What do you think about mental illness?

how is mental health is a choice? people dont decide to develop OCD, or depression or bipolar disorder it could be down to drug abuse which may be seen as a choice to some extent but a lot of people dont realise what the aftermath of drug abuse is until it gets to that point.

it could also be due to life events such as a bad childhood and there is even neurological evidence for some for example OCD could be linked to low levels of serotonin which is the hormone which inhibits repetition of tasks

People I don't trust to talk about mental illness in a respectful, non-stigmatising way: psychology students.

I believe 100% in mental distress, and I cannot see why others do not believe in that, or that it is not real to the person experiencing it. However, I'm not sure I 100% believe in mental illness. I don't think that mental health diagnoses are entirely helpful in all cases, and I disagree with how psychiatric diagnoses are created.

Why?

lmao, someone who is extremely close to me have a few mental health illnesses so i have knowledge from personal experiences and school

And as a mentally ill person I know that anyone who relates their knowledge of MI to a psychology course is not to be trusted because they're either super stigmatising or think of us as curiosities rather than people. Talking about MI from the perspective of a friend or relative can be ok. Talking about it from the perspective of being a student is A MASSIVE RED FLAG.

I don't completely agree that it is helpful to label certain experiences/behaviour as an illness as that implies that it is wrong, and that the person in question needs to be fixed. Some people do not like their experiences and want to change them, and that is fine, but not everyone feels like that. I feel that what we currently label as mental illnesses are normal responses to our surroundings, which can sometimes be quite extreme. To me, a social model explains mental distress better.

In terms of diagnosis, to my knowledge the large majority of diagnoses are formed not on the base of scientific discovery, but rather the opinion of a number of individuals who make judgments on what behaviour and experiences are abnormal or normal. Yes they do use their professional opinion and experience, however, to call it scientific is a very big stretch. The same is true when psychiatrists diagnose an individual - it is based on opinion, not some scientific test. For example - this is indicated when one individual can go with the same experiences to many different psychiatrists and come out with wildly different diagnoses.

What is your view on personality disorders and schizophrenia?

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In both of these, and other diagnoses, I think a big issue is that recovery from them is defined by the medical profession as "clinical recovery" - so basically getting rid of symptoms. However, for some individuals, this may not be the focus. For them, the most important thing in their recovery may be getting a job, and they may be less concerned with getting rid of their symptoms altogether.

The term personality disorder carries so much stigma and discrimination. The term itself is just horrible - you are telling someone that something is wrong with their personality. I know some will find it a relief to be diagnosed with it (and I know I did), but in the long term, I feel the disadvantages hugely outweigh any benefits. With the discrimination and stigma you face from both professionals and the general public, I wish I was never diagnosed. I think telling someone that the way they behave is wrong is not beneficial. The whole way we approach people who have experiences similar to what we now call PD needs to change.

In terms of Schizophrenia and other psychotic illnesses, I think there is too much emphasis that the individual's experiences are wrong and the only way to make things better is to get rid of them. The hearing voices network has a good model - they have more of a focus on understanding one's experiences, but not necessarily getting rid of them. For example, some people can find some symptoms positive e.g. hearing positive voices. Also, it is culturally inflexible. For example, in a western culture, if you report hearing the voice of God and believing that you can heal individuals, you could be classed as suffering from psychosis, however, in other cultures, this could be seen as normal, and would not warrant a diagnosis.

I'm not saying that individuals with these experiences do not require support - they do, however, classing their experiences as an illness is not always helpful. I think understanding it in a social context is preferable. For example, there is a lot of evidence regarding mental health and trauma, as well as social exclusion - as opposed to a biological explanation (or in some cases, it has been used alongside a biological model).

I think a lot of it is down to the clinical professionals in questions. This isn't like other areas of medicine I guess. I had one psychiatrist who wanted to prescribe me meds to control the symptoms, and another who wanted to get down to the route of the symptoms.

I personally think labels are needed, but this comes from my own experience. It helps me not feel like I'm in the inbetween and gices me a starting point.

I also think the links between genetics and prenatal exposure to toxins, pathogens etc. are important. But each to their own, I guess. I'm planning to go down the path of psychiatry and for the time being my views are pretty set, but I guess that may change with more experience.

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Yes it definitely depends on the professional. Some doctors are very focused on medication, others not so much. Also different types of professionals have different views. I'm (well I will be in 2 weeks) a social worker and there a lot more social workers who believe in the social model over the medical model compared to other professions. That is partly due to our training, and we usually have a much larger focus on discrimination than other professions.

In the past I was very much for labels and I strongly desired one for myself to do exactly what you said - stop me feeling lost in the middle and give me a start to figure things out. However, I don't think it was helpful at all. When you go to a psychiatrist, and they look at your diagnosis, and then suddenly that tells them all you need to know about you, how does that work??

I would much prefer a system where we drop labels and symptoms and then describe experiences. For one thing this is much more descriptive and this benefits professionals and individuals. For example, if you are about you meet someone for the first time and you see that their diagnosis is schizophrenia, it doesn't tell you anything about what they experience, so that person will have to go through that all over again. Also, you can make assumptions about that person. For example - you see BPD as the diagnosis and you assume that the individual self harms. But not everyone who has BPD self harms. So you can go through the entire meeting assuming they self harm when that isn't true! But if we described individuals experiences - not only would it be more detailed, factually correct and accurate, it would also be described in their own words - which is much more empowering for the individual.

In the current system we may need labels - but that doesn't mean that we need to settle for it.

Personally, I am more inclined to a social explanation but I do accept that there are others and I work alongside that explanation. I think having both and having a debate is beneficial for all. Everyone is different and our experiences and research/training will affect our views. I think there is something to learn from both sides.


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The point of disease classification is not to take a short-cut past patient experience, nor is it to make the patient feel better. Its to direct treatment and research. Say you've got a new drug or new psychotherapy and you want to find out if it works? Well, you test it on people and you do that by category based on what we know so far and your results may well create new categories. That is how medical science works, and the whole point of diagnosing someone - so you know what treatments to give to who. Without that structure all research stops and no medical professional can make any meaningful input any more. You may as well just use a random number generator to determine your drug/psychological therapies.

If a health professional is not treating someone as an individual, or making assumptions based on an old diagnosis that is a problem with the health professional, not the science underlying psychiatric disorders.

of course they are real but i feel that until i experience having a mental illness for myself ill never truly understand them.

We diagnose individuals through opinion rather than any scientific test, which is unreliable. The BPS Division of Clinical Psychology states that "due to their limited reliability and questionable validity, [psychiatric diagnoses] provide a flawed basis for evidence-based practice, research, intervention guidelines". What you've said makes sense if diagnoses were reliable and valid. However, you cannot guarantee that one person will always receive the same diagnosis by every doctor (despite reporting the same symptoms and limited changes in their presentation). So if we are deciding what treatment to give individuals based on the diagnosis, I feel it would be important that the diagnosis is consistent, and not open to bias.

I would argue that you can still provide meaningful input without a diagnosis. Peer Support Workers use the recovery model (alongside other professionals) and this states that a person should be seen as an individual other than their diagnosis, and many peer support workers prefer to abandon diagnosis and talk about their experiences (a shift from "what's wrong" to "what's happened". Peer support has been shown in research to reduce hospital admissions and increase service user satisfaction compared to a traditional approach.

With research, I feel there is still scope to strip it back to experiences. For example, if you are testing a new anti-psychotic drug, surely you could look to recruit participants who experience sensations/noises/sights etc. that no one else experiences, or individuals who believe strongly in things that others do not believe in, and perceive as odd and out of character. That would include everyone with those experiences, rather than individuals with a set diagnosis. It could even benefit research as it could allow individuals who share these experiences but have a different diagnosis to participate in research, which could enhance the findings. Not all research around interventions requires diagnoses, for example, social work research in mental health nearly always talks about experiences over diagnoses. And it is still possible from this to decide on appropriate intereventions.

In response to your "random number" bit - I have nowhere suggested that you just randomly select an intervention or treatment. You can still select a treatment without looking at diagnosis, instead, choosing to look at a person's experiences.

If there is a way to select treatment/intervention which increases the individuals empowerment, allows them to state what they feel their issues are, reduces the amount of stigma/discrimination they will face and is more reliable than diagnoses (which for some can change frequently) - then isn't it worth thinking about changing?

You've just reduced it to semantics. You just want to use "participants who experience sensations/noises/sights etc" rather than 'hallucinations', and "individuals who believe strongly in things that others do not believe in" rather than 'delusional'. Your labels are longer but serve the same purpose.

Peer support workers might not directly involve telling someone with schizophrenia that they have schizophrenia - what would be the point - but i bet the allocation of their time and the research you refer to was done in context of people with specific diagnoses, and severity of diagnoses. You aren't going to provide a peer support worker to every single person with a mild depressive episode, for instance. The costs would be astronomical and ultimately no one would get anything. And that's the point - the structure is there to target therapies where they are needed.

Diagnoses are sometimes wrong, and research is not perfect either. But that's why we keep doing more research and keep questioning a diagnosis when things aren't going to plan.

But words are important. Some people do not want to discuss their experience in the context of an illness. For me personally, I find labels such as that dehumanising and discriminatory, so I would prefer that professionals would ask me how I would like them to discuss those experiences. E.g. some people don't like to talk about hallucinations, but prefer voices, or some people would even prefer to call them a personal name that has nothing to do with science. Also, doctors do disagree on whether a person is exhibiting such a symptom or not - for example, with individuals diagnosed with a personality disorder who hear things that others don't there can be a big debate around whether it is psychotic or dissociative. In that case, if doctors cannot decide on whether a person exhibits a symptom, or if it is something else - then I would argue that labelling a person with that symptom is problematic, as they may meet another doctor who completely disagrees with it. However, the individual's perception of the experience is unlikely to change between doctors.

I can only talk from my experience as a peer support worker, and from working in CMHTs and other services where we had PSWs in the team, but we did not get allocated to individuals by diagnosis. It was more to do with whether the individual would benefit from peer work, which was more to do with their goals, their current situation and their wishes. That could be someone diagnosed with treatment resistant schizophrenia on section 37/41 or someone visiting their GP complaining of mild low mood. In terms of severity, in some cases yes care coordinators may get allocated to those who are more unwell, however, in my experience, this is more to do with the severity of the impact on functioning rather than any symptoms.

I do understand that. My main concern is how it impacts the individual. My view is that diagnoses can do more harm than good. But if I'm working with someone and they want to use that model to understand themselves then I'm more than happy to work with them in that way. But I prefer to start from the other end which is probably influenced by my own experience and the training I have had.

You have your own opinion and experiences and the system overall has many flaws, but it works.


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