Q. I am a final year psychiatric nursing student. I am researching how diagnostic labeling can disempower mental health client and need some information on this topic. Do you have any literature on how a diagnosis impacts the client?

A. There are certainly those in the mental health profession who argue that diagnostic labels can disempower mental health patients--often referred to as clients by those who subscribe to this view. I am not fully in agreement with this position, but I do recognize its prevalence. My own view is that patients or clients are entitled to know their diagnoses, which, if presented in the right way, can actually be quite empowering--provided the individual is taught ways of understanding and managing the condition.

There may be exceptions to this, of course, and a misdiagnosis in psychiatry may have profoundly negative consequences for the individual. In any event, several studies have examined this issue. You may want to see articles by Wadley & Haley (J Gerontol B Psychol Sci Soc Sci 2001;56:244-52); Schwartz et al (Women Health 2000;30:63-75); Markowitz (J Health Soc Behav 1998;39:335-47); and Link et al (J Health Soc Behav 1991;32:302-20). The Schwartz et al study looked at the impact of the diagnostic label "late luteal phase dysphoric disorder" (commonly known as PMS) and found that, in general, this label did not have a markedly negative impact.

On the other hand, it is certainly true that the public at large often does stigmatize those with known or perceived mental illness. I am not sure that the solution to this is to abandon diagnostic labels; rather, progress lies in educating the public about the nature of mental illness, and helping those who suffer with it to re-integrate into the larger community. But, I will admit this is often an uphill battle.

April 2002

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