Mental Health: More Diagnoses, Fewer Answers?

There's something that's not working in the way that we approach mental health care. What seems to be happening in mental health care is something that people refer to as the treatment prevention paradox. The more people are accessing services, so there has been more and more access to assessments, different types of treatments, interventions, more people getting mental health diagnoses. So the Prevalence of mental health conditions has been expanding and expanding pretty relentlessly.

And the amount of access that people are having to various types of treatments, whether they're psychological, social, or pharmacological, has also been expanding rapidly. And if what we were doing in the mental health sphere was successful, what you would expect would be at least a stabilization of the prevalence rates, but hopefully the prevalence rates would start going down because we would be seeing an improvement in outcomes. I've come across a lot of people who've been prescribed SSRIs and in my experience I have not come across anyone yet where this has led by itself to lasting change. ADHD starts out as a very rare condition called hyperkinetic disorder.

When I was training as a child psychiatrist, I didn't come across any child with this condition. It was considered to be rare. If you had a learning difficulty, that would be an exclusion criteria, but then it goes through a what I call a mutation of constructs. And at no point was there any new scientific information coming forward to tell you that there is something empirically in common with people getting the diagnosis that you can find in their bodies or brains. So expands to become to include not just levels of activity, but also attention levels and expands to 3%.

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