The Ethics of Labeling in Mental Health


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About the Book

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.

About the Author(s)

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.

Bibliographic Details

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

Table of Contents

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