Can ‘schizophrenia’ diagnosis be divorced from social contexts?

Raza Griffiths, Service User Campaigner and Trainer

Some years ago, I was in a desperate situation and was rushed off to hospital after I collapsed, unannounced and without appointment, on my doctor's surgery floor. I told her the moon had been talking to me and directing me to do things that were placing my health and wellbeing at risk. This had been going on for some time and I found my feet were running me quickly to my doctor after a particularly frightening incident in which I had a narrow escape. My doctor immediately arranged for me to be taken to the local inpatient ward where I was interviewed by a ward psychiatrist and became fascinated by the objects in the room and her stethoscope and various metallic objects.

My doctor gave me various mental health labels. "Let's see if the labels fit," I said to her in response. I had a vague understanding that I was being evaluated and labelled. She told me I had what was called ‘schizophrenia’ by the professionals.

However, my mother, who is an articulate and sharp-elbowed person who had recently trained as a counsellor, was concerned at this diagnosis and the effect it might have on my long term life prospects. She asked the professionals for this diagnosis to be changed and I was then given what I later learnt is sometimes seen as being a slightly less (though not always much less) socially damaging diagnosis of bi-polar manic depression. 

I wonder if this would have happened, say, if my mother, who like me is from a south Asian background, had been less sharp elbowed or not spoken fluent English. And what does it say about the degree of objectivity of making a diagnosis? Can this process ever be divorced from a social context which is governed by prevailing unequal power dynamics (of knowledge, professional status, class, ethnicity, gender, sexual orientation etc.)?