This chapter reflects on the approved mental health practitioner’s approach to diagnosis and its significance. It recognizes that this is more than an academic debate in that the degree to which a practitioner accepts a diagnosis will have a clear impact on the outcome of assessment and their understanding of appropriate treatment. As the author indicates, approved mental health practitioners are not asked to take a ‘pro’ or ‘anti’ stance in relation to diagnosis, but to search out and embrace the complexity of any service user’s lived experience. Sadness, madness and distress are very much a part of this, but these can be masked or overlooked by the diverting aspects of diagnosis. Being diverted in this way limits reflection and continues to give priority to all that follows from this — including loss of meaning and understanding within assessment. The author locates the process of diagnosis within a social context and recognizes the inherent undercurrents of power. The author goes on to balance these ideas with arguments that exist in defence of diagnosis, and also then to review some viable alternatives. Clearly, approved mental health practitioners will not in the short term be enabled to overhaul the systems and processes as they currently exist. However perhaps simply accepting that there is an alternative will enable them to use a language that influences their understanding of human suffering and any consequent ideas around treatment. As the author concludes, the way that we conceptualize mental ill health and its attendant crises structure how it can be understood, experienced, assessed and addressed. An approved mental health practitioner who is unable to embrace an appropriately critical perspective risks colluding with a rigid, limited perspective that affects their ability to act creatively when considering alternatives to hospital and treatment options.
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