I can’t help but notice the word “honestly” there.
I am sceptical that people are being more honest now than they were before. I think that people feel more sick than they did before. I also feel there is a huge societal trend of medicalizing how people act and feel and expressing it in terms of it being a mental illness or disorder.
I’ve noticed that mental health outcomes keep getting worse and worse and doctors consistently go “wow that’s great there must be so much more awareness and acceptance of mental health problems!” That’s a very self-serving interpretation and I don’t understand why people don’t question it more.
> That’s a very self-serving interpretation and I don’t understand why people don’t question it more.
People say "don't talk to police" because they can fuck you over, legally speaking. Regardless of whether you're innocent or guilty, you stfu when police are around
Psychologists can also fuck people over legally speaking (and likely will be able to even more so in the future), but the same standard doesn't exist for some reason, instead it's a bunch of people willingly talking. And there's also no due process either, the entire system goes around it
This is a whole different tangent, but I could go on about
1: That psychiatrists can give you a lifetime diagnosis, without your consent to doing so, or agreement as to the diagnosis, with demonstrably negative social and legal consequences, without your consent or ability to remove the diagnosis from your medical history (barring exceptional circumstances). Being gay/trans already had to be removed as mental health conditions due to psychiatrists admitting they were only hurting them by labelling them mentally ill, but they fixed this by deeming these things as NOT mental health problems, but still not actually giving people the ability to refuse to consent to a diagnosis which would have prevented much of the harm to begin with.
This is then reinforced by scheduling and denying access to useful medicines like amphetamines and insurance coverage UNLESS you accept a legally and socially consequential label of being mentally disordered first, so even if people had the choice not to be labelled as disordered, they may not take it anyways because they will live a lower quality of life if they do not accept that label. I have NO idea how to solve this issue.
2: the whole involuntary hold thing. This I won’t get into that much, because it’s one thing to come up with a morally self-righteous take on this issue, and it’s another to deal with the reality that some people if left to their own devices WILL hurt themselves. Also there really is a lot of due process around this matter, the problems are really around the details and implementation. I have NO idea how to solve this issue.
> This is then reinforced by scheduling and denying access to useful medicines like amphetamines and insurance coverage UNLESS you accept a legally and socially consequential label of being mentally disordered first, so even if people had the choice not to be labelled as disordered, they may not take it anyways because they will live a lower quality of life if they do not accept that label. I have NO idea how to solve this issue.
Is an ADHD diagnosis really that "legally and socially consequential?" What are these consequences you describe, and how would one become subject to them?
I'm struggling to think of any real consequences, unless you are an airline pilot or have a security clearance, and even then I don't think ADHD is a deal breaker.
It really is, and I only used ADHD as an example. Still:
> The diagnosis may result in exclusion or special scrutiny in various militaries.
How: The military can require access to your medical records.
> Mental health is legally required to be considered in a custody dispute to evaluate the "best interest" of a child. A diagnosis can make it a legal fact that you have a mental health problem.
How: The courts can request your medical records.
> Immigration to other countries, notably America, especially under Trump, denies people with disabilities entry under certain circumstances and always gives them special scrutiny. This can impact both the disabled person and anybody with disabled family members. This specific issue is actually potentially impactful to somebody on HN.
How: Immigration will find out by simply asking you and threatening you if you lie.
> When trying to get medical services, healthcare providers who have access to your medical records themselves stigmatise the condition[1], and know that you have it. Also diagnosis of virtually all disabilities correlate to having other issues, obesity/asthma/sleep disorders in the case of ADHD. However, the very fact you have the diagnostic overshadowing[2] where physical health problems just get treated as mental health symptoms by doctors, and are less likely to be treated.
How: Medical records can be directly looked at.
> It's also that once the data about somebodies disability is on a database, it could be there for a century, and it can leak. Unexpected social changes are a bit of a threat. Germany went from conservative christians to socially left to far right in about a generation and went from totally being against killing the disabled, to totally being in favour of killing disabled. This, incidentally was facilitated by German doctors, who were early and fervent Nazi Party supporters[3].
How: Medical records will be directly looked at.
> There are sperm bank bans on donating with ADHD and other disabilities[4], and even more commonly than that policies of disclosing any diagnosed disability, so generally being diagnosed as disabled makes you subject to contemporary eugenics as well.
How: Such places will request medical records.
>K-12 schools, I can go on and on about the practice of removing disabled kids from PE classes to try and get them to study more and ignoring their physical health problems, or about the systemic unwillingness to consider what the disabled child wants to any degree when it comes to something like accommodations in an IEP (not accommodating them in socially stigmatising ways for instance). Private schools notably can just straight up discriminate against students for having ADHD and this DOES happen although I think the ADA in the US does outlaw this[5][6].
How: The school needs to either be told or have formal confirmation of a disability here
>Casual employment discrimination happens all the time
How: Generally word of mouth has to get around.
>Some people really do have negative attitudes towards anything considered a disability
P.S. Out of everything here, "diagnostic overshadowing" is the issue that seems most relevant to this topic. If some physical issue started causing a bunch of health problems that looked like mental health problems, what are the changes we would attribute it to a physical health condition instead of "mental health awareness" and the patient population simply being more woke than in the prior year?
I am sceptical that people are being more honest now than they were before. I think that people feel more sick than they did before. I also feel there is a huge societal trend of medicalizing how people act and feel and expressing it in terms of it being a mental illness or disorder.
I’ve noticed that mental health outcomes keep getting worse and worse and doctors consistently go “wow that’s great there must be so much more awareness and acceptance of mental health problems!” That’s a very self-serving interpretation and I don’t understand why people don’t question it more.