“Mental disorder is vital for administrative purposes” – discuss with reference to contemporary society.

Categorizing people with mental health problems is a sensitive issue due to stigmatization and discrimination, but is arguably a requirement for administrative purposes spanning medical, social, political, economic and legal connotations. Mental disorder became a legal construct as outlined in the Mental Health Act of 1983 where it has a clear definition as pertaining to a ‘disorder or disability of the mind’.

In order to get people suffering from mental disorders the help they need, classification of disorders is a fundamental necessity. This allows for a better targeted and more informed approach to treatment.

Many new categories of mental disorder have arisen particularly in the last few decades, with familiar disorders such as bipolar and PTSD emerging within the last few decades. However, along with the growth of novel categories comes an increase in diagnostic creep. With ever more labelling being inappropriately applied e.g. the introduction of bipolar disorder for juniors in America.

Diagnostic criteria manuals such as DSM-5 and ICD-10 allow for a relatively straightforward, rudimentary diagnosis however, they are highly criticized for creating new categories without sufficient investigation, lacking validation, not being transparent enough and promoting pharmaceutical sales. For example, in the DSM-5 bereavement exclusion was not applied to major depression. Thus promoting pharmaceutical treatment for bereavement which should not be categorized akin to major depression as it is a natural process for loss of a loved one (Waldon, E.G. 2014).

Mental disorders have proven to be the most significant criteria of non-communicable diseases in terms of numbers of sufferers, economic accountability and impact to society at large. The stigma associated with mental disorders has been a heavily debated topic with some advocating treating them like physiological diseases rather than psychological. However, although this may ease the discrimination in terms of reduction in condemnatory public views, this evidently opens up other avenues of discrimination such as stigmas of being dangerous or charity cases (Corrigan & Watson 2004).

Defined criteria for mental disorders such as in the Mental Health Act, gives a better framework for epidemiological surveys and phenomenological inquiries. It also allows policies to be formulated based on thorough assessment and needs of broad populations as well as supporting budget allocation reasoning.

The disability adjusted life year (DALY) provides a measure of the burden of disease and has been used as a basis for comparison of the impact of mental disorders on quality of life between different populations. Which has proven useful to gauge the average quality of life in a country. However, it’s accuracy is controversial as being analogous to an economic output potential of an individual and some facts do not fit with the model. For example, Japan has a low DALY value yet relatively high percentage suicide rate.

Being categorized with mental health disorder often exacerbates the side effects such as difficulty integrating into society and finding a job, making the person feel even more ostracised than they already are for the mental disorder alone. It can also give others further reason to shun that individual.

For legal issues, the term ‘mental disorder’ is often applied to benefit defendants as they are entitled to special treatment. However, the increase in mental disorder prevalence and categories has made it easier to escape reasonable punishment for crimes committed, by using the defendant’s mental disorder as a clinically verifiable reason for their actions (Morse 2011). This has been the case in many mass shootings in USA in recent years. Whereby the gunman’s mental disorder was a convenient scapegoat for their actions. Furthermore, it even helps gun laws to remain unquestioned as the root cause of such crimes can be more readily assigned to lack of sufficient mental health care rather than ease of access to firearms. Another instance where the term ‘mental disorder’ is abused is in benefits fraud.

Mental disorder presents a catch 22 dilemma in contemporary society. The administrative benefits are clearly evident with regard to allocation of resources, epidemiology, comparative studies as well as legal implications. However, there is much controversy over what should fall under the umbrella of ‘mental disorder’ and an abundance of misuse.

 

Waldon, E.G. (2014). DSM-5: Changes and Controversies

 

Morse, S.J., (2011). Mental Disorder and Criminal Law. Journal of Criminal Law and Criminology Volume 101 Issue 3 Symposium: Preventative Detention Article 6.

 

Corrigan, P.W. & Watson, A.C. (2004) At Issue: Stop the Stigma: Call Mental Illness a Brain Disease. Schizophrenia Bulletin, 30(3):477-479, 2004.