The Underdiagnosis of Mental Health Disorders

What makes mental disorders overdiagnosed? How can we, as a society, define a mental disorder? And what dictates a mental disorder? A mental disorder is a condition that affects one’s mood, thinking, and behavior. This, in today’s society, a social stigma and discrimination has worsened towards mental health and has impeded on treatment and recovery. The social isolation of mental health problems can cause one to be stuck in a constant cycle of illness. This event leads to the diagnosis of mental disorders and how as a society they are defined. An uncertainty of over or under diagnosis of mental disorders is a problem that needs to be solved for a better understanding of the condition. In this paper, I will discuss how mental disorders have been underdiagnosed through the exploration of research that begins to look beyond the surface of stigma and discrimination. Even, I consider the influence of social and cultural diversity, in regards, to the rights of the mental health consumer.

Before the analysis of looking into the overdiagnosis or underdiagnosis of mental disorder, first, we have to look at how mental disorder is defined; not only now, but throughout its history. This event is important because it gives an understanding and sense of how mental disorder is treated in social and cultural diversity and its connection to mental health consumers. In order to look into the history of mental disorder, the DSM (Diagnostic and Statistical Manual of Mental Disorders) allows for a standard definition and classification of mental disorders to look to improve diagnosis, treatment, and research. The need for a standard definition and classification of mental disorders has been needed throughout mental health history, however, the universal understanding of what is a mental disorder is not fully in agreement. A method of agreement towards mental disorders has been developed throughout history by the DSM, but there is always room for improvements in regard to mental health. Beginning in 2000, the DSM-5 has been lead by a group of researchers to create a summary of the state of mental disorders and their diagnosis. The analysis and emphasis of, the DSM-5 begins to look beyond the definition and classification of mental disorders, and determining if they are being overdiagnosed or underdiagnosed.

The common goal of, the DSM-5 is the evaluation of the diagnosis criteria of mental disorders, and the organization of the revision process. It states in, DSM-5, “the reliable diagnoses are essential for guiding treatment recommendations, identifying prevalence rates for mental health service planning, identifying patient groups for clinical and basic research, and documenting important public health information.”^[1] This shows shows that the understanding of mental disorders have evolved, both medically and scientifically, and its relationship for treatment and research. First, it is important to see the advancement of treatment and research of mental disorder because once that is figured out, then determining if mental disorders are being overdiagnosed or underdiagnosed can be assessed. The science of mental disorder is not an easy subject, however, the DSM-5 has been overseeing and recognizing its revision process so as to correctly define and classify mental disorders. Its development of defining and classifying mental disorders explains and determines the problems of overdiagnosis and underdiagnosis. Now, seemingly, it seems like the overdiagnosis of mental disorders, but in reality, is it just a better understanding of a disorder and its social and cultural diversity? Is it possible that our scientific understanding of mental disorders is due to research? And how can this event be determined accurately for correct diagnosis and not a manipulation of science and medicine?

Underdiagnosed; Stigma and Discrimination

Through the exploration of research, the understanding of mental disorders has been questioned. The research into the question of mental disorders being underdiagnosed reflects itself in the stigma and discrimination of mental health consumers. Although the research does have mixed results, it is indeed an underdiagnosis because of inconsistent diagnoses and criteria associated with mental disorders. It is the understanding that an underdiagnosis of mental disorders is a reality because, through research, there can be a claim made that people who are not diagnosed actually have a disorder. And when one is diagnosed with a mental disorder, there is often a negative connection and attitude among others that look down upon the mentally ill. This overshadowing of mental illness and disorder means a lack of physical illness signs and symptoms that often lead to the underdiagnosis and mistreatment of mental health consumers.

A stigma and discrimination that is attached with mental disorder causes mental health consumers a disconnection associated with a lack of society’s knowledge of causes and symptoms and the treatment of mental disorders. A lack of knowledge in the public and lack of personal contact with affected individual results in negative attitudes and stigmatization and discrimination.^[2] As a result, humans suffering with a mental disorder are outcast and put into a category and classified as being different and weird. These individuals tend to not feel like a part of a community or society, making them not accepted by other members. Instead of stigmatizing and discriminating humans with mental disorders, us as a society, must provide the opportunity of acceptance, and an understanding of recognizing the difference of mentally ill humans compared to the ‘normal’ standard. Without an acceptance of mentally ill humans, the stigma, and discrimination leads to an underdiagnosis of mental disorders; possibility the fear of being an outcast or the failure of normality. The many challenges that arise from stigma and discrimination of mental disorders can social and cultural affect mental health consumers or someone whom is mentally ill. It cannot be overlooked, there has to be a universal understanding of the impact that is faced every day for the mentally ill. If not understood, this is where a problem begins.

With many people with a mental disorder challenged daily with symptoms from the diseases, there is also the side that they are challenged with the stereotypes that follow. According to Patrick Corrigan and Amy Watson, “as a result of both, people with mental illness are robbed of the opportunities that define a quality life: good jobs, safe housing, satisfactory health care, and affiliation with a diverse group of people.”^[3] This begins to explain and demonstrate the challenges of people with mental disorders, and the loss of opportunities related to stigma and discrimination. Yes, research has begun to explain both the issues and impact of diseases, but it is still a far way away from a full understanding of the impact of stigma and discrimination towards mental disorders. As a result, there can be a connection made that a lack of knowledge and understanding of the research of stigma and discrimination can and will result in the underdiagnosis of mental disorders. The underdiagnosis of mental disorders arise from the poor research and the mental health consumer being in fear of an outcast and a seperation of community and society. From Corrigan and Watson, “public stigma is the reaction of the general population towards people with mental illness and then self-stigma is the prejudice which people with mental illness turn against themselves.”^[4] Both public stigma and self-stigma lead to stereotypes, prejudice and discrimination, which affect the lives of mental health consumers. Now, the stereotypes do not correlate the knowledge of them and if a community or society agrees with them. This, in turn, causes a disconnect with mental health consumers. People who are prejudiced are influenced by the negativism of stereotypes and have negative reactions. The negativism is in one’s mood, thinking, and behavior; as a overall belief that this is how it should be. The fact that this affect people with mental illness is a shame on communities and societies, an universal failure and a lack of knowledge that leads to an underdiagnosis of mental disorders.

Overall, the stigma, and discrimination of mental disorders is tied to the underdiagnosis of them. Continuing that thought, the realization of the challenges that arise towards mental disorders needs to be further research. The need for change in the strategies of the diagnosis of mental disorders will result in the proper diagnosis of mental health consumers and prevent the lack of underdiagnoses. When mental disorders are diagnosised correctly, the stigma and discrimination towards them is eliminated, and the equality begins.

BIBLIOGRAPHY

• American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Arlington, VA: American Psychiatric Association, 2013.
• Baumann, Anja Esther. Stigmatization, social distance and exclusion because of mental illness: The individual with mental illness as a ‘stranger’. International Review of Psychiatry, 2009.
• Corrigan, Patrick W and Amy C Watson. Understanding the impact of stigma on people with mental illness. World psychiatry: official journal of the World Psychiatric Association, 2002.

^[1] American Psychiatric Association, Diagnostic and statistical manual of mental disorders: DSM-5. (Arlington, VA:

American Psychiatric Association, 2013), 5.

^[2] Anja Esther Baumann, Stigmatization, social distance and exclusion because of mental illness: The individual with

mental illness as a ‘stranger’, 131.

^[3] Patrick W Corrigan and Amy C Watson, Understanding the impact of stigma on people with mental illness, 16-20.

^[4] Patrick W Corrigan and Amy C Watson, Understanding the impact of stigma on people with mental illness, 16-20.