Abstract
Background
We have previously argued that psychiatric diagnosis, by focusing on pathology, minimises the role of psychosocial factors. Despite suggestions that traditional diagnosis is the only way to access treatment services, we have recommended standardised use of existing codes for possible social determinants and precise description of psychological phenomena.
Aims
This study examines the current use of social determinant and phenomenological codes in mental health care records.
Methods
Data provided by a local NHS Trust included 21,701 cases with a first contact date between 01 January 2015 and 01 January 2016, 4656 of whom received a primary diagnosis.
Results
Overall, codes for possible social determinants were used on only 43 occasions, for 39 individuals (0.8% of the 4656 people receiving a primary diagnosis). Comparison with relevant baseline frequencies revealed a highly significant under-reporting of key social determinants. 19 cases (0.4% of 4.656) used codes for precise description of specific psychological phenomena.
Conclusions
Available ICD codes for social determinants and specific psychological phenomena are under-used in clinical practice.
We have previously argued that psychiatric diagnosis, by focusing on pathology, minimises the role of psychosocial factors. Despite suggestions that traditional diagnosis is the only way to access treatment services, we have recommended standardised use of existing codes for possible social determinants and precise description of psychological phenomena.
Aims
This study examines the current use of social determinant and phenomenological codes in mental health care records.
Methods
Data provided by a local NHS Trust included 21,701 cases with a first contact date between 01 January 2015 and 01 January 2016, 4656 of whom received a primary diagnosis.
Results
Overall, codes for possible social determinants were used on only 43 occasions, for 39 individuals (0.8% of the 4656 people receiving a primary diagnosis). Comparison with relevant baseline frequencies revealed a highly significant under-reporting of key social determinants. 19 cases (0.4% of 4.656) used codes for precise description of specific psychological phenomena.
Conclusions
Available ICD codes for social determinants and specific psychological phenomena are under-used in clinical practice.
| Original language | English |
|---|---|
| Journal | Journal Of Mental Health |
| Early online date | 14 Jul 2021 |
| DOIs | |
| Publication status | Published - 15 Jul 2021 |
Keywords
- Diagnosis
- phenomenology
- social determinants