- Psychiatric diagnosis provides a framework within which to understand mental illness.
- By noticing which symptoms seem to show up together, then noticing which cluster of symptoms a particular patient seems to fall into, treatment decisions can be informed by what has or has not worked for other patients with similar clusters of symptoms.
- Diagnoses can serve as a sort of cognitive shortcut. Rather than list all of a patient's symptoms individually, professionals can name the cluster and understand the patient more quickly, speeding communication.
- When patients are given diagnoses, it can validate their experiences by letting them know that others have had similar experiences.
- When the incomplete and tentative nature of the framework for understanding provided by psychiatric diagnosis is not acknowledged or is forgotten, it is used rigidly and inappropriately. I think this is probably a good part of the cause of the other problems diagnosis can cause.
- Experience with patients having those clusters of symptoms, known as diagnoses, can appropriately be used to inform treatment, however, this tends to be used to dictate treatment.
- As a cognitive shortcut, diagnosis would be useful only if people were mindful of the fact that they are using it as a cognitive shortcut. When people lose that mindfulness, diagnosis becomes a stereotype.
- When diagnoses are overused, this harms those patients who validly fit the diagnosis. Services are taken up by people who don't need them as badly. The people who are inappropriately diagnosed give the diagnosis, and those who are appropriately diagnosed, a bad name and additional stigma in the eyes of the public (i.e. "depressives are just whiners.").
- The rampant co-morbidity of diagnoses makes the framework lose its usefulness as a tool for simplifying and may even make mental illness seem much more complex.
I think that psychiatric diagnosis has some potential to be useful and beneficial. However, I think that the way they are presently used negates and actively prevents the potential usefulness they have. I also don't think the potential benefits are worth all the energy that goes into creating and maintaining this framework of diagnoses, nor do I think that the benefits are worth even the risk of them being used as inappropriately as they are.
I would rather see symptom-based treatment. Symptoms could be used to identify what needs treatment for each patient rather than diagnoses. Patients would list the symptoms that bother them and receive treatment for those and their underlying causes. There would be no misdiagnosis. No one would be treated for symptoms they don't have, because there would be no reason to assume that a cluster of symptoms has to go together. Even when patients have symptoms that do tend to go together, but one doesn't bother them, professionals won't have to feel compelled to treat that irrelevant symptom in the interest of treating the "full illness".
I know insurance-wise this may create practical problems, but I see the GAF score as the only thing they really need to know in terms of approving benefits; anything else is just the insurance companies meddling. I have no problem with GAF scores; I think they do a much better job than diagnoses. I wish that GAF scores were given more attention than diagnoses.