental illnesses prevents errors in the treatment of the mental disorders.

Diagnoses has aided in the development of a common language in the mental health field thereby enhancing the communication between the health practitioners and their clients. The unique and peculiar experiences that patients undergo can easily be explained and described as diagnoses aids in the dissemination of information. A patient’s illness is labeled during diagnosis which in turn helps in communicating vital information about that illness such as the anticipated outcome and its etiology. Troisi (2005) urged that the relevance of labeling in clinical psychology is that it supports an unambiguous knowledge by the client, the society, knowledge that goes beyond that of the practitioner. Before the diagnostic approach was fully implemented in 1980, it is hard to treat the BPD as there was limited public knowledge on the mental disorder.

The diagnostic approach has promoted the evidence-based practice. This practice promotes customized treatments, prediction of future prognosis and effective investigations in mental health care. The medical practitioners in psychology can now make comparisons and contrast existing treatment options and also create the most appropriate treatment plans for their patients. This is because of the standard criteria provided by the diagnosis approach, though it may restrict researchers in investigating in DSM. Diagnosis, therefore, gives the psychological assessment principles that enhance public health in mental illness management (Carr, 2015). Clinicians are consequently expected to make recommendations based on evidence.

Due to the evidence-based approach to clinical psychology, diagnosis thereby facilitates convincing research which is reliable and leads to the discovery of successful interventions for mental illnesses (Spring, 2007). In addition, the knowledge offered by the diagnostic approach speeds up the recuperation period and improves the patient’s cooperation with their clinicians. Research in mental health illnesses is significantly boosted by the diagnostic approach hence it is has a great implication to clinical psychology as other approaches or methods can be developed from the existing approaches.

A major problem that relates to the diagnostic approach is that the approach stipulates nine-criteria in BPD in DSM-IV where five criteria must be met so as to conclude a diagnosis. For instance to make a diagnosis for the BPD, the major requirements include the presence of suicidal behavior and hysterical efforts to avoid abandonment. In a case where the patient does not meet at least the five criteria, they will not be diagnosed with the BPD, which is inaccurate as the person may be suffering from the condition. Equally, in a case where the patient has received treatments of five conditions, the patient will be considered healthy regardless of the remaining four conditions (Barlow & Durand, 2011). All these situations denote that the approach may not offer exact diagnosis and treatment in clinical psychology. A patient may not access treatment simply because they do not meet the requirements of the stated criteria.

When the theory of hopelessness is applied in the case where a patient does not obtain treatment due to their failure to meet the criteria, the patient may experience an aggravated mental condition. The patient will feel powerless, loneliness and piled-up emotional stress which aggravates the mental illness. For this reason, clinicians are widely encouraged to consider their assessment and have fewer criteria in determining the diagnosis of a client. Gotlib, et al., (2004) stated that comorbidity is also an issue in clinical psychology as a person may face two or more mental illnesses. With the diagnostic approach, if occurrences of a disorder are detected in a patient, the possibility of another different kind of disorder is eliminated.

The diagnosis approach also poses problems to an individual who has undergone the process of determining whether he has a disorder or not. For instance, discrimination and stigma are some of the harmful effects of the methodology. Even though a person may be relieved when tests are conducted and they are not found to have mental illnesses, they may be rejected by the society and stigmatized due to negative perceptions (De Silva, et al., 2005). Such incidences in the community will add stress and disrupt the process of recovery of the patient. The society and the clinicians may discriminate on the client affecting the behavior of the patient. To curb this, it is necessary for the mental health profession to prescribing an ethical code of conduct to its members which must be adhered to by all practitioners.

Important causes of mental illnesses are overlooked while using the diagnostic method (Goldberg & Huxley, 2003). One of the causes may include the historical social causes where for example, the BPD may be caused by a history of emotional or sexual abuse. Diagnosis does not place responsibility on the person who abused the person for instance, and omitting the causal effects of historical abuses may delay the recovery of the patient. When an investigation is conducted on the history of the patient by the use of clinical questioning and therapeutic ways, the clinical practice is improved.

Conclusion

The mental health of a person affects the well-being of a person n many ways including their physical, emotional and psychological well-being. The concept of diagnostic approach in mental illnesses emerged to facilitate in the management of mental disorders. The effective management of the mental illnesses that affect a person is covered by the branch in psychology that is referred to as clinical psychology. The diagnostic approach in mental health is relevant in clinical psychology as it helps in classification of mental disorders, improves communication between the professionals in mental health care and also promotes an evidence-based practice. The problems associated with the diagnostic approach which includes the exclusive use of biological treatment can be solved by adopting other approaches such as the biopsychosocial model that incorporates the social and spiritual treatment.

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