DSM-5 Boycott Launched!

Jack Carney, DSW

February 5, 2013

Boycott the DSM-5!

Believe it or not, there’s some confusion about what “boycott” means. Bluntly, it means “Don’t purchase or use the object being boycotted.” Remember the United Farm Workers and table grapes and iceberg lettuce? I remember walking a picket line daily for weeks in front of my neighborhood supermarket carrying a sign urging customers entering the store not to buy grapes and lettuce. It must have worked – this was back in the 1970’s – because the grape and lettuce growers in California’s Salinas Valley were obliged to sign contracts with the UFW and its members.

The Committee to Boycott the DSM-5 is comprised of regular, not-so-famous mental health professionals, users of psychiatric services and their family members and those who’ve managed to survive many years as patients in the mental health system. In short, folks like many others, who’ve grown to mistrust and/or been adversely affected by the psychiatric establishment and its series of “bibles” or DSMs, and who anticipate even worse experiences with the new DSM-5. Our objectives are to trigger the memories and sensibilities of those – professionals, patients, family members and survivors – who’ve had similar unhappy experiences; convince the professionals neither to buy nor use the new DSM; encourage current patients to urge their psychotherapists and psychiatrists to neither buy nor use the DSM-5; and ask the survivors to do what they do best, viz., reach out to those they know still caught up in the system and support their efforts to press those who treat them to neither buy nor use the DSM-5.

I think you get the message.

The Boycott statement below contains a series of brief rationales for our opposition to the DSM-5: that it’s unscientific, unsound and ultimately unsafe; that it continues the DSM tradition of pathologizing ordinary behaviors – the new DSM will contain over 300 diagnostic categories, up from DSM-IV TR’s 250; that it narrows “treatment of choice” to the prescription of psychoactive medications despite their known toxicity and suspect effectiveness; that the APA has undermined its own credibility by disregarding the many criticisms of the DSM’s nosology.

If you’re so inclined, additional and more detailed critiques can be obtained on this very website in the several articles about DSM-5 written by me and others over the last 12 and more months. My last post was on December 10, 2012 and entitled “Boycott The DSM-5: Anachronistic Before Its Time.”

If we succeed in getting a sizable number of the millions of prospective DSM buyers to sign on to our Boycott statement, a copy of which you’ll find at the end of this post, we’ll put a sizable dent in the sales needed by the American Psychiatric Association to recoup its investment in the development of the new DSM.

Allen Frances, the most well-known critic of the DSM-5, has estimated that the new DSM cost the APA $25 million to bring to press, which explains the hefty price for each volume — $199 per – the APA is charging. Which translates to a break-even figure of 12.5 million buyers world-wide. The APA is already soliciting pre-orders of on its website, nearly four months before the new DSM’s scheduled mid-May publication.

One final point. We realize that all professionals employed in the public mental health system, indeed any professional or agency seeking third party reimbursement for services rendered, must use diagnostic codes. Accordingly, we are recommending that, if you must use diagnostic codes, use those contained in the ICD-9. Please be advised that you do not need to rely on the DSM’s codes – they are entirely superfluous to billing procedures, which, by U.S. law and international treaty, must employ ICD codes. Our recommendation should not be construed as an endorsement of the ICD – we consider all diagnoses reductive and demeaning to the persons so diagnosed. Rather, our recommendation to use the ICD codes is meant as a bureaucratic expedient for those obliged to use them. In short, anything but the DSM-5.

The Boycott statement itself can be found and signed by those who agree with its contents and intent at Boycott the DSM-5 (http://www.ipetitions.com/petition/boycott5/) on petitions.com. I realize that our Boycott statement is far from perfect – frankly, it’s impossible to address or anticipate all the concerns of prospective supporters in a brief document. But, as I like to say, any rock that’s handy, I’ll toss it at the behemoth.

