The Mental Health Foundation (MHF) has called for a balanced debate on the merits of diagnosing mental disorders in the wake of the publication of the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
The DSM aims to provide a common language for describing psychopathology. While it is US-based it is influential around the world.
Controversy with critics
The latest edition – the first update since 1994 – has caused controversy, with critics saying that it turns normal behaviour such a childhood temper tantrums and grief into mental illness.
Other new categories in DSM-5 include: binge eating disorder; disruptive mood dysregulation disorder, which was previously known as childhood bipolar disorder; and hoarding disorder.
The MHF is concerned that the new publication should not encourage psychiatrists to medicalise normal behaviour, such as anger and sorrow, which at times everyone will feel.
Crucial first step
However, Dr Andrew McCulloch, chief executive of the MHF, added that an expert assessment and diagnosis can be a crucial first step to help people experiencing mental ill health, allowing them to receive evidence-based care and support.
“The diagnosis of mental disorders is an inexact science, but it is nevertheless valuable. Many people experiencing mental health problems find a diagnosis helpful, and it gives them access to the help they need to recover, or to manage the condition. Others challenge their diagnosis, and feel it is stigmatising and meaningless.
“The crucial thing is that anyone whose life is adversely affected by mental ill-health gets the support they need. The causes of mental ill-health are a complex mix of biological, environmental and social factors which will vary from individual to individual. We therefore need a range of interventions tailored to individual needs. Medication can help in the right circumstances, but the evidence increasingly points to other interventions as being equally effective, such as talking therapies, exercise or workplace wellbeing schemes. But we need to ensure that individuals get treatment which is effective and efficacious no matter what the cause.”