An article recently published in the New York Times, Drowned in a Stream of Prescriptions, raises some important points on which Mental Health professionals and clients alike should reflect. In the field of Mental Health, diagnosis is notoriously difficult. Studies indicate that if a group of psychiatrists or psychologists are given the same information about a client’s presentation the rate of consensus on diagnosis is quite low. In many cases this isn’t a big problem: differences in diagnosis can often have relatively small implications for treatment. In other cases, however, the consequences can be catastrophic: The Coroner’s Court of New South Wales concluded that the suicide of channel 10 news reader Charmaine Dragun may have been prevented if she had been diagnosed and correctly treated for Bipolar Affective Disorder Type II instead of depression. Confirming the challenges of diagnosis, in my own reading of the inquiry on her case (admittedly with less information available to me than was to the inquiry) I find it difficult to imagine I would have made a Bipolar diagnosis, and still wonder if the underlying risks were due to another condition not considered by the inquiry.
Accurate diagnosis is difficult enough when professionals are basing decisions on accurate information. However, the above New York Times article tells the story of a promising young student, Richard Fee, who was able to mislead treating professionals into making a diagnosis of ADHD in order to maintain access to stimulant medications prescribed for its treatment. He was using these medications to help him study. His misuse of the drugs led to psychosis and, finally, suicide.