The politics of diagnosis.

I have said it before that the diagnosis of mental health conditions in Australia is going to transform over the next 10 to 20 years. Now there is clear research evidence to support my claim. Some time ago the diagnosis of autism changed. It stopped being Autism and became Autism spectrum disorder. What this means is people with less severe autism characteristics who would not have previously been defined as autistic now are because it has become a spectrum disorder. These people are now diagnosed as having the mental health illness of autism. The definition of what is “mentally ill’ has widened to include more people.

A study in the international journal Autism Research, has found that in the past 30 years in Australia the number of people who fit the criteria for the original condition of autism has actually gone down. But the numbers of people who now fit the diagnosis of autism spectrum disorder has increased 20 times. Yes that is right – a 20 times increase in numbers. That is a massive increase in the number of people who are now defined as being mentally ill in this way. Nothing has actually changed in Australians. All that has changed is the diagnosis to include more people.

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This makes the idea of a spectrum disorder diagnosis very very appealing to organisations in Australia. There is only a finite number of dollars that government will put aside for mental health. Thus organisations are competing against each other for that funding. The more numbers a mental health organisation can say they have the more funding they will probably get. One quick, sure fire way to get your numbers up is to change to a spectrum disorder diagnosis of the mental health area you represent.

We have already had the condition Fetal Alcohol Syndrome do this. This syndrome now no  longer exists instead it has become Fetal Alcohol Spectrum Disorder with the corresponding increase in numbers. Far more people now fit this diagnosis. The DSM 5 no longer talks about schizophrenia but talks about schizophrenia spectrum. It seems this has also changed in recent times.

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In my view in the next 10 to 20 years there will be a surge in new spectrum disorders appearing in Australia. As these organisations compete against each other for government funding redefining who is included under the umbrella of your organisation can be dramatically increased by making it a spectrum disorder. Simply redefine it to include more people. Easy to do and it may result in a possible 20 times increase in numbers. Again that is a huge increase in numbers. Depression spectrum disorder, anxiety spectrum disorder, self harm spectrum disorder, eating disorder spectrum disorder and so on endlessly. The problem being is the entire Australian population gets pathologized. Every body is going to fit on some spectrum disorder somewhere.

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