Misdiagnosis in Mental Health - Essay Example

According to Kirk & Kutchins (1988), Psychiatric diagnosis is one of the most critical areas in patient care since it informs and predicts treatment. However, it should be noted that diagnosis is an extremely hard process especially for psychiatry since in here diagnosis of mental disorders is based on behaviors and symptoms observed and reported by the family or patient. It also includes a lot of complex inferences made by doctors from complicated interpersonal communication. All of this data have to be interpreted and processed by the clinician before arriving at a diagnostic decision. When investigating unethical behavior in diagnostic process and results, daily challenges faced by the physicians when making psychiatric decisions should also come into consideration (Kirk & Kutchins, 1988).

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Order now

Knowledge

I believe that the matters of under and over-diagnosis of mental disorders must be addressed. However, in my view, I see them as completely separate and more complex matters. Physicians need to have adequate knowledge on multiple cases of mental disorders in order to come up with appropriate diagnoses.What most affects us is the quality of diagnoses that it is the ability of the physician to precisely translate diagnostic technique to symptoms exhibited by the real people. Therefore patient education or marketing does not have any major impact here. From the video, we see that often most diagnosticians may not entirely stick to their diagnostic criteria when explaining their clinical judgments. But, why so? Well, various reasons lead to this kind of a situation. First, I believe the physicians may be influenced by biases and heuristics. This is because mental disorders cannot be noticed by neuronal, physiological or genetic correlates, this means there are no external models for evaluating mental disorders. Therefore, we only depend on what the doctors say after doing their research. Second, the reason there is high incidences of over and under diagnosis in the field of health, is the fact that treatment of mental disorders especially with CBT requires the doctors to conduct a research and gather information about a particular patient before making their clinical decisions. And how does this contributes to over and under diagnosis of mental health? It should be realized that people have different personalities and these personalities change over time. For instance, we have two patients, say patient A and patient B. These two patients have the same kind of problems. However, Patient A is facing a lot of episodic life stress such as financial hardships, medical problems, and job stress and at the same time, he is taking CBT treatment. On the other hand, patient B has a quiet life and is undergoing the same treatment as Patient A. The doctors conclusion would indicate that patient A has a higher level of the medical condition compared to B. Now what do this mean? Stress together with chronic stress can interfere with CBT treatment for mental disorder. Other evidence that supports this views is that; it has been noted that most cases of CBT treatment are not successful due to over and under diagnosis. In fact, it is estimated that most patients withdraw prematurely because they lack motivation and see no progress due to improper diagnosis. About 25 percent of them do not complete the treatment because a significant number of them do not experience meaningful improvements, so they decide to opt out. And these all cases are attributed to over and diagnosis in the field of mental health.

.However, most patients who undergo CBT for mental disorders exhibit significant reductions in symptoms of their particular mental disorders. Often these improvements are seen after a period of about 12 weeks. It is also crucial to note that these treatments are not always successful. In fact, it is estimated that about twenty percent of patients receiving this treatment will prematurely withdraw from the treatment. Moreover, approximately 25 percent of the patients who do complete the treatment will not show meaningful improvements about the baseline functioning.

. Attitudes

At times some events occur and the physicians may experience a lot of pressure from internal and external factors which may force them to use a label that they do not think is the best description of the patients symptoms. The type of doctors attitude towards the patient affects the way in which the doctor will disclose the outcomes of his patients diagnosis. A good example is when the clinician is concerned with the negative reactions from a patient. From the video we realize that the therapist tends to be a little ineffective when it comes to conveying of the diagnostics information to the clients. The reason behind this inefficiency is the fact that most clinicians fear to share the diagnosis outcomes with their patients, since different patients will respond differently to the information. Some of the diagnosis information may convey stigma and as a result, complicate the clinician-patient relationship. Moreover, there are some cases where patients are likely to do better with more positive information, in case the diagnosis tells something different, then the clinicians would be forced to fabricate the diagnosis to make it look good for the patient and give him hope.

Misdiagnosis occurs often, and it is done by the clinicians unknowingly and sometimes knowingly. It is important to note that missed diagnoses and misdiagnosis complicates the lives of those people living with mental illness. Patients tend to receive wrong medication in cases where they receive the wrong diagnosis. This means that incorrect diagnosis translates to incorrect treatment. And when a medical condition is incorrectly treated the condition may grow worse or even take a long time to heal. It is tough for patients to live with improperly treated mental illness, since most of these illness hinders peoples productivity, making it hard for them to succeed at school, home or even life at work. Also, patients with untreated mental illness may experience hardships in maintaining healthy relationships, and in this situations suicidal thoughts are uncommon. I believe apart from marriage relationships; the doctor-patient relationship should have a strong bond of trust. Patients depend on the physicians to help them make life-saving choices. Therefore doctors should also be honest, just like the way patients are honest when speaking out their problems to the doctors. If there is no openness and honesty in the patient-doctor relationships, then there are high chances that the public is likely to lose complete trust on their doctors and by extension their services. Before doing anything unethical, doctors should remember their oaths and put the patients in the center focus.

Skills

Preventing and avoiding the problem of under and over-diagnosis requires a critical re-envisioning of the diagnostic procedure and a comprehensive initiative to change. It requires physicians to be more skillful and innovative.Diagnostic error is often a multifaceted and a complex problem. Therefore we need multiple solutions and ideas to achieve the changes needed. Some of these solutions include; facilitating more effective teamwork in the diagnostic process among clinicians to ensure that likely diagnostic results are obtained. Also, I will want to adopt appropriate health information technologies to support doctors and patients in the diagnostic process. Moreover, diagnostic errors can also be prevented by developing and deploying techniques which allow the doctors to identify and resolve near misses in the clinical practices. In general, to ensure current and future over and under diagnosis mistakes are avoided, I will have to develop a medical liability approach, and a reporting environment which will help me and other physicians improve diagnosis by learning from the previous diagnostic mistakes and near misses. Moreover, I will have to design a care delivery environment and a payment setting that supports diagnostic process. With this approaches in hand, over and under-diagnosing of mental disorders and other illness is going to be a thing of the past.

References

Kirk, S. a. y Kutchins, H. - The Myth of the Reliability ... (1988). Retrieved May 24, 2017, from https://www.bing.com/cr?IG=94BFF71CED104FB1851E4D9B71E751FD&CID=25180855C131689B2FEC02D9C03769B0&rd=1&h=NIe7wZGINfeGe9MiPLoP7yr0fVnYgJLWRiVmK681fYU&v=1&r=https%3a%2f%2fwww.scribd.com%2fdocument%2f116366523%2fKirk-S-a-y-Kutchins-H-The-Myth-of-the-Reliability-of-DSM-2&p=DevEx,5084.1