Critiques of the DSM-5
Since I have done a few posts now discussing DSM-5 disorders, I wanted to also make a post about some of the criticisms that exist for the current diagnostic system.
Many of the disorders have been identified based on Western standards of “normal” behavior. Some disorders have been shown to manifest differently in different cultures, but this makes it difficult for people of these cultures to reach a diagnosis. This is especially important in countries like the USA, where a diagnosis is required in order for insurance to reimburse mental health services. If you want to learn more about this, I recommend the book Crazy Like Us: The Globalization of the American Psyche by Ethan Watters.
The DSM is written by the American Psychiatric Association, which leads to some other concerns. First, the DSM is written exclusively by psychiatrists, and does not include the input of psychologists, counselors, social workers, or any other mental health professionals. In addition, about 67% of the people involved in the Task Force for the DSM-5 have ties to the pharmaceutical industry. This has led to concerns over the intent of the DSM-5. Is is meant to help us, or is it meant to help the writers profit?
Finally, the DSM has historically contained many disorders that are controversial. While some of these have been removed (such as homosexuality) or changed (such as gender identity disorder, now called gender dysphoria), there are still many problematic disorders included. I mentioned paranoid personality disorder, which is disproportionately assigned to Black men due to distrust of the US Justice System despite this not being due to irrational paranoia but rather years of systemic oppression and unjust incarceration, torture, and death.
Of course, the DSM-5 and the diagnostic system does have its benefits as well. Proper diagnosis leads to better mental health treatment and can guide professionals as they determine a treatment plan. It can also help us better understand ourselves and help eliminate feelings of guilt regarding ways that we think or behave.
Overall, the DSM-5 has always made me think of a weapon in an action movie - in the hands of right people, it can be an excellent tool that is used to help many, but in the hands of the wrong people, it can cause devastating harm.
