Wednesday, September 16, 2009

Toward mental illness for all?

We were surprised to read of the open letter by Drs Frances and Spitzer regarding the creation of DSM-V. Over time we have been puzzled by a succession of Diagnostic and Statistical Manuals, and have been forced to conclude the long-term purpose of the DSM is to abolish mental illness from American society. Currently only half of all Americans fit the criteria in DSM-IV to be diagnosed with one kind of mental illness or another. 1 Surely the goal of DSM-V must be to increase the percentage of Americans eligible to be mentally ill. With the inclusion of sub-syndromal categories in DSM-V, the total percentage of mentally ill Americans should reach 75-80%. With a long-term commitment by the American Psychiatric Association to DSM-VI --or, if necessary, DSM-VII - - 100% of the American population can eventually be declared mentally ill. On that glorious day all mental health practitioners can take satisfaction in their decades long quest to abolish mental illness, because, as we all know, when everyone has something then no one has it.

1.“Mental Illness in U.S. Presidents Between 1776 and 1974,” J. R. T. Davidson, K. M. Connor, and M. Swartz, The Journal of Nervous and Mental Disease.

1 comment:

  1. The notion that according to the DSM almost everyone can qualify for one diagnosis or another probably reflects the mistaken impression that the criteria are sufficient, when in fact they are necessary. I have yet to find a statement in DSM to the effect that everyone who meets the criteria suffers from that illness. In fact a clinician must first make a judgment that the individual is ill. Then the DSM helps us classify that illness.

    Whether all this is good or bad depends on how we use it. It would be sad to exclude from access to treatment those who don't fit the criteria.