Mental illness – How heavily gendered should the diagnostic frameworks be?

Following a brief discussion with a psychiatrist who refused to put anger into a diagnostic framework I have considered exactly how the mechanisms operate which lead us to see women report more mental illness and men die younger, statistically speaking because of alcohol related diseases. It was a point made continually through the M.Sc. course I did that women may tend to get depressed, report symptoms and then get diagnosed with depression, thus elevating the statistics of women and mental illness – probably to a level they may be classed as accurate. While on the other hand, men presumably during medical examinations, may report that they have been drinking heavily and this not necessarily be converted to a statistic in relation to mental health. It will be a rather clumsy discussion to deal with such a nebulous terms as mental health, especially in relation to gender; while it may almost not be worthwhile raising these points, I do think some generalisations need to be questioned.

The frequency of reported mental illness does almost invariably indicate more frequent reporting than with men which may reflect how gender appropriate it is to report the symptoms of depression etc within the consulting room of a GP. If the information on the increase in male suicide in the UK is also considered – especially with regard to the increase in rate of suicide for young men. It is approximately twice as high as for women despite the implication that men have better mental health than women by the less frequent reporting of mental health problems.

Arguably, there could be more gendered concepts of mental illness relating to male and female forms of anxiety, depression and other well-being states which increase service use to a suitable degree. At present the diagnostic frameworks may make additional problems emerge and as a nation we could look towards more gendered and more appealing concepts of well being and mental health problems which encourage greater participation in health services that everyone in Britain is paying towards.

At present the use of existing concepts tends to continue an element within our culture which ensures that we are operating in the rules of the asylum and other institutions that we have not been able to make a clean break from over several centuries. There are possibly methods of social management that may be nearing an end in the next few decades which would require – it may simply be a change in nomenclature and make minimal difference but if managed across the whole of society as a significant period of change it could alter things for the next generation.

Whilst there may be some significant differences between Britain and Europe there could be adequate common ground in order to make this a European wide movement coordinated by the EU – this I think is wishful thinking but it could be an area for possible development – would most young men prefer different terminology applied to their life experience which puts them in a position to alter the way they live so they feel better? It may also be a particularly important step for the improvements that could take place for women and reduction in problems with their mental health as well.

This actually arose out of a discussion I had with someone who I knew who worked in the psychiatric profession. She tended to degrade some very intense feelings that had been reported to her of anger because they were not clinically relevant and wanted to home in on issues that were in the diagnostic manual. It strikes me as interesting that anger does not figure as part of the diagnoses that are made when it is to a degree expressed as being a socially appropriate emotion that men may express – are there other instances of men reporting feelings and these being ignored by clinical staff because they aren’t adequately stated in diagnostic manuals? It would be wholly unwise to suggest this outside of a blog in a more formal context as this is not based on a great deal of qualitative information, however, it may be interesting to form a corpus as is termed by Fairclough and to examine the discursive practice around this particular issue.

Whilst staff in mental health services may be committed to what they do, be willing to endure certain maltreatment which most people would be wholly intimidated and offended by there does need to be a strong commitment to the frameworks that psychiatric professional works within. There is a strong belief that the actions of staff who participate in such systems are going to result in significant improvements in the well-being of the patient. Unfortunately, the standards theoretically and procedurally that psychiatric professionals work to are not high and there isn’t a very strong explanatory framework for exactly why interventions work when they do. This is beyond the control of the vast majority of psychiatric staff – contributing further to the difficulties that they have by offering inadequate conceptualisations of how mental illness may be experienced within a culture only may serve to restrict the ability of the staff.

There are a great many concepts within the realms of mental illness, psychiatry and well being that may require significant review at present and while there are so called random attacks that mental health services appear to lack any understanding of why they take place this may be one area that could prove pivotal. Many of the diagnostic categories that are used to tend to exacerbate the mental distress that an individual may experience – for instance if there were action taken against an individual and they were classed as being paranoid for reporting it within mental health services many people would acknowledge that this could cause frustration and lead to anger, especially if there were a willingness only to employ mental health services as a result as a means of protecting the public at large, when there are individuals in the public who were causing such problems. This action of mental health services to have a negative and damaging effect upon the well being of the person reporting ‘mental illness’ could be classed as psychiatric iatrogenesis. It will be a long time until the staff within health services, politics and relevant sections of the Police acknowledge this term and its significance in terms of reducing the so called random and violent attacks.