Let children have an emotion without calling it a disorder

ARE 20% of a group of more than 1,000 11-13 year olds really at risk of suffering from a psychiatric disorder?

Research on a group of middle-class schoolchildren in Dublin found they were after completing a strengths and weaknesses questionnaire.

Those deemed to be at risk were then taken for a more in-depth interview, where 15% fulfilled the criteria for a “current mental disorder” and 37% had experienced a “diagnosable mental disorder” at some stage in their lifetime.

This is extreme language to use when talking about young people.

The study, funded by the Health Research Board, used a “simple yet effective screening tool” which can apparently reliably identify children at risk of suffering from a mental health disorder.

The initial survey asks questions to which the youngsters answer yes, no, or maybe. They include: I am often unhappy, depressed or tearful; I think before I do things; I have many fears, I am easily scared; I am restless, I cannot stay still for long, and so on.

At one end of the scale, many may welcome the fact that young people’s welfare is being analysed, but at the other end we must ask — do we really want to label young people’s emotions as a mental disorder? Surely this kind of language is unhelpful and will only serve to stigmatise.

In our adult psychiatric services, the progressive school of thinking is moving away from labels.

Once you are branded as having a “mental disorder”, it sticks and can affect every aspect of your life.

Take for example, a mother who experiences some form of breakdown and has her children taken away from her. Because of her “psychiatric” history, it is often very difficult to get the children back.

We are in the lengthy and complex process of trying to reform our mental health services, but surely by applying the same drastic language to our young people’s feelings, it’s a step back.

Do we want to go down the route the US has taken, whereby everything from a tantrum to a tear is classified and diagnosed as some sort of illness? And where, of course, there is usually a pill at hand to sort it out?

Professor Mary Cannon, the consultant psychiatrist who carried out the research, said interviewers were not worried about the vast majority of young people — even if they were fulfilling the criteria for a current mental disorder. So why label it in such an extreme way if it is not deemed to be a serious issue that merits follow up or treatment?

Prof Cannon agreed with this. The problem is that she is simply working within the parameters of how her profession views things, and how a diagnosis is made. This is part of a wider debate going on globally about the future of psychiatry and its labels.

Dr Sami Timimi, a British-based consultant child and adolescent psychiatrist, is leading a campaign to abolish diagnostic classifications. Dr Timimi, who is set to speak at a conference on the issue in UCC next month, has written extensively on ADHD, which he calls a socially constructed explanation to describe behaviours that are not genuinely pathological, but rather simply don’t meet prescribed social norms.

So yes, research is the key to knowledge, and without it we cannot understand or learn and thus formulate responses to problems. But if young people are sad, angry, worried, scared or restless, perhaps it’s better to call it just that — and not classify it as a mental disorder.