Focus Area 8: Mental Health Basics
3. What is a Mental Health Disorder

This Mental Health Basics training is a very broad, general overview of the types of mental health challenges prevalent among youth today. It’s important for you to have a general understanding because it is very likely that some of the youth you work with directly will be experiencing mental health struggles. This training is not intended to make you an expert in mental health.

It also bears noting that this training is not intended to teach you how to diagnose mental health disorders. The diagnosis of a mental health disorder is up to professionals like psychologists and psychiatrists who have that specialized training and the proper assessment tools to evaluate an individual.

Unless you are a mental health professional, it is not your role as a youth worker to attempt to diagnose any of the youth you serve. However, you need a basic understanding of mental health issues so you can inquire about risk factors and recognize warning signs, and know when to consult with your supervisor about appropriate steps to take.

Having a general understanding of how a diagnosis is made and how the appearance of symptoms can vary will definitely help you to better support a youth struggling with a mental health issue. We’ll start with the resource mental health professionals consult when making a diagnosis. 

THE DIAGNOSTIC STATISTICAL MANUAL (DSM)

What constitutes a mental health disorder? The American Psychiatric Association publishes the reference most commonly used in the United States by mental health professionals to diagnose mental conditions - the Diagnostic and Statistical Manual of Mental Health Disorders.

As of 2017, the manual is in its 5^th edition and is commonly known as DSM-5. The DSM-5 is the resource used for the information provided in this section of the module.

This is how the DSM-5 defines a mental disorder:

“A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities.  An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g. political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above.”

That’s a lot to take in so let’s break out two important points and add some further detail:

Clinically significant and significant distress: There is a degree of subjectivity reflected in the phrases “clinically significant” and “significant distress.” Whether a mental disorder is clinically significant or of significant distress is decided upon in collaboration between the client and the mental health practitioner and relies on self-report, research, assessments, and experience.

Not a Mental Disorder: The statements regarding what is not considered a mental disorder are important. When concerns are not able to be assessed as clinically significant, treatments or services cannot be billed or reimbursed by an insurance provider as medically necessary. This does not mean that a person does not need or should not get support around that issue. It does not mean services would be inappropriate.

We’ve provided this information to give you a bit of insight into how the DSM-5 defines a mental disorder because that’s how mental health professionals approach making a diagnosis. You can see that making a diagnosis is not arbitrary, and that there is much to consider before arriving at a diagnosis.

For the purposes of just having a broad understanding of mental health basics, consider this from a less clinical perspective:

Mental health disorders are common. They negatively impact thinking, mood, and behavior. When you are concerned enough about those negative impacts that you are observing, it’s time to seek professional help to either rule out a mental health concern or begin treatment for a mental health disorder.