Human First, Diagnosis Second

Diagnoses and the Human Experience

A veteran struggling to adjust to civilian life can be reduced to the diagnosis of “PTSD”. Someone who faces a great loss gets labeled “depressed”. A child dealing with big emotions becomes “Oppositional Defiant Disorder”. It becomes all too easy for someone to be given a label and then find themselves and others identifying with that label.

This isn’t to dismiss proper diagnoses. Diagnoses play a crucial role in our mental health care system. They guide treatment planning and help with insurance. They also provide measurable outcomes and language for suffering.

However, when we focus solely on diagnoses, we overlook something important. The individual risks becoming defined by their symptoms. While diagnostic codes can help, they often reduce complex people to mere labels. This view can create harmful expectations for both the provider and the client. It suggests that a person is broken and needs fixing, ignoring the many facets that make us human.

Moving from Diagnosis to Understanding

Moving beyond this limited and flawed model means shifting from symptom elimination to person-centered care. It means shifting from what’s wrong to something more valuable of what’s happened? What matters to you? It means exploring emotional pain as part of the territory to explore, not just a symptom — something to understand and be curious about.

Holistic care asks:

• What is this person’s story?
• What moments of connection speak to their soul?
• Who or what shaped them?
• What meaning do they make of their pain?
• What strengths are already within them?
• What relationships nourish or deplete them?
• What spiritual or creative resources do they draw on?
• What systems and environments support or oppress them?

A System That Prefers Symptoms

One major challenge in this field is a system that often prioritizes symptoms. In many cases, charts focus on symptom scores, like a GAD-7 score, instead of the individual. While these scores can guide treatment, they fail to capture the complexity of human experience. Clinicians may face burnout, which can lead to quick fixes instead of deeper connections. Clients may internalize the belief that they are defined by their symptoms, missing out on the fuller picture of who they are. 

Focusing narrowly on symptoms can make us overlook social factors that affect health. Issues like poverty, racism, and housing insecurity often worsen mental distress. If we ignore these broader realities, therapy can become a place where clients are told to cope, rather than being empowered to challenge their situations. 

Social Determinants of Health  

Mental health doesn’t exist in a vacuum. It’s shaped by the world around us — the places we live, the people we interact with, and the opportunities we have. Social determinants of health (SDOH) include things like income, education, housing, employment, and social support. These factors play a huge role in how we experience mental health. 

For example, a person living in a neighborhood with high crime rates may constantly feel unsafe, adding to their anxiety. Someone struggling with financial instability might experience ongoing stress, knowing they might not be able to pay rent or buy enough food. These external factors can worsen mental health problems, creating a cycle that’s hard to break. 

When we focus only on a person’s symptoms without considering their environment, we miss an important part of the picture. People’s mental health is influenced by more than just their thoughts or emotions — their surroundings matter just as much. Therapy, medications, and other mental health interventions cannot overcome a lack of physical safety, community, or employment. Ignoring this reality can limit the effectiveness of treatment and care. 

Key Points: 

• SDOH include factors like income, housing, education, and employment. 
• These factors can impact mental health, often making problems worse. 
• Focusing only on symptoms can miss critical factors in someone’s life. 
• Recognizing SDOH helps provide better, more holistic care. 
• People’s mental health is shaped by both internal and external forces. 

Addressing SDOH means looking beyond the individual and recognizing how their environment affects their well-being. This approach helps us provide more effective care, making sure we support the whole person, not just treat their symptoms. 

Moving Towards Whole-Person Care 

This deeper philosophy of mental health care shifts from a narrow focus to a more human-centered approach. It encourages us to see individuals as whole beings to support, rather than problems to fix. 

So, how do we implement holistic care? 

• Narrative over checking boxes: We prioritize the client’s personal story. It’s important to understand not just what they’re feeling, but how they make sense of it. 
• Contextual and cultural understanding: We consider the client’s cultural and social background. We look at how trauma and oppression have shaped their mental health. 
• Values-based focus: Clients are more than their symptoms. We help them reconnect with their strengths and resilience. 
• Relational depth: The therapist-client relationship is a healing space built on trust and safety. 
• Integration of body, mind, and spirit: Mental health involves our bodies, emotions, and connections. It acknowledges the importance of love and belonging. 

Many practitioners find creative ways to work within these limitations. They use person-first language in their notes. They make time for deeper reflection, even with tight schedules. They advocate for trauma-informed and anti-oppressive approaches. This can include helping clients set realistic wellness goals as part of their mental health care. 

Some therapeutic methods might involve somatic work. Clinicians can encourage clients to notice bodily sensations when discussing values. For example, when they talk about freedom or service, where do they feel it physically? This helps link values with feelings. When clients face intense emotions, they can remember their commitments, like healing or connection, to manage better.

Some may benefit from trauma-informed yoga, stretching, or walking therapy. Personal rituals like meditation or spending time in nature can also create grounding spaces. 

Building Community-Based Models of Care 

Another approach is encouraging participation in community groups or peer support. Some are reshaping mental health care by creating community-based models. This model recognizes that healing happens not just through professionals but also through connection and belonging.  

Such networks help reduce shame and isolation, validate experiences, and provide emotional support. Clinicians can support these pathways by exploring clients’ social and spiritual connections and collaborating with community leaders for integrated care.