Personal blog of Dr Alex Mendelsohn

Month: March 2022

Physics World article context #3 – the problem with rating scales

This is the third of a series of blog posts on the context behind my Physics World article: A physicist’s experience of the mental-health system. There is a lot of backstory. So during the editing process, I sent documents to the editor to help explain some of the views I express in the article. I have decided to add them as blog posts.

Alex discusses the use of rating scales in the mental health system, which he encountered during his rTMS treatment. Alex provides an analogy of how rating scales can be problematic by comparing them to rating the weather over a two-week period. He explains that symptoms of mental illness are complex and unpredictable, and that they fluctuate and change over time, making it difficult to provide accurate ratings. Alex attended a support group meeting with other patients receiving treatment and found that none of them knew how to answer the rating scale questions. The author concludes that rating scales are not very good at capturing the complexities of mental illness.


It was during my rTMS treatment that I first encountered the rating scales. And, had I been completely honest, I would have said that I could not answer the questions. That I could not give a rating at all. Especially as every scale asked for an average over the last 2 weeks. I have thought of an analogy that I hope might get across the reason why I felt it was pretty much impossible to give a rating.

Say you have lived in Southern California USA for your entire life. You are used to warm, dry and sunny weather year-round. In the previous two weeks however, the weather has been very unCalifornian. On the first day it was foggy and a bit chilly out, the next few days were pretty warm for this time of year (winter) temps going up to 24 Celsius, with a lot of Sun. On the weekend though it rained persistently. Last week however started extraordinarily with snow, possibly the first time you had seen it in your life. The rest of the week then stayed pretty chilly, five or six degrees Celsius, before returning to warm and cloudy.

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Why has no one taken any measurements of my brain?

This is the original draft of the Physics World article: A physicist’s experience of the mental health system (which then lead to the 24th February podcast)

I sent this draft to the editor around August 2021, when I was quite a lot sicker than I am now. I am proud of what I wrote given I could barely make breakfast at the time. So bear this in mind if some of it doesn’t make sense!

The article is a personal account of a physicist’s experience with mental illness and the mental health system. Alex describes their experiences in experimental physics and how it taught them the importance of accurate, precise, and direct scientific measurements to derive meaningful understanding. They then go on to talk about their experiences with the mental health system and how they have not received any concrete measurements or tests to diagnose and treat their mental illness, which has led to a lack of progress in their treatment. Alex questions why mental health treatment is based on generalizations and guesswork instead of direct measurements, similar to how their work in physics evolved from guesswork to accurate measurements.


I entered my experimental physics PhD way out of my depth. I, like many others, was taken aback by just how much rigour goes into the experiments. “Did you check this?” my supervisor would say “Or that?” he would continue, as I stood there with a feeling of dread knowing that my answer was going to be an inevitable, “No”. “Well, we will have to redo the experiment then” he would say, knowing full well that by “we” he meant “me”.

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Spring 2022 blog previews

Spring is coming, flowers are blooming and the days are getting longer. What better way to celebrate than a critical analysis of the mental health system! My original draft of the Physics World article (I will shut up about it eventually, I swear!) joins a list of weird and wonderful blog posts I have planned for the next few months. Here are their previews.


Why has no one taken any measurements of my brain?

The original draft of the Physics World article that I sent to the editor. In it, I compare my experience as a PhD physicist and my treatment from psychiatrists. I shine a light on the unscientific nature of the psychiatric system and how it affected me personally. I posit a way in which it could be made more scientific.

Physics World article context #3 – the problem with rating scales

I am quite critical of rating scales in the article. To back up these criticisms I tell the story of when I had to fill them in, and why they are completely inadequate as a measurement tool

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