And that’s also why we have a companion information website — Boycott DSM-5— (http://boycott5committee.com) where additional information will be posted by the Committee and where those who wish to can post comments. Should any reader wish to join the Committee and do some work on its behalf or should you belong to an organization that might be interested in co-sponsoring the Boycott, please contact me via MIA e-mail, via our support website or directly to me at [email protected]

I trust that most readers will find themselves able to support the Boycott and sign the Boycott statement. Feel free to cut and paste it, send it on to friends and colleagues, post it on your Facebook pages or websites. Thanks.

Remember, “Don’t mourn, organize! We are all prisoners of hope.”

For the Committee, Jack Carney

References:

Carney, J., “Boycott The DSM-5: Anachronistic Before Its Time,” December 10, 2012, www.madinamerica.com/jcarney/author/

Frances, A., Price Gouging: Why Will DSM-5 Cost $199 a Copy? http://www.psychologytoday.com/blog/dsm5-in-distress/

* * * * * *

Boycott the DSM-5!

We, the undersigned, will not purchase nor will we use the new DSM-5 when it is published by the American Psychiatric Association. Further, those of us associated with professionals who use the DSM – as persons receiving services from them or as family members, friends or advocates – will urge service providers not to use the DSM-5:

• DSM-5 is unsafe and scientifically unsound.

Its categories or diagnoses, including newly introduced diagnoses, are not supported by scientific evidence. These diagnoses will pathologize rather than bring relief to persons in distress.

• DSM-5 will drastically expand psychiatric diagnosis, mislabel millions of people as mentally ill, and cause unnecessary treatment with medication.

All references to psychosocial, environmental and spiritual factors have been removed from DSM-5. This sends a clear message to clinicians that treatment for persons judged to have psychiatric disorders can be reduced to the prescription of psychoactive medications, despite growing concerns of their dangers and skepticism about their effectiveness.

• The APA has been unresponsive to widespread opposition.

The APA has been unresponsive to criticism received from professional, advocacy and lay public stakeholders during the three public reviews of its proposals. The concerns expressed by over 14,000 signatories to the “Open Letter to the DSM-5” and the request for independent, scientific review of proposed changes to the DSM have been ignored.

• The APA has undermined it own credibility, choosing to protect its intellectual property and publishing profits, not the public trust.

Accordingly, we agree to boycott the DSM-5 and to urge service providers and others not to use it. If we find ourselves obliged to employ diagnostic codes, we agree to disregard the new DSM and utilize the codes listed in the ICD-9 and the next edition of ICD, when the latter is implemented in October, 2014.

SPONSORED BY THE COMMITTEE TO BOYCOTT THE DSM-5

http://www.ipetitions.com/petition/boycott5

http://boycott5petition.com

Jack Carney, DSW

Up the River:  A social worker, Jack Carney writes on the contradictions and hypocrisies of the public mental health system and promotes and applauds acts of resistance to it. In the words of the immortal Joe Hill, just before he was executed by a Utah firing squad, he likes to advise:  “Don’t mourn, organize!”

DSM-5 Boycott Launched! Comments RSS

30 thoughts on “DSM-5 Boycott Launched!

    • I agree Nick. I think it important for those of us here and in this “movement’ unify and repeatedly state clearly that we are not affiliated with nor do we endorse scientology or cchr. To not do so is, in my opinion, is to by omission of such statement imply that we endorse or validate the suggestion that we are somehow connected to them.

