Diagnosing a psychiatric disorder, labeling and treating with drugs is the typical cycle of psychiatric treatment. This is based on what is referred to as "the medical model" of mental health.
While most modern college textbooks on psychiatry do not support the medical model, as it is often practiced today, because it is convenient, it is economically justifiable for pharmaceutical and insurance companies, and it relatively easy for doctors to administer, it has become the status quo in psychiatric care.
"When all you have is a hammer, everything starts to look like a nail."
Noted psychologist and theorist Abraham Maslow.
Look Beyond the Label
Many thoughtful professionals find the medical model of mental health inadequate, however, especially when applied to children, as described here by child psychiatrist Scott M. Shannon, Ph.D.
The following is from the introduction of the book, Please Don't Label My Child, by Scott M. Shannon, M.D. Reprinted with permission from Rodale Press.
"Even though I'm a medical doctor with a specialty in child psychiatry, I believe that the behavioral and emotional problems we see in our children today are too readily being considered and are treated as medical problems rather than being addressed as the relational [social], nutritional, and environmental problems they are. Our children--all of whom have the capacity for strong mental and emotional health--are labeled and medicated at an alarming rate, yet they don't seem to be getting better.
Our children, though, truly suffering, are being misdiagnosed at an alarming rate and consequently are not being properly treated. This isn't simply a problem with our health care system, which, in conjunction with the health insurance industry, puts a premium on doctors choosing a diagnosis--a label--as quickly as possible. This is a societal problem.
Our children are being misdiagnosed at an alarming rate
and are not being properly treated.
Our tendency to want to label things has not only left our children without what they need most (our consistent, unconditional love and focused attention), it has also stripped them of the right to enjoy a childhood free of damaging and debilitating diagnostic labels.
The interplay of brain, nutrition, relationships, and environment creates what we come to know as that child's personality and mind.
We fall into what I call the doctor--diagnosis--drug cycle, a nearly inescapable progression of events in which the well-meaning parents of a suffering child find themselves seeking help and invariably being handed a prescription.
Some of the Factors Involved in a Child's Mental Health
In truth, we've actually got it all backward when it comes to treating children. When one of our children is failing to thrive (socially, emotionally, or even physically), it's usually a sure sign to me that rather than something internal being at fault, something external is getting in the child's way. "These external forces-or "brain stressors"-fall into six categories: relational, nutritional, environmental, familial, educational, and traumatic.
These stressors are real culprits, and these are what we should treat when a child exhibits emotional or mental distress. In this book, I'll look at each of these brains stressors and share my approaches for solving emotional and behavioral problems--without labels and, typically, without drugs.
We're Over-labeling and Medicating our Kids
All of us who provide care of the growing throngs of stressed kids and families feel the pressure, the desperation to help. But too many of us still reach first for the prescription pad.
The brilliant psychologist Abraham Maslow, PhD, said, "When all you have is a hammer, everything starts to look like a nail."
The truth is, there is very little science behind most psychiatric labels. We know so little about the brain of an individual that we make our diagnosis based on patient history and personal judgment on the part of the clinician.
A recent psychiatry journal article on the consistency of psychiatric diagnosis summarized the problem by stating that the reliability of psychiatric diagnosis remains poor in clinical practice. And this was in regard to diagnosing adults; everyone in the field acknowledges that diagnosis children, whose brains are still forming, is much more difficult.
The truth is, there is little science behind most psychiatric labels.
The science behind the use of psychiatry medications in children is even more concerning. Most of the medication that we use in child psychiatry do not have FDA approval (which means they have not been adequately tested in terms of safety or effectiveness). We have no body of research that addressed the use of multiple medications in children, and yet, in 2006, nearly 1.6 million American youths were prescribed two or more psychiatric medications simultaneously.
Most psychiatric medication prescribed for children
- does not have FDA approval
- has not been adequately tested for safety or effectiveness
In an article in the New York Times, the director of the National Institute of Mental Health was quoted as saying, "There are not any good scientific data to support the widespread use of these medications in children, particularly in young children, where the scientific data are even more scarce." Yet all over American, overwhelmed doctors are besieged by overwhelmed parents, with a highly stressed child in tow, who demand "action" I understand this pattern well and see it all too often.
Things are finally beginning to change, however and that's why I feel it's time to speak out more forcefully against the rigid doctor-diagnosis-drug cycle that has children, parents, and many of my well-meaning colleagues--caught in a terrible bind.
The medical model supports a "rigid doctor-diagnosis-drug cycle"
which we need to change in mental health treatment.
Our children are innately emotionally and mentally healthy. But they-and their brains-need our help in order to cultivate and maintain that health. It is our duty as parents and practitioners to do the hard work of identifying the stressors that are compromise the emotional and mental health of our children. We have to learn to see beyond labels and do...hard work.
Emotional and mental health are closely related
I am not "anti-medication": I do prescribe medications, but cautiously. Instead of just aggressively treating symptoms and writing prescriptions, I view my job as being primarily that of an educator. We hope our children develop the mental and emotional resources they'll need for succeeding in life.
Parents and families need to learn to "combat brain stress and to learn how to effectively eliminated the offending stressors from their lives."
My goal is to empower families to take ownership of their emotional and mental health, to learn the tools needed to identify and combat brain stress, and to learn how to effectively eliminate the offending stressors from their lives. [This results in [the flowering of every member of a family, from the youngest to the oldest. My approach is one of moderation and restraint.
Conclusion of Psychiatric Labeling and Children
There is undoubtedly one kind of intervention our children always need, especially if they are suffering in any way: our loving, focused, and consistent attention. It is my great hope that this book will serve as a source of empowerment and encouragement for parents and enable them to look beyond labels; to break free of the doctor-diagnosis-drug cycle; and to truly see, support, love and nurture their children toward strong metal and emotional health."
Children need our loving, focused and consistent attention.
End of Introduction.
The introduction from Doctor Shannon's book was edited for brevity. Some of the highlighted material and subheadings are not quoted word for word but paraphrased for brevity and clarity.
Pages Related to Child Psychiatric Labels
- Overcoming Stigma of Mental Health Disorders
- Moral Management
: Successful non-pharmaceutical holistic treatment for mental heath in the 1800's.
Movement - Penn State University
Mental Health Treatment
- A Closer Look at Psychopharmacology
- Let the Buyer Beware! by Louis Kirby, MA
of mental health
- Sharna Olfman - The misdiagnosis and overmedication of children