‘No shame in the diagnosis of a mental health problem’

While many disorders can arise as a result of a combination of nature and nurture, some problems such as posttraumatic stress disorder, depression, and self-harming have much higher adverse childhood experience correlations, when compared with autism and psychopathy (or callous-unemotional traits) which have stronger genetic drivers.

However, regardless of the cause, I do not understand how this in any way counters the idea of early assessment of, and intervention in, any disorder.

Professionals do not defer the identification of early behaviours of autism, ADHD or foetal alcohol spectrum disorder until the mid to late 20s to prevent “stigma”, or because brains aren’t fully developed so why should the identification of psychopathy traits, an obvious neurodevelopmental problem, be any different?

In fact, the failure to identify such issues would be seen as unprofessional and would prevent the child from receiving the support they need to develop to their full potential. The same is true for the early identification of pre-psychopathic traits: prompt recognition permits early intervention and maximises the effectiveness of the treatment.

I do worry that psychologists and psychiatrists and others in this field who express concerns about identifying children with mental health or neurodevelopmental issues are perpetuating the stigma, rather than telling the world there is no more shame in being diagnosed with a mental health problem than with any physical illness.

There are so many assumptions around labels being bad for people, yet many are relieved to get a diagnosis and feel validated. Since the Scottish Government is claiming to promote this concept, via their Mental Health Strategy 2017-27, it would be unfortunate if relevant professions were not fully supportive of this drive.

We sadly have to accept that teachers and some social workers often insist youngsters who are clearly at risk do not have mental health issues, perhaps because they lack the understanding and resources to deal with reality and because it is easier to blame the parents and encourage more home discipline or a more cuddly approach by parents towards their children. But it is rather more worrying if psychologists and psychiatrists encourage such attitudes by arguing against assessment in appropriate circumstances. While it may be policy and practice not to link callousun-emotional traits seen in children with risk for psychopathic behaviours in adulthood, it does not mean there is no such link. In fact, I am sure these professionals do not believe psychopaths are just created in adulthood.

Policies are often based on reasons other than cumulative scientific findings including social acceptance and financial considerations.

There is a well-documented lack of financial support for children with mental health issues, and there have been calls for more money to be diverted into this area. Perhaps those involved in the production of policy are concerned that there is insufficient money to treat those identified with early neurodevelopmental disorders and therefore do not support their diagnosis.