In a 12 May opinion piece published in the New York Times Allen Frances, the chair of the American Psychiatric Association committee that developed the current version of the ‘Bible of Psychiatry’- DSM4, wrote:
“The [American Psychiatric] Association has been largely deaf to the widespread criticism of D.S.M.-5, stubbornly refusing to subject the proposals to independent scientific review…A new structure will be needed, probably best placed under the auspices of the Department of Health and Human Services, the Institute of Medicine or the World Health Organization…All mental-health disciplines need representation — not just psychiatrists but also psychologists, counselors, social workers and nurses.
The broader consequences of changes should be vetted by epidemiologists, health economists and public-policy and forensic experts. Primary care doctors prescribe the majority of psychotropic medication, often carelessly, and need to contribute to the diagnostic system if they are to use it correctly.
Consumers should play an important role in the review process, and field testing should occur in real life settings, not just academic centers.”
Sharing the development of DSM5 as Allen Frances suggests could improve the process and moderate some of the excesses proposed for DSM5. All of that is good for American mental health consumers, however there is a more fundamental question that needs to asked in Australia.
Why do we continue to follow America’s lead? Are mental health outcomes in the U.S. good enough to justify our continued devotion to the DSM model? Or is it time to go it alone?
Martin Whitely MLA