Wow, that was quite a fascinating discussion over at Facebook groups on Neuroscience, Neuroplasticity, Psychiatry & Clinical Psychology, Neuroscience and beyond, in response to our post The way we approach Mental Health today is broken beyond repair. The question is, what comes next, and how fast can we get there?
Here are (lightly edited, randomly ordered, anonymized) some of the most interesting and representative comments among the 100+ shared and discussed:
- Something better hopefully.
- Hopefully it won’t be a book but an easy to navigate web application.
- DSM is a tool, and a very useful one. As any other tool it depends on the use you make of it.
- Well considering we approach mental health from a disease model.…that’s the first problem.
- I find labels do more harm than good because they lead to assumptions that may be very wrong. Better to mark people position on common spectrum (anxiety, imaginary fears, physical symptoms) by seeing the whole patient rather than the label.
- Get a copy of DSM-II, that’s an eye opener. How that turned in to DSM-III is interesting. Real super interesting to read the introduction to DSM-III. All of a sudden the classifications make sense. None of it’s been validated, and it’s all made up. Bunch Of Guys Sitting Around Table (BOGSAT) is not science.
- The hitherto concept of psychopathology itself is largely out of context and there is no uniformity or common consensus among psychiatrists themselves on diagnosis based on DSM criteria. DSM is purely for insurance and billing purpose only.
- None of the issues mentioned in the comments are new and in fact were addressed in detail by the authors of the DSM 5. Everyone is aware of the problems and in the development the authors frequently published articles about these issues, the decisions made and the rational for making them. They did introduce the notion of a dimensional approach which is likely to be developed.
- NIMH’s RDoC project is establishing the structure of what the new diagnosis and treatment manual will look like.
- DSM is only glorified inside USA. In the rest of the world we only read it, and use other parameters and categories.
- ICD 11. That’s the way forward.
- A serious concern is the impact of insurance and how they pigeonhole the mental health world in a model unfit for improving the client’s health.
What’s your take?