We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
As a colleague once said to me, "I've never seen a patient who fit into the DSM." That is hyperbole, but it's true that everybody is an individual and not a diagnosis. Humans are complicated.
During a time-off period from my university studies, I worked a year as a "Mental Health Worker," a.k.a. Psychiatric Aide, at a private psychiatric hospital.After leaving the Psychiatric Aide job, I took a course in Abnormal Psychology. I approached the course from the viewpoint of, "What in this course could have helped me in my job as a Psychiatric Aide?" The answer was: very little. The Abnormal Psych course concentrated on classification. Not very helpful for figuring out how to respond to a patient.
In retrospect, the best help I got for the job were the instructions I got for writing notes on patients. 1) Describe patient behavior. 2) What were the dynamics behind this behavior? 3)What intervention did you make? Keeping those 3 questions in mind helped me do my job, not just for writing notes, but for dealing with patients on a day-to-day basis.
It was a stressful, but interesting job- probably the most interesting job I could have gotten at that wage scale. From what I later heard, a year is about most people can take in that job. I tip my hat to those who stay in the field for a career.
These things are useful for the broad range of mental-health intervention, and I like looking into them when they come out, reading other articles by the author before deciding whether to buy the book or wade through some complicated papers.
But I have an ongoing complaint about mental health writers, including psychiatrists who presumably had training in difficult settings. They never address what I spent my whole career with: the state hospital patients. While those are a minority of those receiving mental health services, they use the most bed-days, long-term community services, forensic services, neuropsych services. In short, everything that is most expensive and would behoove us to solve.
My conclusion over the years is that these patients screw up everyone's theories and data, so better just not to look at them. Better to pretend that other things are happening.
Your colleague said "I've never seen a patient who fit into the DSM." Well come to my unit. A third fit pretty well, almost on sight, into a clear category, and another third might be mixed or more than one diagnosis, but you can make it work. There is that remaining third that don't fit.
Assistant Village Idiot
"If the psychiatrists couldn’t agree on the assessment of student performance, I wondered how much they’d agree on their assessments of patients."
If you are truly mentally ill, loony tunes, dangerous to self and others the psychiatric profession cannot help you. They can agree you should be locked up. They can prescribe medicines which probably are worse than war crimes. But they cannot fix you.
If you have one of the lesser and common mental health issues they still cannot help you... except to give you drugs which will modify your actions in god knows what ways. Sometimes it works and sometimes you would be better off talking to your bartender.
If you are merely convinced that you are mentally ill but are probably ok but simply bored with life/reality THAT is where the psychiatric profession shines. They can talk to you for an hour once a week or more often and they can appease you and temporarily convince you that you are getting better all for a mere $500 per visit. They can relieve you of your anxieties and your excess Benjamins in one fell swoop.