Contested professional rationales for the assessment of mental health problems: Can social theories help?

For health and social care practitioners, the accurate understanding of mental health problems is an important aspect of their effective amelioration. The practices of diagnosis and formulation have both been used for this task. The first has been associated with individual cases being allocated to pre-existing professionally agreed categories. The second is typically expressed by some form of tailored description of the patient's presenting problems in his or her life context. Both diagnoses and formulations are thus traceable to professional assumptions, expressed in codified forms of knowledge. This article provides a description of the tensions between diagnostic- and formulation-based mental health assessments. The picture emerging of theoretical contestation and practical compromise is then considered in relation to the potential sense-making value of social theories.