Paper 3

• aim :To investigate the reliability of the diagnosis of mental illness
• Study 1: 8 Pseudopatients presented themselves to different hospitals across the USA. On admission, they all reported the same symptom (hearing voices) "empty" "hollow" "thud". Once diagnosed they were all admitted and showed no further symptoms. Participants kept a written record of their own experiences and those of other patients in the hospital.
• Study 2: In a different hospital, staff were made aware of the findings of Study 1. They were led to believe that over three months one or more pseudopatients would attempt to be admitted. They each scored new patients out of 10 as to the probability of them being a sane actor
• Results: In Study 1, all of the pseudopatients were admitted to hospital, none was detected as sane by staff. Participants experienced depersonalisation and powerlessness. In Study 2, approximately 10% of genuine patients were judged to be pseudopatients by at least one psychiatrist and one other staff member.
• Conclusion: Psychiatric diagnosis lacks reliability. Labelling people as insane can change subsequent interpretation of their behaviour
• Aim: To compare vulnerability to mental illness of offspring with one or both parents having a diagnosis of schizophrenia or bipolar disorder.
• Method: Rates of mental illness were compared in Danish people who had both, one or neither parent with a diagnosis of schizophrenia, bipolar disorder and unipolar depression
• Results: For both schizophrenia and bipolar disorder, having both parents with a diagnosis increased the chances significantly of suffering that disorder (27.3% for schizophrenia and 24.95% for bipolar) and mental illness in general (67.5% and 44.2% respectively). Having one parent with schizophrenia or bipolar disorder carried a more moderate risk.
• Conclusion: Having both parents with a serious mental illness – and to a lesser extent one parent with a serious mental illness – conveys increased risk of developing mental illness.
• Aim: To review and update Szasz’s own work on beliefs about mental illness as psychiatry becomes increasingly politicised and medicalised.
• Method: Szasz’s paper does not include original participant research, but instead outlines antipsychiatry arguments.
• Results: Szasz rejects the view that those who act in disturbing or disturbed ways should be viewed as mentally ill. The current mental healthcare system treats people as patients with little control over their illnesses. It also frames mental illness as a medical problem which invokes hierarchies of power and control by professionals over their patients.
• Conclusion: Mental illness is little more than a metaphor for the perceived disturbing behaviour of others, and labelling individuals denies them their autonomy and freedom.