  1. I am sure Jack Carney’s intentions are good, but sadly, to urge a boycott of the DSM while urging people instead to use the ICD if they are going to use psychiatric labels reflects an overlooking of the fact that the authors of the DSM and the ICD have said repeatedly and publicly that they work hard to make sure that the contents of the DSM are as close to the contents of the mental disorders portion of the ICD as possible. It is actually dangerous to give people the impression — as Jack’s petition and this article do — that the appalling risks of serious harm caused by the use of DSM diagnoses (which have also characterized the unscientific editions of the DSM produced by both Robert Spitzer and Allen Frances) will be avoided by use of the ICD.
    As for the price of DSM-5, why is charging $199 in 2013 suddenly shocking, when there was no such outcry for Allen Frances’ current edition, DSM-IV-TR, which a call to Barnes and Noble just revealed a price of $142 plus tax? After all, DSM-IV went on the market nearly two decades ago, and the “TR” version has only a tiny number of changes and went on the market in 2000.
    Those who know my work know that I have been a critic of the DSM since serving on two of Allen Frances’ committees to plan DSM-IV from 1988 till I resigned in 1990 because I was so horrified to see how they used junk science, ignored good science, and falsely and publicly claimed that their work was scrupulously scientific (as Frances continues to do, allegedly in contrast to the DSM-5 people, who are also appallingly unscientific) and not harmful. So I, too, wish people would boycott the DSM but also that they would not assume anything about the ICD psychiatric section is either scientifically grounded, helpful in reducing human suffering, or less risky for patients than the DSM.
    I created the first anti-DSM petition in the late 1980s, which drew signatures from individuals and huge organizations (including NOW, the Canadian Psychological Association, and others) representing more than six million people, and I created a year ago last December the first “Boycott the DSM” petition at change.org http://www.change.org/petitions/boycott-the-dsm because I was so alarmed by how many people would continue to suffer from the DSM-IV-TR (as indeed they do right this minute) while Spitzer and Frances and others have focused all of their attention on trashing the DSM-5 editors for doing the same kinds of ignoring of science and harm and making of false claims of which Spitzer and Frances themselves were guilty). Hence, I did not limit my petition to boycotting the next edition of the DSM only. I wish that Jack had accepted my offer to work together on his new project, and it is unfortunate when the few people who want to take action in this movement cannot see their way clear to working together, but I hope his petition will be wildly successful. Not having volunteers or funding to pay people to help get the word out about my “Boycott the DSM” petition, I hope that he will get many more boycott pledges than I have done. But I hope that he will revise his petition to remove the misleading urging to use the ICD instead, because that is just urging people to flip their patients out of the frying pan and into the fire. Remember: unscientific and harmful labels were plentiful when Spitzer created DSM-III and then DSM-III-R, and then Frances freely acknowledges that he got rid of almost none of that when he created DSM-IV and DSM-IV-TR, and it is a good bet that most of that garbage will also appear in the DSM-5…and thus in the next ICD.

    • Thank you, Paula, for your generosity. We’ll get together one of these days and continue what you began many years ago. Thank you.

      We don’t claim anywhere in the text of any of the documents we posted that the ICD is the superior document — equally reductive and degrading. We added the recommendation that practitioners resort to the ICD as a bureaucratic alternative to the DSM. You’d be surprised how few folks in the mental health system know that the DSM is superfluous to the billing system — and, in practice, totally superfluous. We’re stuck with ICD by law and international treaty; so, until the system dramatically changes, better the ICD than the DSM! I know that’s not a terribly satisfactory response, but it’s the most apt for this moment in time.

      • I do not agree that recommending the use of an equally unsound construct is the only solution, or even an acceptable one. In Colorado, the entity that manages the Medicaid behavioral healthcare contracts is considering using a service-based billing system rather than a diagnostic-based system as we always have, and for many other reasons besides OUR reasons of the damaging & unscientific natures of both the DSM & ICD. Not the least of which is that a service-based system falls into perfect step with many ACA mandates, but they have many other valid (primarily fiscally based) reasons as well. Calling for a boycott of the DSM (already done a year ago, by the way), and supporting the use of the ICD is like our advocates here patting themselves on the back for insisting on “people-first language” in the new unconstitutional profiling laws. This is no time for compromise. We must state our message very clearly and with conscious intent; the consequence of lukewarm, politically correct messaging is too serious.

        • Amy,
          Tell me more. I couldn’t find anything online about the service-based billing system you mention. Some of us in Ohio have been wanting something like this. Typically, Managed Care entities have insisted on Diagnoses as a way to gauge the level of benefit they will pay for. If a diagnosis isn’t used, what would be their basis in authorizing services? What type, for how long, etc. I’m very interested in this so I hope you respond.
          Thanks,
          David

