Debate the Future of Mental Health in North America: In ten years, will we see DSM‑6 or Something Much Better (SMB‑1)?

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?

 

About SharpBrains

SHARPBRAINS is an independent think-tank and consulting firm providing services at the frontier of applied neuroscience, health, leadership and innovation.
SHARPBRAINS es un think-tank y consultoría independiente proporcionando servicios para la neurociencia aplicada, salud, liderazgo e innovación.

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