Diagnosis in child mental health – Exploring the benefits, risks and alternatives

Service providers seldom have time to explore the debates, complexities and nuances surrounding the diagnosis of child mental health conditions. This paper is designed to encourage practitioners in the child and family welfare sector to examine their own understanding of diagnostic systems, and to critically reflect on the role that diagnosis plays in their work with children and families.

Key messages

• Like adults, children experience mental health difficulties. For some, a diagnostic label plays an important role in their treatment and recovery.
• In the late 20th century, the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) revolutionised the nature of mental health classification by providing a common language to define mental health difficulties.
• In Australia, the DSM-5 is now the primary system for identifying mental health conditions. The tenth edition of the International Classification of Diseases (ICD-10) is also sometimes used. Both systems focus on overt symptoms, rather than underlying causes or surrounding social context.
• The diagnostic systems used in Australia are still being debated. Critics argue that they pathologise normal human experiences, decontextualise mental health difficulties, lack scientific validity, and are culturally insensitive.
• Emerging evidence suggests that certain mental health conditions may be overdiagnosed in children. Numerous converging factors are thought to contribute to potential overdiagnosis, including the influence of the pharmaceutical industry.
• This paper takes the view that current diagnostic systems are best seen not as scientific certainties, but rather as cultural tools used to understand different varieties of psychological distress and impairment.

This resource has been co-produced by CFCA and Emerging Minds.