          • David, actually there are a number of mechanisms now to avoid diagnostic coding, such as blended or braided funding structures, waivers for non-medical use of federal dollars, and domain-based services. I called Colorado’s Health Care, Financing & Policy (HCPF, our Medicaid payers), yesterday to drill into the details of the “service-based state plan” details and they told me it is a secret, LOL! (They are currently writing the RFP for the next behavioral health managed care contracts) I have calls into quite a few other subject matter experts who I am sure will be more forthcoming & will post here when I know more. Jack wrote me in an email, “First, Amy, we’re stuck with coding for the foreseeable future — Obamacare requires it for all 3rd part reimbursement –Medicare , Medicaid & private insurance. Indicative of what we’re up against. We don’t
            endorse ICD — as I wrote, anything but the DSM. For now. As I wrote to someone else, first steps first,
            tomorrow the revolution. Our next step, assuming we get 10-20 K signatures, will be to launch a no-diagnosis pledge campaign. First things first. The struggle will be a long one. FYI, to date, much of our support is coming from peer/survivors, who are happy that someone is taking a kick at the monster. Please re-read what I wrote. ” I do not think that is correct; I study the ACA and it appears to me it is MUCH more flexible in terms of service delivery options and I know the feds are EXPECTING states to formulate their own rules & regs, including coding protocols. Its a real conundrum to figure out the integration into a behavioral health system (instead of “mental health” and “substance use”. Many SUD providers do not now use diagnoses to provide services and I suspect that is one issue Colorado is attempting to address, as we are one of 15 states that has integrated early. We also have severe access issues, when, for example, a kiddo is dx’d with “mental illness” & “developmental disabilities”, both systems often refuse to treat- some children have almost died at home because of this problem & it was a hot issue this last year after a great, comprehensive report called “The Harvey Report” was published & presented at a number of state policy councils. One thing that really lights a fire under folks here: Colorado just hates to be embarrassed.

  2. I should have added that the DSM editions both current and future are unscientific and harmful, but at least the DSM’s publisher, the American Psychiatric Association publicly announces that it has an Ethics Committee and that complaints can be filed. The fact that they summarily dismissed all nine complaints about harm from DSM labels that we filed last summer is truly terrible, but listen to this about the ICD: When we wrote to ask the ICD people what procedures they have for filing an ethics complaint, they wrote back but would not even give us an answer. The only reason I can think of for considering the ICD less horrible than the DSM is that the APA is a lobby group and, as far as we can determine, has never used a dime of its vast profits from the DSM to prevent or redress the harm its manual causes, whereas the ICD is published by the World Health Organization, so MAYBE — though we have not been able to find this out either — MAYBE the WHO uses the profits from the ICD for some better cause than supporting a lobby group. If anyone can find out, please let me know. Thank you.

  3. This is a guild war, not a movement. If you really cared about labeling people inappropriately, you’d recognize that the ICD-9 is just as unscientific as the DSM-5. I’m all for hassling the psychiatric profession over their latest tome, but come on, let’s get real–it is total hypocrisy to assert there’s any labeling or diagnostic system ‘more appropriate’ or ‘scientific’ for categorizing people seeking counsel from a professional philosopher for problems in living, feeling, or thinking. The pace of the label-makers only increases for people sensitive enough to react to the vapid consumerism and materialism in which we’re immersed, or afflicted by participation in corporate-sponsored wars, or homeless, unemployed or overworked, or raped or beaten as kids, or coerced and force-fed stultifying public school curricula, or otherwise reeling from cultural decline and moral decay. What we don’t want to label is a society which conceptualizes it as mentally healthy to sustain the myth that those who feel something or behave deviantly in response to these kinds of factors are sick. It must be in the genes or in the brain, right? Not in what we tolerate or in how we treat our fellow humans. So let’s use the ICD-9 and keep the insurance companies happy and the checks in the mail, folks. Let’s continue to feed that psychopharmaceutical complex too. May I have some more soma please?

  4. I do not understand why a challenge to bureaucracy is organized around drawing new support for the other evil monster, the ICD. Why cant the challenge to bureaucracy support the BOYCOTT of the DSM entirely, to urge practitioners to refuse purchasing this book of fraud, and to refuse using its diagnostic coding at all? Change has to happen in drastic terms, I am afraid, but not in a way that invites the APA and insurance companies to easily adapt to a new billing procedure based on the ICD. I am afraid this is just rearranging the chairs on the deck of the Titanic. Why replace one stinking rotten bad apple with another stinking rotten bad apple?

