Tag Archives: Diagnosing

Thoughts about Numbers

28 Apr

I have been working on a project for one of my classes, in my project I have been interviewing Hispanic immigrants in North Carolina and while I was transcribing the interview I connected with something my informant told me. He spoke about the value of numbers- particularly the numbers assigned to a person via social security. Growing up those 9 numbers dictated his life, he was ruled by the power of that 9 number sequence- It got me thinking about the numbers we assign people in any system we belong to, take for example the mental health system. In mental health before a client is seen we request their social security number, date of birth, age, insurance number, we call up the management entity to gather information about their record number. Before anyone even talks to this person they become a mathematical code.

The equation continues to complicate as the individual returns their paperwork to the receptionist and the individual waits for their appointment time. The clinician steps out of their office after being informed that their 9:00am appointment as arrived. The clinician starts to build the relationship and starts the assessment process, typically with a standardized form to assess for an array of typical symptoms, many of the symptoms searching for frequency and duration.

More numbers.

The assessment concludes and the clinician sits with the information that was gathered in the assessment; notes about the duration and frequency of the symptoms,  notes about stressors and what brought them to the office for the assessment, Notes about their hopes and dreams for a future without this stressor. Upon reviewing these notes it is time for the clinician to think about the final numbers this person will receive in order to see this person, and bill insurance for the service.

The problem has been calculated down- now it is time for the clinician to justify the final numbers the client will receive, will it be 309.0 Adjustment with Depressed mood, or is it in fact 311 Depressive Disorder not otherwise specified, should the clinician rule out another number and later give them their GAF, or Global Assessment of Functioning number that is in the 50s range or the 60s.

Axis 1 + Axis II – Axis III + Axis IV + Axis V = Service Delivery and Treatment Plan

It is my fear that after a while, with soaring caseloads and the current state of mental health in the nation. It is easy to see where a person would stop existing as a person and is instead the person becomes that number, that diagnosis, that social security number.  It is my hope that people will stop being numbers and get back to being a more human and compassionate world. There seems to be no time to spend that time anymore, but that time is what fosters growth and allows for personal introspection.

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Gabriel Lucatero

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