The topic of people’s mental health has always been considered somewhat taboo. It is not something people typically like talking about openly unless it is in the derogatory sense of calling someone who is unhinged mentally unstable.
However the topic has recently come under heated debate in the public eye as the Diagnostic Statistical Manual of Mental Disorders (DSM) is coming under revision next year in regards to personality disorders.
For those that are not familiar with the DSM it was founded by the American Psychiatric Association and sets the criteria for the classification of mental disorders. It is used across the world (including in the United Kingdom) by almost everyone that works in the mental health sector – from psychiatrists to those in health insurance.
This reformation will affect the criteria used in diagnoses and therefore also the severity of personality dysfunction.
The revisions will create big changes for not only those who work in the psychiatric sector but for the public, who could in fact in turn now be diagnosed with a disorder they previously did not match the criteria for. The question at hand though is if this is a bad thing.
The main reasoning behind the revision is to prevent patients from being diagnosed with more than one condition due to some of the diagnostic categories overlapping.
There are currently 10 personality disorder categories in the DSM-IV model. This will be reduced to six – antisocial, avoidant, borderline, narcissistic, obsessive-compulsive and schizotypal. The categories that are being removed are dependent, histrionic, paranoid and schizoid personality disorders.
At first glance that might seem like a sensible idea but there has been a panic amongst the psychiatric community – as although the categories have been limited the revision could lead to more people being classed as mentally ill and therefore being prescribed drugs that they may not necessarily need.
The revision will result in a wider range of behaviors coming under scrutiny by psychiatrists such as grieving relatives and people with fetishes.
There is already an alarming degree of people using psychiatric drugs – 1 in 4 Americans last year were taking a psychiatric drug and 1 in 3 women will use psychiatric drugs at some point in their lifetime.
If a factor such as grief is brought into the criteria for depression this will no doubt result in people being prescribed anti-depressant drugs to cure an issue that to an extent drugs cannot sort and is just a natural process that a person needs to deal with.
However on the other hand the revision could help people who have gone undiagnosed but struggle with day to day life but the negatives appear to outweigh the positives in this argument.
Another strong argument against the changes is that sex offenders could possibly get out of long-term prison sentences on the basis that their illness will provide an excuse for their behavior.
It is hard to judge who exactly is going to benefit from the revision as there is no obvious scientific value in the changes and already more than 11,000 health professionals have already signed a petition (at dsm5-reform.com) calling for the development of the fifth edition of the manual to be reconsidered.
This could lead people to wonder if money and pharmaceutical companies are the reasoning behind these changes rather than concern for people’s mental health.
It will be interesting to see if the petition continues to gain support and if the outlined changes will go ahead against large scale opposition from both professionals and the public.