Deliberate Misdiagnosis In Mental Health Practice Summary

Americans are now spending billions of dollars on psychiatric medications but according to Frances “We are ignoring the people who have severe psychiatric illness; so that, one-third of people with severe depression see a mental health clinician, two-thirds don’t. Two-thirds of people with severe depression get no treatment at all. At the same time, we’re way over-diagnosing people who have milder problems that would get better on their own.” Diagnosis can cause more harm than good when not really needed. We are over-treating those who don’t need treatment, while neglecting those who do.

An essential job duty for any healthcare professional is to be able to service clients. The Code of Ethics (1999) outlines that service means to use the knowledge that a social worker has acquired through training and education to assist clients with issues that are inhibiting them from living their life completely and without suffering. By this definition, a social worker’s job is to assist a client with real-life issues, such as depression and anxiety, which are faced by the majority of the elderly population (Richardson & Barusch, 2006). For a social worker, assisting clients who face mental illness means

The main pathway for a counselor to help the client is by learning as much about them as they can. Through interviewing and sometimes evaluating say Remley & Herlihy (2015), the counselor decides if they have a diagnosis and together the client and the counselor match a treatment option or options with the client and their diagnoses and goals. In order for a client to use their health insurance, they must have a mental health diagnosis. However, the act of downcoding or upcoding is unethical as well as illegal.

As being diagnosed as mentally ill creates a use of label’s which help us to understand and accept the behaviours that they are displaying within a patient centred environment where the individual will not be held in charge for their actions. However, this use of terms will generate empathy and accepting the attitudes of those who are suffering from the mental health issue/ disorder. In some cases, this type of language is seen as a control by professionals which shows off the power that they have over the service user. In some cases, the label’s give some form of relief to service users and individuals for example they will find out that the illness that they have has a name and reassures the service users in a way because they can receive a more adapted way of getting treatment and information of their illness. The findings that we have on labelling provides us with the evidence which we can use to argue that labelling empowers people and raises individual’s self-esteem which in a way can make their wellbeing better, but this is supported throughout the service users opinions once they’ve been diagnosed some individuals become aware of the illness that they have and they gain an understanding of the behaviours that they are displaying or showing. The mental capacity act 2005 says that choices are made but are made

In the United States the Mental Health Care field is one of the most underserved areas of healthcare. The mental healthcare field faces many challenges to the proper treatment of patients from both a societal and professional standpoint. From a societal perspective a negative stereotype is associated with patients seeking psychiatric care. Patients seeking care are often labeled as defective or damaged. Add in the complication that most patients with mental illness appear to be normal, accepting that someone is ill without outward symptoms can also be difficult for a society to understand. From a professional perspective the challenges within the mental health care industry include personal prejudice, staffing issues, and problems with coordinating care. The combination of these factors has a direct negative impact on the willingness of individuals suffering from mental illness in seeking the care needed to treat the symptoms of mental illness.

The financial liability for the patient is daunting and may keep some from coming to the hospital for treatment and others leaving against medical advice (AMA).

Patients would tell the doctor exactly what illness afflicted them and what the treatment was. The issue with self-diagnosing is that patients don’t know how to interpret the information they have. Doctors undergo years of education and training to get their degrees. Proper training enables doctors to understand the information that they have and make an informed diagnoses. When patients self-diagnose, they interrupt the doctor’s thought process and ultimately waste the doctor’s time. At Mercy Urgent Care, time is valuable and there are many patients to see. Self-diagnosing is a substantial issue at Mercy Urgent Care and many other

Many mental health counselors work with managed care organizations (MCOs) to provide services to clients. While managed care guidelines determine how counselors deliver services and what they will be reimbursed for, many counselors are upset with how limiting the guidelines are. It is a challenge for counselors when insurance reimbursement is denied because the MCOs are not honoring DSM codes (Braun & Cox, 2005). Therefore, counselors tend to submit inaccurate diagnoses that are reimbursable for their clients can receive services and they can be paid. However, this can lead to ethical and legal dilemmas for counselors. Braun and Cox (2005) address this issue in their article “Managed Mental Health Care: Intentional Misdiagnosis of Mental Disorders.”

