Should mental health diagnoses be permanent?

[nanette1985]

My son is autistic. He was diagnosed with autism when he was born.

I've been an advocate for autistic students for a long time.

One of my son's classmates at his special schools was diagnosed autistic by the school sometime like 2nd grade and remained classified for his entire school career. He's never had a medical diagnosis. I've known him a long time, and he's the least autistic person I know. I think the school just wanted to get rid of him.

Now that he's in his 20's he works in a bank, and the bank won't give him a promotion because of his autism diagnosis. He can't get some kind of license because of it.

I'm trying to help him get his diagnosis removed. I'm working with a special needs lawyer that I know. Turns out it is nearly impossible to get his diagnosis changed here in the state of NJ. We're trying to figure out if there is some way to get him a different diagnosis. Except it's not possible to diagnosis somebody as normal.

Should a diagnosis like this be unchangeable?

 

[moonbogg]

If he were to take a test today, would the results be autistic? Also, I didn't know that they could discriminate like that. If he is able to perform the work he should be able to IMO.

 

[DaveSimmons]

> Should mental health diagnoses be permanent?

No. A person could be mis-diagnosed, or their illness might be curable. Or if their illness can be fully controlled with some treatment such as a drug, then as long as they are taking the drug as directed they should be treated as "normal".

I can some fields where discrimination might be allowable, for example if the work involves long periods away from monitoring and treatment services. You wouldn't want someone on a nuclear submarine if their meds need to be monitored and adjusted as needed.

 

[Howard]

They should be as permanent as driver's licences, I suppose.

 

[the DRIZZLE]

I'm not calling you a liar but there's a few issues here. First, the guy was in no way obligated to disclose his diagnosis to his employer. Second, not promoting him on those grounds would be illegal under the ADA.

Your question is moot because these diagnoses generally don't follow you around in the ways that you are implying, except for very limited situations. For example, I believe you have to disclose certain mental health issues when you enlist in the military.

 

[Greenman]

I'm kind of with the Drizzle on this, some very pertinent piece of information is missing. I didn't think you had to disclose that sort of information under normal circumstances, and I would think there would be some protection from the ADA. I also don't see how a school could diagnose anything. They may have had a staff member with the appropriate training, but at some point or another a real doctor has to confirm the diagnosis, and that confirmation is privileged information.

The parts you've given us don't equal the sum of the story.

 

[SMOGZINN]

I'm not calling you a liar but there's a few issues here. First, the guy was in no way obligated to disclose his diagnosis to his employer.

That is not quite true. Some state or national licensing can require disclosure. It is required for security clearances in the US Federal Services for example. To get a drivers license in the State of Texas you have to disclose epilepsy and the AMA does not consider it a breach of Patient/Doctor confidentiality for your doctor to report your diagnosis to the Texas Department of Public Safety.

Second, not promoting him on those grounds would be illegal under the ADA.

Also not fully true. Not promoting him on the grounds of a protected disability is illegal only if that disability is not directly contraindicated by the job. For example blindness is a protected disability but not hireling or promoting a blind person to a truck driver position because of their blindness would not be considered a breach of ADA.

 

[nanette1985]

I'm not calling you a liar but there's a few issues here. First, the guy was in no way obligated to disclose his diagnosis to his employer. Second, not promoting him on those grounds would be illegal under the ADA.

Your question is moot because these diagnoses generally don't follow you around in the ways that you are implying, except for very limited situations. For example, I believe you have to disclose certain mental health issues when you enlist in the military.

Unfortunately, the special needs school that this guy ended up in is considered a mental health facility. So he's on the FBI mental health registery When his bank did a background check, they discovered that he's ineligible for certain licenses because of this. He also can't buy a gun, not that he would ever want to. Yes, autistic people can serve in the military, as long as they pass all the normal requirements.

There is, BTW no medication and no cure for autism. This is a matter of getting his diagnosis removed. Which is why we are working with lawyers.

 

[EagleKeeper]

Unfortunately, the special needs school that this guy ended up in is considered a mental health facility. So he's on the FBI mental health registery When his bank did a background check, they discovered that he's ineligible for certain licenses because of this. He also can't buy a gun, not that he would ever want to. Yes, autistic people can serve in the military, as long as they pass all the normal requirements.

