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“This is Why you’ve Been Suffering”: Reflections of Providers on Neuroimaging in Mental Health Care

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An Erratum to this article was published on 22 January 2011

Abstract

Mental health care providers increasingly confront challenges posed by the introduction of new neurotechnology into the clinic, but little is known about the impact of such capabilities on practice patterns and relationships with patients. To address this important gap, we sought providers’ perspectives on the potential clinical translation of functional neuroimaging for prediction and diagnosis of mental illness. We conducted 32 semi-structured telephone interviews with mental health care providers representing psychiatry, psychology, family medicine, and allied mental health. Our results suggest that mental health providers have begun to re-conceptualize mental illness with a neuroscience gaze. They report an epistemic commitment to the value of a brain scan to provide a meaningful explanation of mental illness for their clients. If functional neuroimaging continues along its projected trajectory to translation, providers will ultimately have to negotiate its role in mental health. Their perspectives, therefore, enrich bioethical discourse surrounding neurotechnology and inform the translational pathway.

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Notes

  1. Mental health providers often use the term “client” to refer to individuals who receive healthcare services, usually in lieu of the term “patient.” This paper will use the term client in the same way, however client may be used interchangeably with patient in the narratives of the mental health providers highlighted in our text.

  2. For reviews of the current thinking in psychiatric ethics, please see: Murphy and Illes 2007; Levy and Clarke 2008; Hoop and Spellecy 2009; Buchman and Illes 2010.

  3. The Journal of Psychiatric Practice lists Cheung’s paper as the “Winner of the Resident Paper Award 2008–2009.”

  4. Blood oxygen level-dependent. In the MRI, the BOLD signal is correlated with changes in deoxyhemoglobin in the brain.

  5. All names of participants are pseudonyms.

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Acknowledgements

Supported by NIH/NIMH 9RO1MH84282, the Canadian Institutes for Health Research, Institutes for Neuroscience, Mental Health and Addiction (CIHR-INMHA) CNE #85117, the British Columbia Knowledge Development Fund (BCKDF), the Canadian Foundation for Innovation (CFI), and the Vancouver Coastal Health Research Institute. Special thanks to Dr. Allan H. Young and members of the Institute of Mental Health, Department of Psychiatry, University of British Columbia, and to the anonymous reviewer for thoughtful remarks.

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Authors and Affiliations

  1. National Core for Neuroethics, University of British Columbia, Vancouver, Canada

    Emily Borgelt, Daniel Z. Buchman & Judy Illes

  2. Canada Research Chair in Neuroethics, Division of Neurology, University of British Columbia, 2211 Wesbrook Mall, Koerner S124, Vancouver, British Colombia, V6T 2B5, Canada

    Judy Illes

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  1. Emily Borgelt
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  2. Daniel Z. Buchman
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Correspondence to Judy Illes.

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An erratum to this article can be found at http://dx.doi.org/10.1007/s11673-011-9284-4

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Borgelt, E., Buchman, D.Z. & Illes, J. “This is Why you’ve Been Suffering”: Reflections of Providers on Neuroimaging in Mental Health Care. Bioethical Inquiry 8, 15–25 (2011). https://doi.org/10.1007/s11673-010-9271-1

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