I am once again fascinated by a recurring problem: how politicians have the art of asking the wrong questions and making useless, even harmful, decisions for the population.
The bad question of the day: how to ensure that more Quebecers have access to a mental health diagnosis? The bad idea: let’s expand the number of professionals who would be authorized to make these diagnoses. But not doctors, eh, no, no. Professionals who have neither the training nor the real skills, much less the experience, to practice this very precise and delicate art of understanding what is happening in our psychiatric patients.
Let’s increase their power, and thus allow patients to speed up the process of accessing a diagnosis.
What if the right question was completely different? What if the right question was: why so many Quebecers and – I see it myself in my specialty in child psychiatry – why so many children are doing badly? Could there be a microclimate here that would cause so much suffering, intra-family and school behavioral problems?
Rather than simply asking ourselves, like good neoliberal soldiers, how to “produce more diagnoses”, we could finally ask ourselves the real questions, those which bring us back to the roots of evil – or rather to the roots of our ills.
What if we really dared to take the time to sit down, collectively, to tackle all of this rather than granting new “abilities” – to use the term used by the Treasury Board – to non-competent professionals in this area to do so. What a miracle is this neoliberal thinking which believes it can replace one pawn with another to do the same job even though it is not trained for that!
We have already had a small example of this in the field of education, when some people thought they could recruit “people” to be teachers, just because the ranks had to be filled.
This is about mental health and that of our children.
We have been denouncing for several years, through open letters, parliamentary committees and books, the problem of overdiagnosis in our children, in particular that of attention deficit disorder with or without hyperactivity (ADHD).
Obviously, this is neither to deny the existence of this disorder nor to question the effectiveness of the medication. When the diagnosis is made correctly, things are clear.
But what about these children who will soon be seen by unqualified professionals, whose field experience is not sufficient, who do not know the subtleties of the child psychiatry diagnostic process, who have no training on attachment or complex trauma, among others, who do not have a systemic vision of these issues?
We already hear here and there dubious anecdotes about professionals who have been granted new powers allowing them to make diagnoses of autism spectrum disorder (ASD) by taking one of the tests (designed to be done in person) by videoconference… We already exchange stories among ourselves of patients who we have “recovered” with prescriptions “without any common sense” because, yes, prescribing is also a delicate art, and it is not a question no piling up pills for every symptom that appears.
What about these children who will find themselves given a wrong diagnosis and medicated accordingly, due to a lack of clinical discernment (despite all possible goodwill and kindness)?
Can we congratulate ourselves for having facilitated access to mental health and for having made it possible to respond adequately to the (real) problems of these children? Or will we be in a form of productivist contentment, ready to draw out the figures for the “melting of waiting lists” thanks to this false good idea?
I will be very interested, when this arsenal is in place, to see – beyond this reduction in waiting lists – to what extent child psychiatric diagnoses will have soared.
Without wanting to be the perpetual Cassandra of the gang, there is no doubt that we are heading towards an unprecedented wave of botched diagnoses, of shameful overmedication, which will solve nothing, but will, for a time, gag our little ones. Because that’s ultimately what we want, right? No longer hear their cry of warning in the face of this world which no longer makes sense?