1.2 Growth of the Mental Health Industry

Despite the known shortcomings of psychiatric diagnosis, the mental health industry continues to expand. In the United States between 1975 and 1990, the number of psychiatrists increased from 26,000 to 36,000, clinical psychologists from 15,000 to 42,000 and clinical social workers from 25,000 to 80,000, while the total cost of mental health care rose between 1980 and 1990 from about $20 billion to about $55 billion.[11]

The ‘medicalisation of deviance’ is becoming particularly apparent in the socialisation of children and the early detection of supposedly serious psychiatric problems in children is a widely discussed imperative. In New South Wales the Schizophrenia Information Centre, for instance, warns parents to be watchful for early signs of schizophrenia in their children, advising that treatment should be given immediately if any symptoms are observed. One of the signs they advise parents to look for is a child who is observed to ‘say or do things most people find socially embarrassing—such as telling someone they’re ugly or their nose is a funny shape . . . It is as if their brain disorder involves some damage to the internal "filter" which helps people sort out what’s appropriate from what’s not.’[12]

A recent paper on childhood schizophrenia in the US gives a number of examples of supposedly psychotic symptoms that have been observed in child patients. The observations include:

"An 8-year-old girl reported hearing multiple voices including the voice of a dead baby brother saying—'I love you sister, sister I’m going to miss you'. An 11-year-old boy heard God’s voice saying, ‘Sorry D., but I can’t come now, I’m helping someone else’. An 8-year-old girl reported an angel saying things like, ‘You didn’t cry today’ and ‘You’ve been a very nice girl today’. An 8-year-old boy stated, ‘I can hear the devil talk—God interrupts him and the devil says "shut up God". God and the devil are always fighting’. A boy described monsters calling him ‘Stupid F …’ and saying they will hurt him.’"[13]

The researcher reports that the mean age of the onset of nonpsychotic symptoms in these children was 4.6 years; the mean age of the onset of psychotic symptoms was 6.9 years; and the mean age at diagnosis of schizophrenia was 9.5 years.[14]

It is worth noting that this particular study was conducted in Los Angeles on 38 children, 17 of whom were black, 16 Hispanic, 4 white and 1 Asian. All the children had been screened to ensure their symptoms met strict DSM criteria for schizophrenia.[15] The DSM description of schizophrenia is normally used to determine abnormality in adults, and it seems extraordinary to read a paper such as this, published in a prestigious journal of the US National Institute of Mental Health, reporting research that has adapted the diagnostic criteria for use on children without any explanation. The researcher seems to believe that children should meet the same standards of conformity in their thoughts, beliefs and expression that are expected of adults.

Perhaps the racial background of the children can help explain why the researcher might hold such an intolerant view. Observers of psychiatric trends in the US have become concerned about a tendency to fund research into a perceived link between inner-city street crime and an assumed imbalance of brain chemistry in the perpetrators. A part of this line of research involves the development of new psychiatric drugs which it is hoped will pacify aggressive people by increasing the availability of serotonin in their brains. Young black males are seen as the prime targets for this type of therapy and the accompanying debate has inspired the headline in at least one black newspaper, ‘PLOT TO SEDATE BLACK YOUTH’.[16]

Next: Social Control, Youth and Unemployment

[11] Stuart A. Kirk and Herb Kutchins, The Selling of DSM: The Rhetoric of Science in Psychiatry, pp. 8–9.

[12] Schizophrenia Information Centre, ‘Schizophrenia: The Early Signs’.

[13] Andrew T. Russell, ‘The Clinical Presentation of Childhood-Onset Schizophrenia’, Schizophrenia Bulletin, pp. 631–46.

[14] Ibid., p. 631.

[15] Ibid., p. 632.

[16] Robert Wright, ‘The Biology of Violence’, pp. 68–77.