How mental health diagnosis should be more collaborative

April 18, 2018

Mental health diagnosis should be a collaborative and useful process, not a meaningless label - according to new research from Norfolk and Suffolk NHS Foundation Trust (NSFT) and the University of East Anglia.

Doctors should work alongside service users to approach diagnosis in a way that is sensitive to individual needs and preferences, so that they explain difficulties, give hope, empower and guide recovery.

A study, published today in The Lancet Psychiatry, offers practical guidance for doctors and could lead to service users having a better experience of diagnosis.

The research was undertaken by a team that included a clinician and a service-user from the Department of Research and Development at Norfolk and Suffolk NHS Foundation Trust (NSFT) and researchers at the Norwich Medical School at the University of East Anglia (UEA).

The major review synthesises for the first time the perspectives of service-users, carers and doctors in an attempt to understand and improve the diagnostic journey. It contains data from 13 countries and includes more than 2,220 participants.

One of the authors, Dr Corinna Hackmann, a research clinical psychologist based at Hellesdon Hospital, Norwich, said that diagnosis can be validating and helpful but can also be detrimental and lead to stigma.

"For me, an interesting finding of this study is the discrepancy between the views of service users and clinicians," she said.

"Many doctors feel that service users have a right to know their diagnosis but at the same time rightly fear the potential harm this might cause, which can be associated with withholding or delaying sharing the diagnosis.

"However, the results suggested that if a diagnosis is made, service-users would prefer that it is shared and discussed with them rather than withheld."

Dr Caitlin Notley, from UEA's Norwich Medical School, said: "This research supports a sensitive, individualised, collaborative, and holistic approach to mental health diagnosis, which is informative, can empower service users, provide hope and guide treatment."

A major diagnostic manual, the International Classification of Disease - 11th revision (ICD-11) is set for release by the World Health Organisation (WHO) this summer. This study forms part of an important and timely programme of International research aimed at improving the diagnostic process in collaboration with service-users.

"We have developed research in dialogue with the WHO that feeds service-user views into the process of revision for the ICD-11," said Dr Hackmann.

The paper reports that diagnosis can be experienced as labelling and this can cause stigma.

The authors found evidence of feelings of isolation, confusion, insignificance or distress when a diagnosis is not discussed with service-users, is discovered via health records, in a letter or inadvertently mentioned in a care meeting.

The study suggests that service-users prefer their diagnosis to be given face-to-face, with helpful information, and clearly leading to reciprocal discussions about care-needs and treatment.

Dr Hackmann co-authored the study with Amorette Perkins and Joseph Ridler (former Research Assistant Psychologists) and Daniel Browes (expert by experience and former Peer Support Worker) and colleagues from Norwich Medical School and the School of Health Sciences at UEA - Dr Caitlin Notley, Senior Lecturer in Mental Health; and Dr Guy Peryer, Lecturer in Health Sciences.
-end-
'Experiencing mental health diagnosis: a systematic review of service user, clinician, and carer perspectives across clinical settings' is published in The Lancet Psychiatry on April 18, 2018.

University of East Anglia

Related Mental Health Articles from Brightsurf:

Mental health strained by disaster
A new study found that suicide rates increase during all types of disasters -- including severe storms, floods, hurricanes and ice storms -- with the largest overall increase occurring two years after a disaster.

The mental health impact of pandemics for front line health care staff
New research shows the impact that pandemics have on the mental health of front-line health care staff.

World Mental Health Day -- CACTUS releases report of largest researcher mental health survey
On the occasion of 'World Mental Health Day' 2020, CACTUS, a global scientific communications company, has released a global survey on mental health, wellbeing and fulfilment in academia.

Mental illness, mental health care use among police officers
A survey study of Texas police officers examines how common mental illness and mental health care use are in a large urban department.

COVID-19 outbreak and mental health
The use of online platforms to guide effective consumption of information, facilitate social support and continue mental health care delivery during the COVID-19 pandemic is discussed in this Viewpoint.

COVID-19 may have consequences for mental health
The COVID-19 pandemic appears to be adversely affecting mental health among hospitalised patients, the healthcare professionals treating them and the general population.

Mental health outcomes among health care workers during COVID-19 pandemic in Italy
Symptoms of posttraumatic stress disorder, depression, anxiety and insomnia among health care workers in Italy during the COVID-19 pandemic are reported in this observational study.

Mental ill health 'substantial health concern' among police, finds international study
Mental health issues among police officers are a 'substantial health concern,' with around 1 in 4 potentially drinking at hazardous levels and around 1 in 7 meeting the criteria for post traumatic stress disorder and depression, finds a pooled data analysis of the available international evidence, published online in Occupational & Environmental Medicine.

Examining health insurance nondiscrimination policies with mental health among gender minority individuals
A large private health insurance database was used to examine the association between between health insurance nondiscrimination policies and mental health outcomes for gender minority individuals.

Mental health care for adolescents
Researchers examined changes over time in the kinds of mental health problems for which adolescents in the United States received care and where they got that care in this survey study with findings that should be interpreted within the context of several limitations including self-reported information.

Read More: Mental Health News and Mental Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.