Examining diagnosis

Ahmed Samei Huda, consultant psychiatrist specialising in early intervention, has an openness of approach on social media that is also evident in his book. Huda's thoughtful responses to difficult questions from service users and professionals on Twitter is mirrored in his thoughtful examination of topics at the interface of general medicine and psychiatry.

Huda devotes a substantial chapter to social factors and health; an area that is overlooked in many medical textbooks. Research into background factors in mental health is examined, and adverse social consequences of diagnosis are discussed in a historical context. Huda demonstrates an acute awareness of the harmful effects of stigma and restriction of rights, as well as the pressures an individual may be subjected to by mental health professionals, resulting in 'informal coercion' (as opposed to legally enforced coercion), arising from persuasion, interpersonal leverage and threats.

The book also covers the value and clarity that diagnosis can provide. Huda does not attribute too much meaning to diagnostic constructs; he regards diagnosis as just one part of the individual's wider clinical information. He emphasises the utilitarian and human value of diagnosis – enabling professionals to communicate a recognised pattern of signs and symptoms, aiding the identification of mental health conditions. This pragmatic description of diagnosis renders it a flexible and constructive tool to guide treatment in multi-disciplinary settings.

In a comprehensive discussion of the 'critical' school of psychology, Huda evaluates the strengths and weaknesses of the medical model. By underpinning this assessment with research, rather than ideology, he respectfully considers the views of those who vigorously challenge the medical model. Huda uses an evidence-based, pragmatic approach, evaluating and contrasting different sides of the argument and alternative models. He emphasises that clinicians should use whichever classification system they find most effective in helping people.

This book provides a detailed foundation for understanding the medical model in mental health. As stressed throughout the book, the medical model is part of a broader, integrated approach, designed to meet each individual's needs through collaboration between mental health professionals. 

Reviewed by Dr Annie Hickox
Chartered Clinical Psychologist/
Consultant Clinical Neuropsychologist