Kroska, A. Harkness, S.K. (2008). Exploring the role of diagnosis in the modified labeling theory of mental illness. Social Psychology Quarterly, 71, 193-208

Dr. Ofer Zur (2016) reported that some mental heath providers have submitted inaccurate insurance bills to get paid more units for services they did not render. For that reason these same therapists may have over- diagnose youth with disorders in order to defraud the insurance companies. Dr. Zuf (2016) also states that these therapists have included patients in their illegal activities by promising them that they receive larger reimbursement check from their insurance company(para.1). According to research “false billing practice has become very common, some therapists are not even aware that they are involved in what some people call "theft by deception”( Zur,2016.para,1).

Medical history records of a patient could reveal a history of mental illnesses, depression or other conditions. In an event that these people were to lose health insurance, they may find it impossible to obtain a private health insurance outside due to their pre-existing medical condition.

According to Erford (2010) defines diagnosis as a framework used to identify problems or the focus of intervention. Mental health settings typically use the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition- Text Revision (DSM-IV- TR) (American Psychiatric Association, 2001). Diagnosis is the recognition of a problem that becomes the objective and goals of the counseling intervention it is also the detection of a disease, disorder, or syndrome based on some form of systematic assessment. “The problems associated with diagnosis include identifying clients by their diagnosis as opposed to focusing on their unique situations and experiences” (Erford, 2010 p.285). Understanding the implication of a diagnosis on the client and the counseling relationship is something that all professional counselors need to consider. To develop a treatment plan counselors uses the DSM- IV- TR which includes a five axial system that comprises of clinical disorders and other factors that are the focus of treatment, long-standing socio-emotional problems, medical conditions, environmental stressors, level of symptom distress, and functional impairment. This five axial system is intended to provide a comprehensive diagnostic picture. Professional counselors need to be diligent regarding the use of diagnosis. It is an ethical requirement that counselors providing diagnostic formulations be adequately trained in the use of DSM- IV- TR and that

He first ensures it can be helpful in the case of more severely debilitated clients requiring medication, such as those struggling with schizophrenia, bipolar disorder, etc. People who encounter these struggles appear to require a different kind of therapy which must recognize and address a specific problem and its ripple effects. However, Yalom (2012) appears to not buy into the thinking every individual who comes in his door requires to be put in such a box. I have deeply struggled with this issue recently because of conversations with colleagues outside of class. I have heard both sides of the fence, and I cannot shake the presenting issues with always looking for a specific diagnosis. Such a belief is not solely due to the fear of being wrong, but also because clients seem to identify themselves with their psychological problems. How many times do people say, “I’m depressed” or “I’m anxious.” I do not want to play a part in a person defining themselves by their

Applying a diagnosis to a client’s profile has complications as well. The labeling of a client with a diagnosis related to mental illness can have negative effects on his or her self esteem and also result in insurance and employment issues (Mears, 2010). Without careful attention to issues of culture and social justice in a person’s life, responses to oppression can be improperly diagnosed (Mears, 2010). A woman who is diagnosed with an anxiety disorder without exploration into the fact that she is being sexually harassed at work would be an example of this issue.

In the mental health profession, the variability of symptoms has an impact on misdiagnosing clients, that can’t be overlooked. An example of how the variability of symptoms can lead to misdiagnosis is with the diagnosis of post-traumatic stress disorder after a traumatic brain injury. For example, memory gaps resulting from coma and post traumatic amnesia have the same characteristics Personality change, including impulsiveness, reduced insight, rigid thinking, reduced motivation, and impaired learning and concentration resulting from traumatic brain injury, may also cause some complaints to be mislabeled as PTSD symptom (Sumpter, & Mcmillan, 2005). However, how a person processes information from life’s circumstances also varies. For example, there was a young lady I grew up with, that was being raised by her grandmother. She had the misfortune of her biological mother being a prostitute, and her biological father was a pimp. Personally, I don’t know how I would process this information if this was my presenting problem. Nevertheless, the fact that she was our friend cause us to ignore the circumstances of her life; in her resilience, she went on to college after high school and is now happily married in a successful career, has children and grandchildren. The obvious questions I now have about her: was she receiving therapy as a child that helped her make since of this senseless situation she was born into? Did she have to receive any type of therapy in college? Or