Diagnosis, treatment and effect size (and something else)

Doctors have spent a lot of time making diagnosis in research reliable and valid. The cluster of symptoms approach backed by evidence is both a marvel of science and a mockery. The latter is because of the pathologisation rather than the objective view of the phenotypes described by the labels.

What doctors do as treatment is where there's a problem. There's many areas. The measures and the systems are still far away from assessing the right variablews. There are more interactions and there is more individuality than is understood by the system. This is perhaps part of the reason why effect sizes in systematic reviews in mental health often show effect sizes which are smaller than what's considered good evidence in a trial in physical health.

The diagnostic system and the link to the treatment options is not able to accurately refer a person to the right treatment. Physicians aren't equipped with the tools or the learning to do this. It affects their ability to be effective in suppressing phenotypes. I mean ensuring good social and clinical outcomes.

On another note....

The system has never attempted to be able to fix the thing which patients come to it for: subjective unwellness. This will be the future mental health system and I guess it will evolve from psychiatry. The measures will be different. The measure will be subjective unwellness based on patient report. There is the problem of resilience but only because resources are limited. There is a greater resource, the people, from where mental healthcare in a distress based system can come from.