Misdiagnosis of Mental Health Problems and Medical Negligence Claims
- Mental health problems can be very difficult to diagnose accurately
- Since there is general agreement amongst the medical community that diagnosis can be hard, cases of misdiagnosis will often not count as clinical negligence in the eyes of the law
- This does not mean that a misdiagnosis or delayed diagnosis will never count as negligence
Mental health problems can be difficult to diagnose since there are no strict tests that deliver a definitive diagnosis. Instead, diagnosis comes from a practitioner’s observations and a patient’s subjective description of their experience. People with mental health problems often provide anecdotal evidence when it comes to the difficulty of getting the correct diagnosis, or of not being properly informed of their own diagnosis. A lot of classified mental health disorders have very similar symptoms, which can lead to confusion and disagreement amongst medical practitioners.
Misdiagnosis of conditions such as ADHD or Schitzophrenia most often will not be classed as clinical negligence, whereas injuries caused by the lack of care given to a mentally ill patient may be.
By way of two examples:
Patient A is admitted to hospital and it is found that patient A has ADHD instead of Autism - medical negligence cannot be established.
Patient A is admitted to hospital and the patient has a mental health condition, patient A goes on to harm themselves and the nurses failed to monitor the patient appropriately - there may be a case for medical negligence.
Why does misdiagnosis of mental health happen?
It’s a very complicated issue, and in part, it’s to do with the nature of mental health disorders. There is a lot of anecdotal evidence to say that misdiagnosis is certainly common - one individual didn’t get a diagnosis for 30 years, another was eventually diagnosed with bipolar disorder but had disguised her symptoms behind alcoholism.
Healthtalk interviewed 30 people diagnosed with mental health problems and found a variety of reasons as to why misdiagnosis, or delayed diagnosis, happens.
Those interviewed who disagreed with their diagnosis:
- thought that their symptoms could be caused by a physical problem that needed to be treated.
- claimed that the diagnostic process was imprecise and that certain diagnoses were offered as last resorts if no other suitable label could be found.
- claimed that under certain conditions, all sorts of behaviour could be interpreted as being indicative of a mental illness that might not be there.
Medical journals claim that accurate diagnosis can be difficult because patients sometimes present a partial picture of their symptoms. For example, people with bipolar disorder tend to go to their doctor when they are feeling low, without mentioning the other part of bipolar which can involve periods of manic highs.
There are also physical illnesses that can cause psychological disturbances and be misinterpreted, for example hypoglycaemia, Diabetic ketosis, Wernickes-Korsakoff’s Syndrome and more (see Section V for more information).
What disorders are commonly misdiagnosed?
- Bipolar disorder – 69% of patients with bipolar are initially misdiagnosed. One-third remain misdiagnosed for 10 years or more.
- Borderline Personality Disorder – BPD has many similar symptoms to bipolar and the two are often mixed up.
- Post-traumatic Stress Disorder – PTSD has many similar symptoms to depression, anxiety and sometimes schizophrenia which leads to frequent misdiagnosis.
- Anxiety – A lot of the time, people with anxiety are not given a diagnosis for a long time. For women, the average length of time between the onset of symptoms and actual diagnosis is between nine and 12 years.
Tips to help you get the right diagnosis:
- Make sure your medical practitioner doesn’t try to rush you through your first consultation. Maybe book a double appointment so you have plenty of time. Ideally you should speak more than they should, even though it can be hard to talk about your symptoms at first. If they talk over you, or don’t give you time to properly describe how you feel, then they could be making assumptions about your condition.
- Try to notice which questions you are being asked. Your medical practitioner should be asking you about the following:
- The Importance of Your Diagnosis
- A full medical history, including past symptoms.
- Specific details about each symptom.
- Before you go in, ask close friends and family for input on your symptoms. It might be worth bringing someone close to you so they can help expand on your symptoms.
- If you disagree with something the doctor says, say something. Like with any illness, a doctor or GP can misinterpret what you say during consultation.
- Ask your doctor about other things your symptoms could be, so you can keep these in mind if you decide that you want a second opinion.
How do you know if you have been misdiagnosed?
It’s not always easy to tell if you’ve been misdiagnosed and it is perfectly possible for a patient to insist they have been misdiagnosed when they haven’t. That being said, it’s possible for patients to be disregarded when they question doctors, especially in the context of mental health disorders.
Generally, all you can do is trust your own sense about whether the diagnosis is correct or not. It’s perfectly acceptable to get a second opinion if you have some doubts. If you get a second opinion, you should voice the concerns that you have about your diagnosis. You might find that the doctor you see can address them without having to change the original diagnosis.
What can you do about it?
- Make a complaint
- Change doctor
- Get a second opinion
Can you make a claim if you’ve been wrongly diagnosed?
In some instances you might be able to make a claim for misdiagnosis of a mental health problem. The main difficulty in proving negligence in these type of cases is that misdiagnosis of mental illnesses is incredibly common.
That means it’s often understandable when a GP, or even a psychiatrist, makes a wrong diagnosis. In the eyes of the law even when they make a mistake, they haven’t failed in their “duty of care”.
In order to bring a claim it must be proven that harm has been caused and that a medical practitioner has failed in their duty of care.