Diagnosis in child mental health
Diagnosis in child mental health
Exploring the benefits, risks and alternatives
Service providers seldom have time to explore the debates, complexities and nuances surrounding the diagnosis of child mental health conditions. This paper is designed to encourage practitioners in the child and family welfare sector to examine their own understanding of diagnostic systems, and to critically reflect on the role that diagnosis plays in their work with children and families.
Like adults, children experience mental health difficulties. For some, a diagnostic label plays an important role in their treatment and recovery.
In the late 20th century, the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) revolutionised the nature of mental health classification by providing a common language to define mental health difficulties.
In Australia, the DSM-5 is now the primary system for identifying mental health conditions. The tenth edition of the International Classification of Diseases (ICD-10) is also sometimes used. Both systems focus on overt symptoms, rather than underlying causes or surrounding social context.
The diagnostic systems used in Australia are still being debated. Critics argue that they pathologise normal human experiences, decontextualise mental health difficulties, lack scientific validity, and are culturally insensitive.
Emerging evidence suggests that certain mental health conditions may be overdiagnosed in children. Numerous converging factors are thought to contribute to potential overdiagnosis, including the influence of the pharmaceutical industry.
This paper takes the view that current diagnostic systems are best seen not as scientific certainties, but rather as cultural tools used to understand different varieties of psychological distress and impairment.
Authors and Acknowledgements
Rhys Price-Robertson is a Workforce Development Officer at the Australian Institute of Family Studies. He works as part of the Emerging Minds National Workforce Centre for Child Mental Health, which was recently established to assist professionals and organisations who work with children and/or parents to have the skills to identify, assess, and support children at risk of mental health conditions.
Special thanks to Morwynne Carlow for her wise counsel throughout the production of this paper, and Jessica Little for providing a case study of her work with children and families. For valuable advice and feedback, thanks also to Louise Newman, Elise Davis, Daniel Moss, Amanda Coleiro, and Allen Frances.
This resource has been co-produced by CFCA and Emerging Minds. They are working together as part of the National Workforce Centre for Child Mental Health, which is funded by the Australian Government Department of Health under the National Support for Child and Youth Mental Health Program.
Cover image: © istockphoto/ClarkandCompany
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