Can Psychiatric Labelling of Kids be Dangerous?

kariseedenIn 2012, an amazing, talented young woman by the name of Karise Eden became the winner of the first ever series of “The Voice” in Australia. She is, without doubt, an enormous talent and has a voice that is both powerful and haunting.

Like all good contestants on any reality television show, she has a heart-wrenching, emotive story that involves grief, rejection, self-harming, domestic violence and other problems.

Recently, on Australian Story, we got to hear Karise’s back story delivered with much more authenticity and intimatacy than was possible on The Voice. Unfortunately, you can no longer watch the interview online but here is one of Karise’s profound comments:

“When I was a teenager, they thought all these things were wrong with me. They diagnosed me with all sorts of things. Asperger’s was one, aggressive depression, split personality, bipolar… They put me on all forms of medication, and I used to say, ‘It’s just like putting a Band-Aid over a scab, it isn’t going to get any better, it’s just going to fester, and you’re going to take the Band-Aid off, and what’s going to be left? A big wound that hasn’t healed!’

That’s what medication was like, because I knew that there wasn’t anything psychologically or mentally wrong with me. I just knew that I needed a cuddle. You know, that’s all I needed! I was just a really sad little girl.”

Karise is one example of what I see in my work, day after day, week after week, month after month and year after year. With tongue firmly implanted in our cheeks, my colleagues and I often refer to this diagnosing as “psychiatrising” of normal behaviour. The Diagnostic and Statistical Manual (DMS-V) which is our “bible” for diagnosing mental illness, for all its good points and validity, has this habit of pathologising normal human behaviour. Allen Frances, Professor Emeritus at Duke University, is of the opinion that the DSM is “almost certainly over-inclusive” when it comes to diagnosing mental illness.

If a child is exposed to trauma and loss, rejection and grief, and they are not living in a stable, safe, predictable environment, you can almost guarantee that they will act out. They are scared. They are lonely. They are overwhelmed. And instead of us grown-ups creating the safety and support they so desperately need, we label them and medicate them instead. Oh how I wish that wasn’t true, but it’s exactly what I see in my work.

Check out this thought-provoking little clip about Psychiatric Labelling and kids:

Now please understand me. There are times when it is perfectly appropriate and correct to diagnose a child. It can help us understand their behaviour. The diagnosis itself can open doors to accessing subsidised services to support that child, so it can be crucial. But the question is worth asking:

Are we over-diagnosing kids?

It is a really hard question to answer, mainly because it is a really hard thing to investigate and I’m not here to argue that point anyway. I just want to challenge you to think, to be a savvy consumer, to ask questions of the treating specialist about why they believe this child needs this particular diagnosis. And maybe to ask ourselves, “What purpose would a diagnosis serve here?”

I am deeply concerned about the effects labelling may have on a child, such as the possibility that the label may easily be slapped over the top of other issues, and prevent them from being adequately addressed. Anecdotally I can tell you that I, along with so many of my colleagues, are seeing young people who we are confident do not meet the diagnostic criteria but who do have multiple social and environmental issues which are not being addressed.

And don’t forget that at the heart of diagnosing mental illness is something called the “Biopsychosocial” model of mental illness. We’ve come to understand with confidence that a person’s mental health (or illness) is a complex interaction between the biological, the psychological and sociological. Our first priority in assisting a child is to provide safety, security and stability; these are the essentials for good mental health. It’s basic common sense! Maslow’s Hierarchy of Needs is a good place to start in understanding this issue. If you meet the basic needs, the others flow on quite well.

I saw a very funny re-do of Maslow’s Hierarchy of Needs on Facebook recently:


I’ll wrap up with a final quote by Karise from her Australian Story interview:

“I think music and animals are the key to a happy life.”

And quite possibly WiFi.


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