    I applaud the effort, and the intent. But I wish this effort were as revolutionary as the work of Paula Caplan. I have read about what she is doing, and remain totally amazed at her bravery and courage. She is actually “taking it to them” (the APA), showing up at their offices, (the APA), relentlessly challenging them about their lack of scientific evidence and invalid procedures, and constantly finding ways to publicly out the devastating harm that they have committed for decades (and have gotten away with).

    Admittedly, I do not know a lot about the bureaucracy involved in billing procedures; but as I keep coming back to this proposed bureaucratic challenge of swapping DSM codes for ICD codes, I keep wondering, “why dance with the devil?”

  5. From Norman Decker, MD
    I am a psychiatrist and fundamentally agree with most of the criticisms of DSM and ICD above. (I do, however, believe that some kind of diagnostic categorization is still warranted, albeit not the one we have now.) In particular, I abhor the involvement of the insurance industry in mental health care. They constitute an unwanted middleman in this area and the bureaucratic costs secondary to this involvement and their company profits are major components in overly high and escalating health care costs. Accordingly, I am a supporter of eliminating them in favor of a single payer national health plan.

    However, I (and other mental health professionals) still have to make a living. We still have to charge for our services. Only the wealthy can afford to pay out of pocket. Most others still, unfortunately, depend on insurance payments. Accordingly, I still have to depend on insurance payments to make a living – and to give care to most of my patients in spite of my wish to eliminate the medical insurance industry. Therefore, I have to bill the insurance companies and use some kind of code to generate reimbursement. To me, using ICD9 coding and boycotting DSM5 is a way of making an important statement. I don’t see it as my supporting the ICD coding. I see no other way of managing this quandary at this point.

    • Please see my response above. While a different billing system based on expressed or perceived needs is a big shift, it can be done at the local level, making it much more doable. This sort of philosophy is strongly preferred in the ACA; actually the quandary of integration of MH & SUD is perplexing to many payers & a follow-the-person, service-based billing system solves those issues nicely. This reform is the biggest ever in USA history and the feds are counting on states to work out the details- it is a STUNNING opportunity to effect significant change, but PC thinking, compromising & dejectedly voting for the lesser of two evils is NOT the way to accomplish that.

      • Thanks for your response above Amy. I appreciate your efforts. I should have been more specific in my first response but it looks like Jack picked up on what I left out. Medicaid, Medicare and Private Insurance. Those are the plans I’d like to see abandon the DSM, ICD, DC-03R, etc. Local levy or foundation funding gives us great flexibility but if those big three above ever changed their stance on coding it would be a significant.
        Thanks again,
        David

        • I AM talking about the public system,David, which is primarily Medicaid & Medicare, if you can find a provider. Waivers are a Medicaid function. I don’t know much about private insurance, although I know some CMHCs use it. I CERTAINLY am not talking about municipal or foundation funding; you are correct that that is a completely different thing. I also will say again I don’t think Jack is correct when he states the ACA does not allow third party funding without a diagnostic code & the examples I mentioned address why- those are all in place NOW & the ACA allows for much more state-based protocol creation and innovative models to address some of the new mandates, such as integration of MH & SUD for example. I asked Jack to point me to where in the ACA it states that but haven’t heard back from him yet.

          • This is great news! I’m glad I mis-understood earlier. I will pursue what is necessary for our State to secure Medicaid/Medicare waviers of this type. I know this already happend in the DD system, but a diagnosis is necessary to be eligibile. That’s where I’m curious, if they don’t use Diagnosis to determine who is eligible for the waiver they must be using…what? Hospitalizations? So-called “functioning” Incarcerations? I’ll let you know what I find out. Thanks again for your time.

  6. Yesterday, I was told by my psychologist that Medicare would no longer allow coding for an extended session of pychotherapy of 75-80 minutes. That prompted me to do a lot of reading last night about CPT codes and the changes which were passed into law last November and took effect Jan.1, 3013. Since I’m not a provider I didn’t really have much knowledge of how codes are used in billing. Well, I learn a lot about it last night.

