The Ethics of Labeling in Mental Health

The myths of mental illness are numerous and negatively affect the lives of patients on a regular basis. For this reason they demand exposure and rectification, and this book proposes the means to accomplish both. The focus of this book is the institution of professional mental health as it operates in America today, specifically addressing how the Diagnostic and Statistical Manual for Mental Disorders (DSMMD), the primary resource used in the mental health profession, has influenced much larger social issues. Chapters are organized around the discussion of prominent myths of the mental health system. Case studies of mental health patients are presented to illustrate the serious misfortunes that befall individuals who have been mislabeled and mistreated. As the examples reveal, in many instances the patients’ lives have been plagued by the designation of mental “disorders” that perhaps never existed. The book challenges the mental health system to evolve beyond the DSMMD focus on pathology and develop a more humane method of addressing the functional needs of patients. International perspectives are presented, and specific steps are outlined for providing mental health services that adequately serve individuals with serious and persistent mental illnesses.

Kristie Madsen is a medical social worker at Mendocino Coast District Hospital in Fort Bragg, California. She lives in Fort Bragg.
Peter Leech is a licensed clinical social worker and psychotherapist. He lives in Fort Bragg as well.

Kristie Madsen and Peter Leech
Format: softcover (6 x 9)
Pages: 208
Bibliographic Info: appendix, notes, bibliography, index
Copyright Date: 2007
pISBN: 978-0-7864-2872-4
eISBN: 978-1-4766-0947-8
Imprint: McFarland

Preface      1

1. Making the Case Against Diagnostic Labeling      7

Myth I: The Mental Health System Truly Serves the Public Good
Introduction: The Myth of Serving the Public Good      19
2. What We Believe About Helping Professionals      24
3. The Therapist Always Knows Best      30
4. What We Mean by Mental Health      32
5. The Medical Model      35
6. The World of Secrecy      39
7. Twin Sisters of Different Mothers: Disability or Disorder?      44

Myth II: The DSMMD Applies to Every Client
Introduction: When the DSMMD Just Doesn’t Serve      47
8. Humpty Dumpty’s Guide to the DSMMD:
Critical Issues in the Diagnostic Approach      52
9. About Fitting the Square Peg into the Round Hole      59
10. Looking Deeper into the Pond: Continuing the Case
Against Diagnostic Labeling      62
11. The Mental Health Paradox: Helping or Harming      70
12. Special Forever: A Kid’s Worst Nightmare!      75
13. Everyone Needs a Label, Don’t They?      77
14. Looking Beyond the Label to Serve Every Client      80
15. The Acknowledgment Approach      85
16. Assessment Approaches      88
17. The Role of the Therapist      91

Myth III: The Mental Health System is Accessible to the Disadvantaged
Introduction: No Clear Pathways to the System      93
18. Case: Joey      95
19. Case: Sally      98
20. Case: Barry      104
21. Case: Tammy      110
22. Case: Max      114

Myth IV: The System of Diagnostic Labeling Provides Solutions to Social Problems
Introduction: The Ultimate Betrayal      121
23. Understanding the Origins of Labeling      143
24. Defining What We Mean by Serious Mental Illness      154
25. Facing the Ultimate Challenge      159
Afterthoughts      165

Appendix: Code of Ethics of the National Association of Social Workers      167
Notes      191
Bibliography      195
Index      197