Stigma & the diagnostic label ‘schizophrenia’It has been argued in previous research that the diagnostic label schizophrenia is often associated with many disadvantageous factors.
The disadvantage most frequently highlighted in current literature is the activation of stereotyping and stigmatisation of those with mental illness or cognitive impairment because of diagnostic labelling (Gerand et al, 2009). Lai, Hong & Chee (2000) suggest that “stigma appears to stem from the psychiatric label and not the presence of a chronic illness”. Research in Germany even found that mental illnesses, such as schizophrenia, in comparison to somatic illnesses were ranked last in the public’s preferences to be given financial resources (Matschinger & Angermeyer, 2004) Suggesting that the diagnosis of schizophrenia is not considered to be as important as a physical illness, and can often be left with little resources for treatment as a result. Gerrand et al. (2009) found that stigma associated with the diagnostic label schizophrenia often lead to a significantly negative impact on those with the diagnosis.
Interpersonal relationships with family, friends and the community are often affected by the stigma (Gerrand et al, 1009; Link et al., 1987) with literature suggesting that those with the label struggle with employment and acceptance within society. The diagnosis of schizophrenia often goes hand-in-hand with many other derogatory labels and stereotypes such as “dangerous”, “unstable” and “strange” (Lai, Hong & Chee, 2000) Research supporting this suggests that the diagnostic labelling of illness is positively related to public perceptions of “dangerousness, unpredictability, and to fear and desire for social distance” (Read et al., 2006) This stigma is often reinforced by the portrayals of those with schizophrenia within popular culture such as media coverage (Lai, Hong & Chee, 2000) Those branded with the diagnostic label may even act out these stereotypes, also known as the self-fulfilling prophecy (Jussim et al., 2005). Jussim et al. (2005) found that pseudo-patients with fake diagnoses of schizophrenia started to believe they were exhibiting symptoms of the disorder, such as hallucinations. The findings from Jussim et al.
(2005) demonstrate just how damaging the diagnostic label ‘schizophrenia’ can be, triggering individuals to change their behaviour to fit the expectations of others because of the psychological damage that comes with their given label. Equity & the importance of acknowledgement of individual differences in mental health diagnosis of schizophrenia and treatment Another crucial disadvantage to consider when looking at diagnosis labels such as schizophrenia is the trivialisation of equity and disregard of individual differences. Often after a diagnostic label has been applied to an individual, they will usually be given similar, if not the same, therapy as others with the same label. Fossati (2011) and Widiger (2011) suggest that it is important to consider a person’s personality and personal experience, developmental history and biopsychosocial factors instead of applying a ‘one size fits all’ medical approach that comes with applying a label and focusing only on the disorder itself instead of unique individual needs.
These differences should be considered when looking at the best therapy for the client to ensure these needs are met, and the client can receive the most effective form of therapy. Although equality is about treating everybody as ‘the same’, in some cases such as in diagnosis and treatment it is important to acknowledge differences that build up an individual’s identity. Equity “acknowledges that applying the same treatment or standard to everyone without considering the individual differences does not have an equitable impact on everyone” (Creamer, 2000) The acknowledgement of difference is fundamental for democracy (Wildemeersch & Vandenabeele, 2007) If we do not recognise difference, we cannot meet the unique needs of individuals (Armstong et al., 2012) It is important to recognise that schizophrenia varies according to the individual, and is not the stereotypical belief that comes with the diagnostic label that everyone with the disorder is ‘insane’, there are also patients who have minimal impairment as a result of remission (Lai, Hong & Chee, 2000) Rolls et al. (2017) investigated individual differences in those with schizophrenia, finding that negative symptoms and their severity are a ‘major source’ of differences accounted for in schizophrenia sufferers. Further research supporting this also shows that individual differences play a role in the negative affective traits, mood, social interactions and coping style in people with schizophrenia (Horan & Blanchard, 2003) The literature discussed demonstrates that the disorder ‘schizophrenia’ is much more than just a diagnostic label and differs according to each person, often overlooked because of the stigma associated with the label itself.
Concluding pointsThis essay has carefully considered the different advantages and disadvantages associated with the diagnostic label ‘schizophrenia’. The literature has shown that diagnostic labels are important to help those suffering from mental health issues are given the best-suited therapy for their symptoms. The type of therapy allocated to the client by the clinician could be positively life changing, with improvements in mood stability, delusions and erratic behaviour. A diagnostic label also allows people with schizophrenia to understand their own behaviour and thought patterns and feel heard, being able to relate to others with the same experiences.
Diagnoses of schizophrenia also allow enables research to be carried out surrounding gender differences related to the disorder. However, it is also crucial to consider the disadvantages explored in this essay which highlight the severe issues with diagnostic labels, particularly the stigma and negative stereotypes associated with those labelled as schizophrenic. Research has suggested that in the process of diagnosis, the behaviour is matched to a diagnostic label of ‘schizophrenia’ instead of treating each case as unique to the individual. It is important for professionals to consider individual differences in treatment, not only in the symptoms of the disorder displayed by the client but also their personality and social influences. The evidence has suggested that although diagnostic labels can be useful in the treatment of mental disorders such as schizophrenia, the scale of the disadvantages discussed ultimately outweigh the advantages. Public perceptions of schizophrenia must be changed through the decrease in usage of diagnostic labels and the increase of public awareness and education about mental illness.