The New York Times describes a study that’s provoking reactions for both its comprehensiveness and its results:
Most Will Be Mentally Ill at Some Point, Study Says
More than half of Americans will develop a mental illness at some point in their lives, often beginning in childhood or adolescence, researchers have found in a survey that experts say will have wide-ranging implications for the practice of psychiatry.
The survey is the most comprehensive in a series of censuslike mental health studies undertaken by the government. The findings of those studies are frequently cited by researchers, advocacy groups, policy makers and drug manufacturers to emphasize the importance of diagnosing and treating mental illness.
The earlier, less comprehensive surveys, which were published in 1984 and 1994 and which also found a high prevalence of mental illness, came under attack on the ground that they defined mental illness too broadly. Now, experts say, the new findings are sure to renew debate about whether mental illness can be reliably distinguished from garden-variety emotional struggles that are part of any life.
At least one expert considers the findings laughable:
“Fifty percent of Americans mentally impaired — are you kidding me?” said Dr. Paul McHugh, a professor of psychiatry at Johns Hopkins University.
While the new survey was carefully done, Dr. McHugh said, “the problem is that the diagnostic manual we are using in psychiatry is like a field guide and it just keeps expanding and expanding.”
“Pretty soon,” he said, “we’ll have a syndrome for short, fat Irish guys with a Boston accent, and I’ll be mentally ill.”
Given Dr. McHugh’s, er, vivid imagery, one might be tempted to dismiss his viewpoint in favor of National Institute of Mental Health Director Thomas Insel, the primary study sponsor whom the Times also quotes:
“The key point to remember is that mental disorders are highly prevalent and chronic.”
The study, Dr. Insel added, “demonstrates clearly that these really are the chronic disorders of young people in this country.”
But the article fails to note that Dr. Insel himself acknowledges some of the problems caused by expansive definitions of illnesses. See this report in yesterday’s Nature:
US Mental Survey Depresses Experts
The definition of disorders used by the study was quite broad. A few instances of road rage, for example, might qualify as an “intermittent explosive disorder”. Such a wide net may not be any use in determining who needs medication or treatment, says Thomas Insel, head of the National Institute of Mental Health and co-author of a commentary on the results.
If some forms of aggressive driving behavior are categorized as illnesses, then I’m inclined to be suspicious of the liberal definitions. But I may just be losing my mind.
