Mental Health Services: The Impact of DSM-5

June 10, 2013

Will mental health services see any changes as a result of the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5)? The answer is not immediately clear, although the latest edition has certainly created a buzz in the mental health field. The last edition of the DSM was published in 1994, making the recent changes the first in nearly 20 years. The new manual was published on May 18th, 2013, and has re-named or re-categorized many mental health conditions. So what kind of impact do these changes have?

Mental Health Services and the DSM-5

Changes to terminology

According to the manual, there is no more Asperger’s or Autistic Disorder. These conditions now belong under the umbrella term of ‘Autism Spectrum Disorder,’ and individuals will be diagnosed according to the severity of their symptoms. The result of this change is that children may be re-evaluated and receive a different diagnosis. This could be confusing for both the children and their parents, who may identify with their existing diagnosis.

Concerns about over-medication

Some people are concerned that ‘normal’ behaviors like shyness in children or depression after a loved one’s death may now be classed as medical problems treatable with drugs. The result could be an increase in possibly unnecessary prescription medications. This may be a case of over-reaction, as the manual has specific criteria for identifying depression or anxiety disorders, and these differ dramatically from the normal range of emotional ups and downs. Mental health services will likely continue to be very careful about prescribing medications, and strive to do so on a case-by-case basis rather than according to a diagnosis.

Need for overhaul

The National Institute of Mental Health (NIMH) has called for the APA to put a stop to symptom-based diagnosis, which has formed the basis of the DSM since its onset. As technology changes, so do research methods and our understanding of how mental health works. NIMH supports drawing information from emerging research data that comes from a broader range of fields. Then medical professionals can use all of the data to make a decision regarding treatment. The way mental health care stands now, making a mental health diagnosis is often subjective, in some ways rendering the concept of the DSM-5 outdated.

Guide vs. ‘Bible’

We should keep in mind that the DSM-5 is simply a reference guide based on years of research and medical knowledge. It may have its shortcomings and strong points, but it is not the only resource that informs mental health services. Treatment plans are typically designed based on a number of personal factors after a careful individual assessment, not simply by flipping to a page in a medical manual.

If you or someone you love is suffering from a mental illness and is facing financial obstacles to services, please call us at 1-800-338-5770.  At Guardian Behavioral Health Foundation we provide access to low-cost or no-cost mental health services through a variety of community mental health centers and professionals.  We also offer educational workshops for families and professionals.