ABSTRACT
This chapter discusses the importance of diagnosis for evidence-based practice and empowering and facilitating self-management. It explains the complementary importance of diagnosis, formulation and narrative. The chapter presents the relationship of stigma to diagnosis. Diagnosis and classification systems of mental disorders have raised controversy over many years. They have been extensively criticized as being: reductionist, unreliable and invalid. A core problem is the confusion about how mental disorder relates to mental illness. The Diagnostic and statistical manual (DSM) in particular has struggled with this, and it seems to be attempting to define illness rather than disorder. Homosexuality provided the most controversial representation of this, as it was defined by the DSM as a mental disorder until a vote of the American Psychiatric Association in 1973 overturned this decision. Culture also influences the way in which people attribute symptoms to mental illness, engage with services and choose treatments.
