Neuroscience-Informed Self-Advocacy for Individuals with Psychiatric Disorders

Self-advocacy is an effective way to foster improved quality of care for people with psychiatric illnesses. By understanding their conditions and needs they are better able to collaborate with their clinicians and form effective treatment plans. Introducing basic neuroscience to individuals with mental illnesses equips them to navigate the American mental healthcare system, which relies on neuroscience to create diagnoses and medications. This thesis aims to create neuroscience-informed mental health resources so that individuals with psychiatric disorders can access information that may help them better advocate for themselves in the future. Mental Healthcare in the United States The United States mental healthcare system is predicated on an epidemiological model of psychiatric illness. This approach to mental health gained prominence during and after World War II as an alternative to psychoanalysis. Psychoanalysis believes that each individual comes with their own individual psychopathologies that cannot be separated into discrete diagnoses. Although psychoanalysis can be useful in an individual therapeutic context, its individuallytailored approach was woefully inadequate to support the influx of traumatized veterans returning from World War II (Murphy & Leighton, 2009). The epidemiological model of mental health views psychiatric illnesses as discrete, diagnosable entities. These illnesses could then be treated via well-established therapies, resulting in quality-of-life improvements for the client. The Diagnostic and Statistical Manual of Mental Disorders, the DSM-5, is the current criteria for all diagnosable mental disorders in the United States (Horwitz & Grob, 2011). There are definite strengths to the epidemiological model of mental health. Discrete diagnostic labels allows for the collection of data, which can inform therapeutic advancements Neuroscience-Informed Self-Advocacy for Individuals with Psychiatric Disorders 3 and public policy (Kelly, 2017). Clear diagnoses with required symptoms can standardize diagnosis, minimizing clinician biases. Public screening programs can also help identify individuals who may benefit from psychiatric treatment (Horwiz & Grob, 2011). Unfortunately, there are also some massive problems with the epidemiological model of mental health, especially with its validity. Accurate diagnoses require that an appropriate diagnosis exists and that diagnoses are distinguishable from each other (Horwiz & Grob, 2011). For example, the DSM-5 contains an entire section for potential disorders it does not yet diagnose and there is substantial overlap between criteria for schizophrenia, schizoaffective disorder, and bipolar disorder with psychotic features (American Psychiatric Association, 2013). Although acknowledgement of future areas of research is a good thing, the presence of an entire nebulous section indicates that the DSM-5 may not contain all the diagnoses required to support clients. Emerging neuroscience and genetics also suggests that psychiatric diagnoses are far more nuanced than once thought. The DISC1 gene is a connecting factor between individuals with schizophrenia, schizoaffective disorder, bipolar disorder, and major depressive disorder. The common involvement of this gene implies that all of these disorders may be caused by errors in the same proteins (Porteous et al, 2011). These findings suggest that mental illnesses may be spectrum disorders, similar to autism another disorder also associated with the DISC1 gene. Regardless of the issues in the epidemiological model, it is what the United States healthcare system utilizes and what mental healthcare clients must learn to navigate. Juggling medications and diagnoses can be difficult, especially in a landscape that is shifting as rapidly as contemporary psychopathology.