Frontlines – Outdated modes of medical classification

Many years ago, while I was still training, my older sister was diagnosed with schizophrenia. It was then that I realised what a hopeless label it was for problem-solving and caring for someone in severe mental distress. The term is so broad it is nearly meaningless. It generalises and medicalises a profoundly individual trauma that has physical, mental and spiritual dimensions. And here I was, a fledgling professional, with my sister going through the biggest crisis of her life that my line of work – I naively thought – was supposed to remedy. Yet I never felt so helpless, so redundant in all my life.

Now when someone is referred to me with a diagnosis of schizophrenia I have an ill-defined sketch of someone who may be showing at least some of a raft of possible symptoms – though I can bet a month’s salary they will be on some fairly heavy duty medication. But it doesn’t get close to any significant level of understanding.

As a category it’s damaging. The media have a woeful history of using the label to stigmatise people. Schizophrenia becomes synonymous with deranged killers or even a source of cheap jokes. And every nonprofessional or carer I meet seems to think it means a split personality.

Despite so many advances in psychological and philosophical ways to explain human experience the medical model still clings on to these outdated modes of classification. Medical diagnosis of human experience leaves most mental health workers scratching their heads, while continuing to perpetrate the disempowering paradigm of Us and Them.

The label should be abandoned to allow us to concentrate on the experience of behaviour of people suffering severe psychological distress. Mental health is a continuum, a line we are all for ever moving somewhere along, shifting towards, at one end, complete mental well being or the other severe mental distress.

My sister is dead. Do I, did I, see her as schizophrenic? Of course not. And it wasn’t because I was in denial. For the people who really knew her she was a mother, a sister, a daughter, a wife, a friend, a rebel, a one-off.

She was all this and so much more. Schizophrenia? She would have told you where to stick it.

Nigel Leaney manages a mental health residential service

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