You are here, navigating the mental illness diagnosis maze

October 2, 2015

By Asha Tarry, LMSW, PLLC, Behavioral Health Consulting Services

Worried woman lying on the couch while psychologist writing

Worried woman lying on the couch while psychologist writing

Mental illness is something many people live and cope with but rarely openly discuss. On average, about 43 million Americans have some form of treatable mental illness ranging from depression, to bipolar disorder and schizophrenia. Unfortunately, 12 million adults are misdiagnosed each year in a mental health setting. So, it’s not uncommon when people like author, mental health advocate and survivor, Agyei Ekundayo, or AJ Mental as she’s more affectionately known, also report being given five diagnoses including depression and bipolar disorder, more than 13 medications and has interfaced with about 10 different specialists during the course of her initial struggle with mental illness. She recounts struggling through the maze of misdiagnosis in her 2014 jarring memoir, Hindsight is 20/20: How An African American Girl Grows Up Mentally Ill and Is Dead Last To Find Out.

My question is: why is accurately diagnosing someone so seemingly tenuous? Mental illness has cycling periods, which means that when the signs and symptoms arise they last for a specific period of time. Sometimes, those symptoms are very distinctive and occur much the same way each time. At other times, new symptoms or changes in the presentation of the illness occur thereby creating a diagnosis of one type and sometimes multiple diagnoses. Also, based on the patient’s report of symptoms and those that have spent significant time with a patient may report some observable signs and objective symptoms and not others. In addition to that, some signs may become dormant or not invisible for a period of time.

For these reasons it is so important that when a person is first diagnosed that the evaluation is conducted thoroughly and include other key factors such as a medical report, a family history, other significant people’s reports with whom the client spends most of their time, e.g. a spouse, a teacher or parents. Also, the cultural competence of the professional and the interpretation of a client’s reports by the diagnostician can influence the determination of the diagnosis assigned to the client.

This is not to assume that mental health providers are playing a guessing game. However, what is being said is that again, there are many factors. The more accurate and reliable the information from the client, the family or significant others along with the knowledge, skill set and cultural comprehension of the professional, the more successful the therapeutic process can be for everyone.

As the dawn of the mental health care system is attempting to make vital shifts to the way in which medical and mental health providers and law enforcement handle the rapidly increasing population of people living with mental illness, the more important it is for clients and providers to work together in identifying the true diagnosis or diagnoses. Today, the treatment and care of clients is no longer about the professional being seen as omnipotent and the client being viewed as helpless. The client is in many cases seen as a partner in the recovery and maintenance process, so that survivors like AJ Mental don’t have to encounter an assembly line of health care professionals before solidifying the appropriate illness(es). Instead, clients can rest assured that they will receive accurate diagnoses, proper treatment and recovery.