Psychiatrization of, with and by children: Drawing a complex picture

Abstract

When discussed in the context of diagnosing or medicating children, psychiatrization is usually portrayed as a more or less monolithic top-down process, which, according to some, enables a child's right to health, while for others is a form of child abuse. This article challenges these conceptualizations in two steps: First, it draws on available literature on psychiatrization (including its top-down and bottom-up operations, and its ideological and material aspects), and its relationship to various psy-practices, and wider processes of (bio) medicalization, psychologization and reification. Second, using two detailed vignettes from ethnographic research with children and youth in Poland, the article demonstrates that children and youth are not necessarily passive recipients of psychiatrization as they themselves navigate, appropriate, resist, and transform top-down influences. While one vignette details a child's more or less open resistance to psychiatrization through their attention-deficit/hyperactivity disorder label, the other vignette shows young people embracing and positively identifying with bio and psy-knowledge in relation to depression. However, both vignettes show how children and youth make psychiatrization meaningful as it shapes their lifeworlds, with them sometimes becoming agents of psychiatrization themselves. Our data illustrate the nuances of psychiatrization of, with and by children, and we draw on this to complexify existing literature and framings of psychiatrization.

Designed to Clash? Reflecting on the Practical, Personal, and Structural Challenges of Collaborative Research in Psychiatry

“…Also, the economic inequality between CR and EE increased steadily over the three years, as academic payment structures determined that the EE were paid significantly less than the CR. On the other hand, our results will most likely contribute to bringing about a reform of mental health care toward approaches which are more emancipatory in some aspects, firmer grounded in human rights, and which may even serve to counteract the progressing psychiatrization of society ( 56 , 57 ). Furthermore, although the material gap between CR and EE could not be closed, our project opened up what could be called a new career path for all three EE: Even prior to the official termination of PsychCare, all of them had signed contracts in successive projects.…”

Psychiatrization of Society: A Conceptual Framework and Call for Transdisciplinary Research

“…A comprehensive model of psychiatrization and any further analysis needs to incorporate these two main levels and the vectors of interaction in between (see, Figure 1). This structure may also serve as a scheme to help characterize single sub-processes of psychiatrization (93).…”

“…This expertise may consist of scholars with research interest in particular conditions, or in clinicians who also identify as activists for a certain kind of suffering and become "moral entrepreneurs" [48, p. 476]. Top-level agents may thus even actively encourage bottom-up psychiatrization (93). Also, as in the case of CHADD, financial support from the pharmaceutical industry might help to maximize reach and political leverage of self-advocacy (48,116).…”

Teachers With Special Needs. De-Psychiatrization of Children in Schools

“…Especially in the large group of children and youngsters with mild to moderate problems, the benefits of a classification—such as greater understanding and support—may not outweigh its potential harms, like stigma, self-stigma, underperformance due to self-fulfilling prophecies, and side-effects of medical treatment ( Batstra et al, 2012 ). While diagnosis can promote social identification and acceptance, and children themselves sometimes actively engage in their own psychiatrization, it can also lead to social alienation, invalidation and stigmatization ( O’Connor et al, 2018 ; Beeker et al, 2020 ). Psychiatric diagnoses in youth are associated with social exclusion in later life ( Ringbom et al, 2021 ).…”