Friday, November 4, 2011

Mind Games

Ever since I read Robert Whitaker's book about the explosion of mental illness in the United States (see my recent post) I've been much more conscious of mental health trends.

The 2011 Pfizer Health Index provides recent information about health and illness in Ireland. I've highlighted data from one of the report's tables showing the incidence of depression and of other mental illnesses. It comes to about 5% of the Irish adult population (the same as in the recent CSO study of the nation's health status). Though even at 5% that is still nearly 150,000 people - more than twice the numbers affected by cancer over the same period.

Of course, the predominant paradigm for the treatment of mental illness is a biological one (necessitating treatment by psychiatric drugs): even though there are several other models of mental illness that have stood the test of time. This means that any increase in the incidence of mental illness tends to automatically increase the prescription of psychiatric drugs. Whitaker and others have charted the alarming increase in the incidence of mental illness in the United States and elsewhere - and the manner in which it has grown in lock-step with prescription drug consumption.

Almost uniquely in the medical domain, the incidence of mental illness (as opposed to, say, cancer or heart disease) isn't just a function of epidemiology. It is also a function of 'definition'. Which is why there is so much controversy about the forthcoming edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5 in the jargon). Effectively, the APA are being accused of widening the definitions of mental illness to such an extent that huge majorities of the population could be diagnosed as mentally ill. In effect: the APA are 'inventing' mental illnesses (my favourite: 'Apathy Syndrome' - as if anyone cares).

Practitioners of the 'other models' (cognitive therapists, psychoanalysts etc) see DSM-5 as a more-or-less self-serving initiative by psychiatrists to 'grow the market'. With the implication that we will see a growing population of 'mentally ill' (as more and more people are so-defined), and the resultant growth in demand for prescribed psychiatric drugs that will inevitably follow.

Economic reality (certainly for the HSE in Ireland) might curb such a trend - and cultural influences may also have an influence (e.g.: I still haven't figured out why the Portuguese are three times as likely to take anti-depressants as the Irish - see my previous post). Given that the share of Irish adults suffering depression hasn't risen the past five years, then perhaps we are somewhat immune to the 'mind games' of the psychiatric profession?

No comments:

Post a Comment

Related Posts Plugin for WordPress, Blogger...