Seeing Professional Boundaries through Similar Eyes?

• In Event: 538 - Regular Session. Mental Health: Social Consequences

Abstract

Contemporary inter-professional debates surround the rights and qualifications to prescribe psychoactive medications. Arguing that the public provides an important source of legitimation for professional claims, we use the case of child and adolescent behavioral problems to understand public responses to socially constructed professional boundaries. Data from the 2002 General Social Survey asks whether respondents are willing to follow medication recommendations of general doctors, psychiatrists, and non-medical providers (e.g., counselors) for children/adolescents described as meeting criteria for ADHD, depression, or a control case of “daily troubles.” Endorsement levels are highest for depression, followed by ADHD, and lowest for the control. The public is likely to follow recommendations if they had endorsed a provider in the first place, making the lines of demarcation “light” to start. Further, while it appears that attributions, specific problem type, stigma, and medical beliefs appear to reveal differential public willingness to endorse providers in the overall analysis, detailed findings among contrasting types suggest that differences lie between the unwillingness to follow any provider’s advice to medicate, rather than discriminating among them. While there are clear cases of demarcation (e.g., general doctors, not psychiatrists when the vignette is seen as a physical problem; reverse for “mental illness”), psychiatry’s exclusive jurisdiction over prescribing is not supported by the public. These findings speak to professional credibility contests relevant to theory, clinical practice, and mental health care policy.

Author

• Sigrun Olafsdottir, University of Iceland