Considering the moral implications of psychiatric diagnosis for children

Abstract

Increasing numbers of children are meeting criteria for psychiatric disorders. While diagnoses may be of situational and individual benefit, they also have sustained and significant impacts on children's lives, including what they believe to be true, and how they understand themselves. Psychiatric diagnosis, therefore, has moral implications for children. This paper considers these moral implications, including uncertainty about the accuracy, treatment efficacy and long-term effects of psychiatric diagnosis for children through a critical lens. Challenges of identifying, diagnosing and treating childhood mental illness are explored, including a discussion of the familial and societal contexts of adversity and understandings of accepted behaviour and responses. Emphasis is sustained on the importance of child agency and rights and how these may conflict with protective discourses about childhood, compounding epistemic injustices for children. The author proposes that there is a need to consider the child voice, while also being conscious of the boundaries of possibility of constructed reality, alongside the development of new ways of speaking about and understanding child distress. Achieving this requires questioning and critique of systems of psychiatric diagnosis applied to children and increased consideration of shared social and political responsibilities to prevent childhood adversity.