From criticism of protocols to criticism of the diagnostic practice. The sociological contribution to psychiatric practice in an age of mental illness epidemics

This paper discusses the role that sociological reflection can play in learning and improving knowledge in the field of mental health care. Two different positions within sociology will be discussed. The first one, taken from a constructionist perspective, interprets the role of sociology as a critical instance and highlights how the adoption of rigid formal protocols in psychiatry has hindered and endangered the autonomy and necessary discretion of clinicians at the moment of diagnosis. The second position, which takes an ethnomethodological point of view, holds instead that it is pointless to focus on formal protocols because concrete diagnostic practice consists of other procedures, not at all comparable to the official ones described by the DSM. For ethnomethodology, the contribution of sociology is not to add sociological knowledge to psychiatric knowledge, but to make the real resources and competences of clinical work explicit.