Blog content: Beyond the Label

Experts by experience: Young advisor, Amelie

Mental health diagnoses can be both helpful and challenging for children, young people, and their families. They provide a language and structure for understanding mental health, access to treatments, and validation that the person being diagnosed is not alone in what they are going through (Thompson et al., 2022). They can also impact non-clinical areas such as education when adjustments are requested and acted upon to accommodate the condition. However, emotional distress does not always fit neatly into diagnostic categories. Therefore, while diagnoses can open doors to support, they are only one part of understanding a young person’s mental health.

Diagnoses should be seen as a framework to organise and understand patterns of symptoms; they do not define people. Researchers note that many mental health conditions overlap, but also that a condition doesn’t always look the same in different individuals (Dalgleish et al., 2020). For example, autism is now understood as a spectrum to illustrate the different strengths and areas for support which exist within the umbrella of the diagnosis (Wozniak et al., 2017). While stigma exists, a diagnosis does not change who a person is. It is one aspect of a multifaceted human with unique values, opinions, skills and qualities and it should be seen as such. A label can help structure support without defining identity.

Mental health in childhood must also be understood within the context of development. Over childhood, emotion regulation and identity develops, shaped by relationships with peers, learning new skills, and educational systems, for instance (Puroila, 2019). Because of this, symptoms for the same condition can look different at different developmental points. For example, in children, depression may be shown through self-destructive themes in play, whereas in adolescents it could look like impulsivity and irritability (Mullen, 2018). This means that, as well as diagnoses looking different between people, they may also look different in the same person at different times in their life, adding complexity to childhood diagnoses.

Another factor which is important to bear in mind with diagnosis is that mental awareness has increased dramatically in recent years. While this is helpful as awareness can reduce stigma (Shim et al., 2022), it also means that mental health misinformation is more readily accessible. Social media platforms can distribute unreliable information about mental health (Suarez-Lledo & Alvarez-Galvez) which can lead to complex conditions being simplified, increased stigma when misconceptions are shared, and reliable medical advice being diluted or overshadowed. Therefore, it is important to seek reliable sources of information when understanding a diagnosis. This can be found on the NHS leaflets, charity websites, or through conversations with practitioners.

Rather than focusing solely on diagnosis, it is important that practitioners understand the child’s unique needs and experiences. While diagnosis can guide treatment, room must be left for individual differences. This concept is reflected in the NHS’s Ask Listen Do project, giving patients the chance to feedback what is helpful and what is not working for them to create care which is patient-centred rather than diagnosis focused. This could include considerations such as the environment a child feels safe and supported in, the resources provided, or the modality of support. Through this approach, the focus shifts from the diagnosis to the support needed to enable the child to thrive.

Overall, diagnoses can play an important role in mental health care, particularly when they help young people access support and feel understood. However, they are most helpful when they are viewed as one tool among others, rather than a definition of the child’s experience. Maintaining this balance allows the focus to be kept on the child or young person behind the label and is necessary for thoughtful and compassionate care.

References

Dalgleish, T., Black, M., Johnston, D., & Bevan, A. (2020). Transdiagnostic approaches to mental health problems: Current status and future directions. Journal of consulting and clinical psychology, 88(3), 179.

Mullen S. (2018). Major depressive disorder in children and adolescents. The mental health clinician, 8(6), 275–283. https://doi.org/10.9740/mhc.2018.11.275

Puroila, A. M. (2019). Who am I? Shaping young children’s identities through everyday narratives. In Story in children’s lives: Contributions of the narrative mode to early childhood development, literacy, and learning (pp. 55-75). Cham: Springer International Publishing.

Shim, Y. R., Eaker, R., & Park, J. (2022). Mental health education, awareness and stigma regarding mental illness among college students. Journal of Mental Health & Clinical Psychology, 6(2), 6-15.

Suarez-Lledo, V., & Alvarez-Galvez, J. (2021). Prevalence of health misinformation on social media: systematic review. Journal of medical Internet research, 23(1), e17187.

Thompson, M., Parker, H., & Cave, J. (2022). Exploring which aspects of a low-intensity CBT intervention were found to contribute to a successful outcome from the service user point of view: A mixed methods study. Counselling & Psychotherapy Research, 22(2), 279–291. https://doi.org/10.1002/capr.12433

Wozniak, R. H., Leezenbaum, N. B., Northrup, J. B., West, K. L., & Iverson, J. M. (2017). The development of autism spectrum disorders: variability and causal complexity. Wiley Interdisciplinary Reviews: Cognitive Science, 8(1-2), e1426.