There is, BTW no medication and no cure for autism. This is a matter of getting his diagnosis removed. Which is why we are working with lawyers.

So the bank is following the rules/law.

The best you can do is to try to get the diagnosis removed and/or weakened

 

[Carmen813]

Hello,
I work in mental health as a therapist. Getting a diagnosis removed would be tricky. That said, it sounds like he is running into stigmatization due to have a mental health condition. You would likely have some success in looking into discrimination rather than having his diagnosis changed.

Diagnosis in mental health is a difficult process and the fact that people get stigmatized by their diagnosis is one of the reasons my profession has traditionally been against it as a whole (counselors). But that is probably a discussion for another day.

If you believe the diagnosis is inaccurate, then I would recommend seeking a mental health professional meeting with him and having him undergoing some formal assessment & evaluation. It's time consuming/costly and bit grueling, but it can clarify him from a mental health perspective. Look into some licensed practitioners (psychologists tend to do a lot of testing) and search around for someone who you trust. But...don't expect them to give/rule out any diagnosis without finding objective evidence.

It's not common to think of any mental health diagnosis as "curable." Symptoms can often be alleviated with various interventions, but searching for a "cure" a mental health condition can rapidly lead people down a dangerous path. Generally mental health favors a recovery oriented approach at this time (wikipedia it).

The Diagnostic and Statistical Manual of Mental Disorders just released version five, which radically changes how autism is diagnosed. (http://en.wikipedia.org/wiki/DSM-V) Autism is now a "spectrum" disorder which basically means there are varying levels of intensity. He may have something akin to the old Asperger's Disorder which now no longer exists.

 

[AViking]

Wow asbergers is gone? That sucks since there's a different social status of Asbergers vs Autism.

I don't know how you are going to get rid of this label. I know a number of people with "asbergers" and even in the most minor cases it's fairly noticeable after some time with the person and pops it's head here and there with stubbornness and traits that some employers are simply not going to tolerate.

A bank though? That I don't get.

 

[EagleKeeper]

Hello,
I work in mental health as a therapist. Getting a diagnosis removed would be tricky. That said, it sounds like he is running into stigmatization due to have a mental health condition. You would likely have some success in looking into discrimination rather than having his diagnosis changed.

Diagnosis in mental health is a difficult process and the fact that people get stigmatized by their diagnosis is one of the reasons my profession has traditionally been against it as a whole (counselors). But that is probably a discussion for another day.

If you believe the diagnosis is inaccurate, then I would recommend seeking a mental health professional meeting with him and having him undergoing some formal assessment & evaluation. It's time consuming/costly and bit grueling, but it can clarify him from a mental health perspective. Look into some licensed practitioners (psychologists tend to do a lot of testing) and search around for someone who you trust. But...don't expect them to give/rule out any diagnosis without finding objective evidence.

It's not common to think of any mental health diagnosis as "curable." Symptoms can often be alleviated with various interventions, but searching for a "cure" a mental health condition can rapidly lead people down a dangerous path. Generally mental health favors a recovery oriented approach at this time (wikipedia it).

The Diagnostic and Statistical Manual of Mental Disorders just released version five, which radically changes how autism is diagnosed. (http://en.wikipedia.org/wiki/DSM-V) Autism is now a "spectrum" disorder which basically means there are varying levels of intensity. He may have something akin to the old Asperger's Disorder which now no longer exists.

If the discrimination is a result of a Federal/State requirement; going after the employer for discrimination is a lost cause.

Tread lightly in that regard. If the employer has a leg to stand on; the job may vanish as a result of such an action.

 

[nanette1985]

Hi Carmen! Thanks for your interesting reply. Glad to hear you're a therapist. As you know, we need all of them we can get.

So, if you happen to know a mental health professional who has successfully re diagnosed someone, and managed to get them removed from the Federal databases, please let me know. We are working with some really great people but no success so far.

A question about Recovery Oriented Approach. What I know about it is that it applies to Medication. Do you have a different source? I'd appreciate it.

I'm very familiar with DMS-v. I first got to know Dr. Allen Frances back in 1989 (dms-iv) Also, be prepared for new changes to 299, since so many important people are getting away from the spectrum idea.