Clarifying the Nature of Psychiatric Diagnoses
Many years ago, I wound up in the emergency department due to kidney failure. I required hospitalization and intensive care. I was rolled, in a bed, to my room. Three years later, I wound up in the emergency department again, this time due to post-traumatic stress symptoms. I required hospitalization and intensive care. Leaving the emergency department, I was handcuffed, placed into the back of a police car and taken to the local inpatient facility.
Did I miss the part where I committed a crime? Are we aware of the unspoken, long-term effects those handcuffs can have on a person who is in crisis?
The Current Approach Retraumatizes Victims
In my time volunteering with NAMI North Carolina, I have learned that some understand the ramifications of how people with mental illness are treated. I will never forget a brief conversation I had with a doctor while calling affiliate members about our public policy meetings. This doctor was furious over me being handcuffed. His ambition was to be at that policy meeting to shed light on the injustice of handcuffing psychiatric patients.
Post-traumatic stress disorder specialists have long understood that a person experiencing a crisis is highly susceptible to forming false beliefs about the self, the world and others. When a person in crisis, due to intense depression or hallucinations, is handcuffed, do we know what that says to a person? I can tell you what it said to me: “You are a criminal, and therefore, you are evil. Therefore, you must be restrained.” This view of myself took over a year to shake off — during a time when viewing myself as evil was the absolute last thing I needed in order to recover.
A New Approach Requires Clear Definitions
In the Spring 2019 issue of the NAMI Advocate magazine, Max Guttman wrote that decriminalizing mental illness will require a new approach. And a new approach must include clarified definitions. We must clarify what a psychiatric diagnosis is and what it is not; what it does and what it does not do; and what it implies, and what it does not imply.
What is a psychiatric diagnosis? It is a cluster of symptoms commonly seen in the general population included under a diagnostic label and code. A psychiatric diagnosis describes the thinking processes and behavior patterns commonly seen in, and significantly associated with, that specific label. It implies that a person needs help concerning specific, problematic thought patterns and behaviors.
What is a psychiatric diagnosis not? It is not a comprehensive understanding of who a specific person is. It does not tell us who or what the person loves, it cannot define what the person intends to do in any given moment, and it will not accurately predict the beautifully unique and varied actions of that particular person. Knowing that a person has a psychiatric diagnosis does not imply whether or not that person is a criminal any more than knowing the color of a bird can tell you which species of bird it is.
Toward a Clarified Approach
If we are going to make any headway in the decriminalization of mental illness, we, as an organization, must unite through clarified definitions. As definitions are clarified, unity is established. And a united front is much more powerful than one that is divided or confused. We must be precise, united and bold in standing for the unique nature of each individual. We have to stop perpetuating the myth that a psychiatric diagnosis is simultaneously an identity statement, a case study and a personality profile. The Diagnostic Statistic Manual may tell us how a person might beat some times, but it can not tell us who a person is.
Jordan Parks just completed his Advocacy & Programs internship with NAMI North Carolina and is in recovery from PTSD. He is finishing a B.S. in psychology with a concentration in crisis counseling.
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