"We may be able to come up with all kinds of cleverly nuanced perspectives on how we, as professionals and philosophers, understand psychiatric diagnosis but the fact remains that people are being told that they have mental illnesses and disorders, with all of the usual connotations of those terms in Western societies. Moreover, they are heavily encouraged to take on the particular narrow understanding that you refer to–we are all bombarded with messages about "mental illness" being "as real as a broken arm", and needing to be managed by drugs "just like diabetes." Even the dubious compromise of the "biopsychosocial" model–a way of acknowledging some role for psychosocial factors while at the same time instantly relegating them to "triggers" of a disease process–is not much in evidence on the ground. And furthermore, the biomedical message is reinforced by the fact that these labels are being applied by doctors and nurses working in hospitals and clinics, who use not just the labels themselves but the whole medicalized discourse of symptom, patient, prognosis, treatment, relapse, and so. The "stereotypical biomedical understanding of diagnoses", as you put it, is absolutely everywhere. […] I have yet to hear any real life service user say "Although the doctor told me I have schizophrenia I'm not too worried, because "illness" is just a metaphor for suffering in this case and it doesn't exclude personal meaning." I'm sure readers are aware that the consequences of being diagnosed–such as being sectioned, forcibly injected, and so on–are not just metaphorical. Some of these learned articles strike me as a form of defense against admitting to the fundamental inadequacy and devastating damage of the current diagnostic system. Essentially, we need to acknowledge that we are not dealing with patients with illness, but people with problems." - — Lucy Johnstone, PsyD, Moving Beyond Psychiatric Diagnosis
