What to think now: Connecticut shooting, stigma, & mental health
As a therapist I want to urge you to separate yourself from the erroneous reports scampering across the screen and look at the facts as best you can regarding mental illness and developmental disorders such as Autism. Many parents are fearful that stigma will arise after the CT shootings. We have to avoid stigma, while being factual.
I have worked with some very sweet children, very gentle that have been diagnosed on the autism spectrum. I love working with them. However, I have also worked with kids on the higher functioning side of the spectrum who have some rather threatening behaviors (manipulation, lying, physical violence, and even threatening to bomb a facility). The reality is sad. The reality is that ALL human behavior is unpredictable.
Research suggests that there is no identifiable link between the spectrum and violence, but can that change? Perhaps. We don’t know exactly how to characterize ALL children on the spectrum, that is why it is a spectrum. The research we currently have suggests that there is no link but further research might reveal differently. The ultimate goal of those of us who work in the field of psychiatry is to reduce stigma, my main goal is to give parents and society a balanced view.
Because professionals in the field of psychology are STILL studying behavior and mental diagnoses, we cannot say in all confidence that we understand the full range of human behaviors. We cannot reduce a human’s behavior to a label. We have to keep a pocket of suspicion open for those behaviors that we have yet to observe. That being said, a child on the spectrum may reveal behaviors that we as society, as professionals, as researchers, as therapists have yet to see.
Please allow me to mention that there are two other factors at play here:
- Repeated DSM changes motivated by politics, pharmaceutical companies, and money
Most are very perplexed by the new DSM-5 (Diagnostic and Statistical Manual of mental disorders, 5th edition), which is set to be released in May 2013. The manual is used to classify behaviors and provide guidance to mental health professionals when diagnosing an individual. Many diagnoses are changing, not because we have the research behind us to change them, but because “elite” professionals in the field feel the need to re-structure our thinking about mental illness. An example would be the current diagnosis of “Disruptive Mood Dysregulation Disorder,” a diagnosis that millions of children who have a temper tantrum 3+ times in 1 week will receive once the new manual is used by therapists. The problem here is that the diagnosis is not researched and no studies have been conducted to PROVE that such a label should exist. Kids who have normal temper tantrums will probably be characterized as mentally ill. The DSM is often unfounded and lacks much research into the diagnoses we use.
That being said, I want to encourage you to be open to the possibility that we don’t know ALL there is to know about a disorder or diagnosis. There is always room for improvement.
Misdiagnosis can also be a very REAL problem. Misdiagnosis is more common than we we’d like to believe. Dr. David Muzina, MD, and colleagues examined 100 patients admitted to the Cleveland Clinic Center for Mood Disorders at Lutheran Hospital, in Ohio, and found that anxiety disorders and thought disorders are commonly misdiagnosed as a mood disorder. In 2008, Dr. Akhil Sethi, MD completed an interview with MedScape Psychiatry and stated that 1 in 4 patients did not have the correct diagnosis. Correct diagnosis isn’t just a common phenomenon at the Cleveland Clinic Center for Mood Disorders, but many facilities. Children and adolescents diagnosed with an autism spectrum disorder could have the wrong diagnosis because it can be very difficult to differentiate or separate behaviors and “symptoms” from other disorders. Many kids diagnosed as psychotic have been re-diagnosed with an autism spectrum disorder.
At any rate, most children with autism are very sweet. They are challenging and many kids show different behaviors. If we spoke to half of society’s mothers of children on the spectrum, we could find an array of behaviors that would shock us. The media puts forth one thing, but reality says that behavior is unpredictable. Every individual under a label is not going to exhibit the same behaviors. We should keep our mind open to this.
My sincere prayers are for the families and greater clarity for society and those of us who have to now evaluate a better way.
Busko, M. (2008). Medscape Psychiatry. Adults admitted to a mood disorder clinic are often misdiagnosed. Retrieved December 17, 2012, from http://www.medscape.com/viewarticle/582125.
National Center for Children In Poverty. (2012). Adolescent mental health in the United States: Facts about adolescent mental health. Retrieved December 17, 2012, from http://www.nccp.org/publications/pub_878.html.