Greening of Mental Health?
Source: Eugene Weekly, Oregon, USA
Psychiatrists are wrestling with changes in definitions and diagnoses that will be included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The final edition will have consequences for insurance reimbursement, research and individuals’ psychological identity for years to come, according to a Dec. 18 story by Benedict Carey in The New York Times. But will the content reflect any input from millions of mental health patients?
“We definitely tried to have input and dialogue, and there was none allowed. Period,” says David Oaks, executive director of MindFreedom International, based in Eugene.
MindFreedom was founded [in 1986] to advocate against forced medication, physical restraints and involuntary electroconvulsive therapy, says Oaks. Members worldwide identify themselves as survivors of human rights violations in a mental health system heavily influenced by outdated practices and pharmaceutical interests.
[Oaks] says Dr. Darrel A. Regier, a key figure in the new DSM, is also head of the special “research” wing of the American Psychiatric Association. APIRE, an independent component of the APA, [led the planning] the DSM and “tends to get millions upon millions of drug company dollars.”
“Even though Dr. Regier got federal money to hold international seminars on the ‘future of psychiatric diagnosis,’ he has absolutely refused to even respond to civil inquiries from anyone outside his closed-door process,” says Oaks.
Oaks says a prominent official with the World Health Organization’s mental health section, “has twice personally asked Dr. Regier to respond to requests from MindFreedom about having mental health consumer input in the re-writing of the DSM,” and was told “no.” “So these few hundred unelected mainly rich, mainly white males are cooking up behavioral guidelines for us all, with zero input from the public who is impacted by these rules.”
MindFreedom is working to break the undemocratic domination of mental health care by the medical establishment, says Oaks. “Our issue is kind of like where energy policy was in the 1950s, totally dominated by the system. Now we’re pushing for ‘greening of mental health,’ to allow for more holistic, empowering, non-chemical approaches, and especially direct involvement by citizens in helping to plan mental and emotional well-being programs.”
The revised DSM, due out in about three years, is expected to reflect some public pressures. Early editions of the book defined homosexuality as a mental disorder. Protests by gay activists provoked a scientific review, and the diagnosis was dropped in 1973, replaced by “sexual orientation disturbance,” and then “ego-dystonic homosexuality.” Homosexuality as a disorder was dropped from the book in 1987. Some GLBTQ activists are now lobbying for similar changes regarding gender identity issues, but others are wanting to keep transgender identity as a formal diagnosis so that treatment or surgery can be covered by insurance.
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