Diagnosis pressure and false positives: Toward a non-reductionist, polytomic approach of child mental problems

Abstract

This paper discusses diagnosis pressure and false positives in child mental health care. Diagnosis pressure is the pressure to give a diagnosis even though the criteria for the diagnosis are not all satisfied. Such pressure may be exerted by clients, their context, or professionals. False positives are incorrectly assigned as mental disorders. The paper discusses prevalence of diagnosis pressure and false positives, some of their causes, and advantages and disadvantages of "getting" a diagnosis. Two relevant issues are discussed, namely, categorical versus dimensional approaches of mental disorders and the mind-body relation. Instead of mental health models that are based on a disorder–no disorder dichotomy or that reduce mental problems to either the brain or society, a polytomic (multifaceted) approach is proposed in which all people with mental problems, light or severe, have a place and can get the support they need. It is argued that Daniel Dennett's view of the relation between body and mind is fruitful such that mental-health problems can be explained at different levels of abstraction: physical, functional, intentional, and/or moral. The Network Approach is briefly discussed as a promising application of what is proposed in the article.