A new study has unexpectedly revealed that entry into, and receipt of, NHS mental health services in the UK seldom require individuals to have received a diagnosis of a psychiatric condition.
Despite debate over their validity, psychiatric diagnoses — such as for depression, anxiety, schizophrenia and bipolar disorder — are widely viewed as essential criteria for determining whether it is appropriate for individuals to receive mental health services from the NHS. However, a new study, conducted by researchers from the University of Liverpool (UK), has determined that psychiatric diagnoses are in fact rarely used as entry criteria for NHS mental health services in the UK.
Diagnoses of psychiatric conditions are considered critical to determining care access arrangements, treatment options and allowing for effective communication between mental health professionals.
In this novel study, researchers made Freedom of Information enquiries to 17 NHS Trusts providing adult mental health services, concerning the criteria they employ to determine whether individuals are to receive service from them.
Study analysis revealed that, whilst psychiatric diagnoses are widely viewed as ‘essential’, these diagnoses were not required for entry into NHS mental health services.
Researchers observed that the majority of NHS mental health services relied on referrals based on individuals’ needs and the specialist skills of Trust staff, rather than diagnoses.
Lead study author Kate Allsopp (University of Liverpool) explained: “Psychiatric diagnoses are controversial — defended strongly by many psychiatrists and psychologists but also criticized as scientifically invalid and pathologizing. One reason that psychiatric diagnoses survive, despite the criticisms, is that they are usually thought of as essential tools for accessing mental health services.”
The study authors hope their work may drive progress in the development of more personalized, less-stigmatized mental health services, such as by focusing on preventative services and considering psychosocial factors.
Allsopp concluded: “Our research clearly shows that access to NHS services rarely depends on diagnosis, but instead on need. This is good news, because it means that there is no barrier to developing better, more humane, services.”
Allsopp K, Kinderman P. The use of diagnoses in mental health service eligibility and exclusion criteria. J Ment Health. doi:10.1080/09638237.2019.1677875 (Epub ahead of print) (2019);