Mental health on campus: Diagnosing mental health issues requires patience, care

Coping with a mental illness is a challenge, but for mental health professionals, diagnosing the problem might be even more difficult.

You cannot take an X-ray or simply perform a test to figure out if a mental health problem exists. Instead, mental health professionals must use patience and care when making a diagnosis. Still, mistakes are made.

“I can’t say it’s easy. I would say it’s hard, and sometimes when a patient is first diagnosed we might not get it right. We just give the best diagnoses we can, and that’s really no different for psychiatric than it is for medical,” said Craig Richman, medical director for The Meadows, a psychiatric hospital in Centre Hall.

“Ideally, diagnosis is a collaborative process between client and mental health practitioner. At times, a practitioner will talk with a client about possible differential diagnoses and treatment options,” said Mary Anne Knapp, a clinical social worker and senior staff therapist at Penn State’s Counseling and Psychological Services.

“No one is happy with a misdiagnosis that misses the mark,” she said.

As an example, a 2006 report by the National Institutes of Health cited 1994 and 2000 surveys showing that 69 percent of people with bipolar disorder were initially misdiagnosed. More than a third remained misdiagnosed for 10 years or more. The surveys were done by the National Depressive and Manic-Depressive Association.

Many background factors go into determining whether someone has a mental illness. Genetics and drug abuse can influence, or even mask, an underlying problem with a person’s mental health.

“To help us with our diagnoses here in the inpatient unit, we also have a psychologist who can do testing to help us better define the diagnoses. If I think I need help ... or I need further testing, I’ll order psychological testing,” Richman said.

Richman said the testing consists of a psychologist running a battery of tests on the patient. These could be used for a number of reasons, including analyzing someone’s personality or their intellectual capabilities, and even seeing if a patient is faking the mental illness.

At Penn State’s psychological services center, mental health professionals often use surveys and talk to family members of the patient to obtain the information they need to make the right decision. This can be especially difficult at the center because there are only 25 mental health professionals, compared with 3,650 patients who were seen last year.

Among students, even having trouble concentrating in class might be an indicator of a mental illness. According to Knapp, students are sometimes misdiagnosed with attention deficit hyperactivity disorder when more serious problems like depression and anxiety are the real cause of their problems.

Knapp said she believes a combination of talk therapies and medication is the best way to treat a mental illness. She also thinks students’ lifestyles can influence their risk of developing mental health problems.

“Stress and poor lifestyle habits such as insufficient sleep, eating irregularities, binge drinking and ongoing worry can make a student at higher risk for developing depression or anxiety conditions, especially if there is a predisposition to these conditions,” Knapp said.

According to Knapp, altering a patient’s lifestyle can be as effective as medicine for someone with mild to intermediate depression.

Students who have multiple mental health problems are even more challenging to diagnose. Mental health professionals say they often have to prioritize one mental illness over another for the student’s safety.

This story was originally published December 26, 2015 at 11:05 PM with the headline "Mental health on campus: Diagnosing mental health issues requires patience, care."