Bias in Diagnosis

The word “name-calling” provokes negative associations, but the term “diagnostic labeling” has an aura of scientific precision, objectivity, and professionalism that lends it tremendous power. Language confers power (Miller and Swift 1977), and that power is “not distributed equitably across the social hierarchy” (Hare-Mustin and Marecek 1997, 106), a fact that has had tremendous impact on those who have sought mental health services. Diagnosis of physical problems has often been extremely useful, and in principle, psychiatric diagnosis can be helpful, too (e.g., Emily J. Caplan, chapter 5 in this volume). Unfortunately, psychiatric labeling has been conceived of and applied in extremely biased ways and is surprisingly unwarranted by scientific research, and thus it can result in serious harm (P. Caplan 1995). As Hare-Mustin and Marecek note: “a diagnostic label . . . has a profound influence on what we think of people so labeled and how they think about themselves” (1997, 105). In addition, diagnostic labels often create problems with employers and the...