The First Cause of Everything Bad in the Mental Health System: Psychiatric Diagnosis Action Think Tank

Paula Caplan, Ph.D.

As I discussed informally with Tim Clune last year (2017) at NARPA after his terrific keynote address, and as I have written for decades, the first cause of everything that happens in the traditional mental health system – and by extension – in mental health courts, use of various approaches and rejection of others, and much more is psychiatric diagnosis. If no professional diagnoses a person who seeks help, in principle they are not supposed to recommend any treatment or “treatment,” but once they have assigned any psychiatric diagnosis, virtually anything can be recommended in the name of treatment of that “disorder.”

I have been an expert witness in a lawsuit for a plaintiff whose life was nearly destroyed by three therapists who did horrible things to her. But the jury failed to find any of the therapists guilty, on the grounds that what they did was according to the “standard of care.” As most people who attend NARPA are aware, the standard of care in the traditional mental health system is often at best not helpful and at worst harmful, even leading to death. The fine people who work to prevent harm in that system often attack psychiatric drugs in one case, forced institutionalization, forced outpatient commitment, physical restraints, electroshock, deprivation of legal rights in a wide variety of ways, and so on.

But sorely needed are ways – likely including but not limited to at least one lawsuit (test case), Congressional hearings, one major documentary film, and a simple brochure – to educate the public and thereby empower them to know what to question and challenge; bring pressure on professionals to inform those who seek their help about the facts about psychiatric diagnosis and ways the professionals will do their best to protect them from diagnosis-caused harm and to use better approaches, presenting a huge array of alternative, nonpathologizing approaches (more than two dozen are already in very brief videos on a Harvard Kennedy School website from a conference I organized some years ago); and expose the crucial role of psychiatric diagnosis, as well as the three major myths about it, i.e., (1) that it is scientific, (2) that it helps reduce human suffering, and (3) that it does not lead to any harm.

Learning Objectives: