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Social Misuse of Diagnosis: Pathologizing Marginalized Populations: Sue Banks, PhD

Social Misuse of Diagnosis: Pathologizing Marginalized Populations: Sue Banks, PhD Program Transcript

SUE BANKS: Hello, my name is Dr. Sue Banks, and I am a core faculty member at Walden University in the School of Counseling and clinical mental health counseling program. I've been asked to speak about how diagnosis has historically been used to pathologize marginalized populations. I think that in the past, many Americans were able to hide mental illness. But today, as jobs become more demanding, our schools become more unsafe, and life just gets in the way, more and more people are just unable to manage their anxiety, to manage their depression, and overall dysfunction.

So as more people seek care, then we've seen an increase in the diagnosis of mental disorders over, let's say, the past 30 years or more. Researchers also argued that the DSM has made it easier for individuals to qualify for mental illness, or to meet the criteria for mental illness.

We've also seen an increase in pathologizing normal behavior. I'm reminded of this with the increase of pharmaceutical commercials on TV. When I think about pathologizing marginalized populations, I have to discuss what pathology means to me. Pathologizing is the practice of seeing normal behavior or seeing common symptoms in certain communities as a disorder.

I also see pathologizing as a means of over-diagnosing certain behaviors or conditions. And also an excessive use of psychotropic medications. When large numbers of people in certain areas, particularly lower socioeconomic areas or urban areas have particular diagnoses, then I think about pathologizing.

I also believe that this causes us to miss really understanding the experiences of the groups. And we miss how to effectively treat the condition for particular groups. Examples of this can be seen in the increasing numbers of children diagnosed with mental disorders like attention deficit hyperactivity disorder, or ADHD, and also adults diagnosed with schizophrenia and schizoaffective disorders in urban areas.

Now I'm sure that there may be additional considerations related to pathologizing behavior, and it might even be necessary in some areas or communities. Frequently, I attend presentations by pharmaceutical representatives who consistently present data showing that clients are three to four times more likely to be misdiagnosed with mental disorders. And, of course, misdiagnosis causes them to receive inappropriate medication treatment.

This is where the problem lies for me. Not only do clients receive improper medication treatment when they've been misdiagnosed, but they also receive inadequate psychosocial treatment like counseling and other psychosocial interventions. What I want to emphasize is the importance of all counselors having a common understanding of assessment.

Social Misuse of Diagnosis: Pathologizing Marginalized Populations: Sue Banks, PhD

Assessment is a valuable tool that supports diagnosis, but it should never be used in isolation. And certainly the results of one assessment should never lead to a diagnosis or medication treatment. Some main purposes for using assessments include to gather information about client in order to make an accurate diagnosis, to formulate an effective course of treatment for the client to evaluate the client's progress during treatment, and also to support a request for additional services for the client.

I believe that understanding the challenges of assessing and diagnosing children and adults, as well as staying abreast current trends in assessment and mental health intervention, will allow us as counselors to serve clients from a best practice approach to mental health care. So thank you for your time.

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Social Misuse of Diagnosis: Pathologizing Marginalized Populations: Sue Banks, PhD

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