The Corner

WHAT IS MENTAL HEALTH?

If, like me, you were at some point in your life fascinated by the ideas of anti-psychiatrist Thomas Szasz (pronounced “Saass”), floruit 1960s, I recommend Jeffrey Oliver’s excellent piece on Szasz in the current issue of The New Atlantis .  Among other things, it delivers the startling (to me) news that Szasz is still alive and still writing.

Szasz argued, approximately, that the term “mental illness” is at best a metaphor and at worst a job- and money-generating operation run by the Psychiatrists’ Guild–that there is no such thing as mental illness, only degrees of unhappiness and eccentricity.  Yes, it was an extreme position; but it was one of those extreme positions that forced people, in their attempts to refute it, to think harder than they had before about the topic under discussion.

It wasn’t that extreme, either.  There is still an awful lot of mumbo-jumbo in psychiatry.  The NY Times recently ran a story on the diagnosis of childhood “mental illnesses” like AHD.  The diagnoses are all over the place.  You need a subscription to read the piece, but here’s the beginning:    

November 11, 2006 What’s Wrong With a Child? Psychiatrists Often Disagree By BENEDICT CAREY Paul Williams, 13, has had almost as many psychiatric diagnoses as birthdays.

The first psychiatrist he saw, at age 7, decided after a 20-minute

visit that the boy was suffering from depression.

A grave looking child, quiet and instinctively suspicious of others,

he looked depressed, said his mother, Kasan Williams. Yet it soon

became clear that the boy was too restless, too explosive, to be

suffering from chronic depression.

Paul was a gifted reader, curious, independent. But in fourth grade,

after a screaming match with a school counselor, he walked out of the

building and disappeared, riding the F train for most of the night

through Brooklyn, alone, while his family searched frantically.

It was the second time in two years that he had disappeared for the

night, and his mother was determined to find some answers, some

guidance.

What followed was a string of office visits with psychologists,

social workers and psychiatrists. Each had an idea about what was

wrong, and a specific diagnosis: “Compulsive tendencies,” one said.

“Oppositional defiant disorder,” another concluded. Others said

“pervasive developmental disorder,” or some combination.

Each diagnosis was accompanied by a different regimen of drug treatments.

By the time the boy turned 11, Ms. Williams said, the medical record

had taken still another turn – to bipolar disorder – and with it a

whole new set of drug prescriptions.

“Basically, they keep throwing things at us,” she said, “and nothing

is really sticking.”

At a time when increasing numbers of children are being treated for

psychiatric problems, naming those problems remains more an art than

a science. Doctors often disagree about what is wrong.

A child’s problems are now routinely given two or more diagnoses at

the same time, like attention deficit and bipolar disorders. And

parents of disruptive children in particular – those who once might

have been called delinquents, or simply “problem children” – say they

hear an alphabet soup of labels that seem to change as often as a

child’s shoe size….

John Derbyshire — Mr. Derbyshire is a former contributing editor of National Review.

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