Who Benefits From Your Label? Diagnosis as an Institutional Tool (Part 2)

 

Who Benefits From Your Label?

Diagnosis as an Institutional Tool (Part 2)

By Dr. Clifford A. E. Illis, PhD of Philosophy in Anthropology (H.C.)

In Part 1, I looked at a single human life: 7,000 days of light and darkness crushed into a diagnostic snapshot. From an anthropological viewpoint, that reduction is already a kind of violence.

Now we have to ask the next question, and it is not a psychological one; it is a political‑economic one:

If diagnosis erases so much of the person,
why has this way of working become so dominant and so stable?

The short answer is uncomfortable:

Because the label is extremely useful to institutions.
Because a code is easier to manage than a biography.

In this part, I will not talk about “disorders” or “symptoms” at all. I will talk about systems: pharma, insurance, professional bodies, and the state—and how they all benefit from turning human beings into diagnostic units.

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Pharma: A Market Loves a Name

From an anthropological angle, pharmaceutical companies are not neutral helpers; they are powerful economic actors with clear interests.

To sell a psychiatric drug at scale, you need at least three things:

A named condition people can recognize and fear.
A standard description that appears in manuals, guidelines, and training.
A story that links the drug to that condition (“This treats X.”).

Diagnostic labels supply all three.

The broader and more elastic the label, the larger the potential market:

“Depression” that covers everything from deep, multi‑year despair to understandable sadness in impossible conditions.
“ADHD” that can stretch from extreme, disabling impulsivity to any child who struggles to sit still in a dead classroom.
“Generalized anxiety” that can equally describe realistic fear in a violent society.

The more people you can legitimately fit under the name, the more prescriptions you can justify.

From this perspective, the erasure of the 7,000 days is not a bug; it is a feature. The less we talk about real histories and real structural harms, the easier it is to present suffering as a disorder inside the individual—and the easier it is to propose a chemical solution.

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Insurance and Bureaucracy: Codes, Not Stories

Insurance systems, whether public or private, are not built to handle human complexity. They are built to handle:

categories,
tariffs,
standardized pathways.

They need codes, not biographies.

A diagnosis code serves several functions at once:

It justifies why money is being spent.
It indicates which “treatment package” is appropriate.
It allows comparison, auditing, and control.

From an administrative point of view, the 30‑year‑old with 7,000 days behind them is not a person; they are a case that must be located inside a hierarchy of codes so the system can decide:

what will be paid,
for how long,
and by whom.

If their story is too complex—poverty, racism, unstable housing, legal problems, past violence—this does not fit neatly into the reimbursement logic. A simple code does.

So we flatten.

We don’t say:
“This woman is falling apart after 15 years of cumulative trauma, unprocessed grief, and social abandonment.”

We say:
“She has major depressive disorder with comorbid PTSD” and assign a billing category.

The flattening is rational from the system’s view, but brutal for the person.

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Professional Associations: Guardians of the Manuals

Professional associations of psychiatrists and psychologists sit at the center of this structure.

They:

help write or adopt diagnostic manuals,
set training curricula and licensing standards,
shape what counts as “evidence‑based” treatment,
lobby governments,
and define what is considered “good practice”.

Their authority, funding, and influence are all tied to one thing:

The idea that their categories and methods are
scientifically valid, necessary, and reliable.

If society were to widely recognize that many categories are:

unstable over time,
heavily overlapping (comorbidity everywhere),
culturally biased,
blind to structural violence,

then the whole professional prestige pyramid would be shaken.

There is therefore a deep, often unspoken incentive to:

defend the manuals,
present them as more objective than they are,
and marginalize voices that point out foundational problems.

The anthropological question is not whether individual clinicians are well‑meaning (many are), but what the institution must believe about itself in order to survive.

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The State: Managing Distress and Deviance

Finally, we must look at the state.

Governments have always needed categories for:

who is “normal” and who is “not normal”,
who can be held responsible and who is “ill”,
who can be left in the community and who can be detained “for their own safety or the public’s”.

Modern psychiatric diagnosis gives the state a medical vocabulary to:

justify coercion (forced treatment, involuntary admission),
separate “dangerous” from “sick” from “criminal”,
produce statistics and policy plans.

From an anthropological point of view, diagnosis is part of a governance toolkit. It helps authorities say:

“This is not a political or social problem;
this is a mental health issue in that person.”

If domestic violence, racialized poverty, or political brutality result in people breaking down, it is often easier for systems to label the individual than to examine the structures that harmed them.

Diagnosis helps redirect attention away from the world and back into the individual brain.

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Putting It Together: Captured Science

When you put these elements side by side, a pattern appears:

Pharma needs diagnoses to sell drugs.
Insurers need diagnoses to process payments.
Professional bodies need diagnoses to defend their authority.
States need diagnoses to manage distress and deviance.

The same structure that defines the disorders is the structure that profits from expanding them.

From an anthropological perspective, this looks less like a neutral science and more like what we might call a captured system: knowledge that has grown around the interests of those who use it, rather than around the full truth of those it describes.

In that light, the disappearance of the 7,000 days makes sense:

Complex human stories are dangerous.
They raise questions about justice, economics, history, and power.
They make clear that much of what is called “illness” is actually understandable reaction.

Flattening lives into labels keeps the machine moving.

In the next part, I will go further into what is missing from the official picture: trauma, culture, and power—and how their absence distorts everything we are told about “mental illness”.