    But, I do believe that in my reading, it was stated that starting in the fall of 2013 Medicare would be requiring providers to use ICD codes instead of DSM codes for diagnostic purposes. What I read said that most insurance companies would probably follow suit. I don’t really know the politics of all of that within the industry but it seems as though the use of the ICD will soon be standard practice by m h professionals.

    This hasn’t been an area of expertise for me so if anyone has different information, correct me if I’m wrong.

    • Thank you for raising this. I have seen a letter to the effect that Medicare and Medicaid are switching from the DSM to the ICD. I would love to know why, and if anyone knows the back story, I hope they will post it here or write to me directly. I am wondering whether the military and VA mental health systems are also considering making the switch. And I have not yet heard what private insurance companies will do. I would also be interested in learning about that if anyone has any information. But let us not let our guard down and assume that these changes will result in less damage. In fact, for those of us in the U.S., at least we were able to find out how to file ethics complaints with the APA about harm from the DSM in order at least to _make the effort_ to hold them accountable. But so far, we have not even been able to get clear information about _whether_ there is a way to file a complaint with the World Health Organization if one has been harmed by psych diagnosis that came from the ICD. And is the filing of complaints the only thing that needs to be done? Of course not. But it seems important to file such complaints in order to see whether the purveyors of these diagnostic classification manuals can ever be held accountable when their work leads to harm.

  7. Personally, I appreciate Wise Monkey’s comment – ban all DSM’s. Although with the new one coming out it makes sense to focus on it.

    I also stand in solidarity with the points made by other commenters on the harm of diagnosis in general. I also see that the discussion of standing against the DSM affects those who are required to use some sort of “labeling” for the requirements to bill insurances and I believe that with concerted efforts that this issue can be overcome. Although – after decades of construct this model will take some time to reshape.

    In the meantime there are many providers of mh services that work on cash only or sliding fee scales. And while that is more difficult perhaps for many – it is one way to make the shift from needing to use labels at all.

    I also think Amy Smith’s comment of an alternative option is a valid direction. I also appreciate and support fully the position presented by Paula Caplan and her work over the years to bring awareness to boycotting the upcoming DSM and the harm of diagnosis in particular this past year as she has done in providing a vehicle for those harmed by diagnosis to speak, even though the APA has refused to hear.

    Also – I’d like to point out that the comments on how damaging the ICD is as an alternative is just as unpleasant as that of using the DSM this essay does address that in this statement:

    Accordingly, we are recommending that, if you must use diagnostic codes, use those contained in the ICD-9. Please be advised that you do not need to rely on the DSM’s codes – they are entirely superfluous to billing procedures, which, by U.S. law and international treaty, must employ ICD codes. Our recommendation should not be construed as an endorsement of the ICD – we consider all diagnoses reductive and demeaning to the persons so diagnosed. Rather, our recommendation to use the ICD codes is meant as a bureaucratic expedient for those obliged to use them. In short, anything but the DSM-5.

    I totally agree that the use of either the DSM or ICD is harmful and should be stopped and would like very much to see some alternative options suggested for providers of mental health services to use.

    So yes; lets stand together against the latest DSM and encourage all providers to NOT purchase it or feed the monster AND lets work on some viable alternatives for getting people paid WHILE also pointing out that the ICD is just as harmful.

    If one HAS to bill insurance then at the very least the benefit is that the message against the powers that be who are custom designing these harmful labels are that their bs will no longer be tolerated nor their fraud perpetuated because providers are required to be complicit in the lies in order to earn a living.

    One final note – what Nick Stewart says (first comment) about making it clear that this site and other actions are not affiliated with scientology/cchr is important to our health as a movement. We don’t have to engage in mud slinging but I think it important to make a clear position statement in order to not be immediately discredited.

  8. Just a few updates:

    –It is so encouraging to read Amy Smith’s post about alternatives to diagnosing, and I hope she will post more details here when she has a chance.

    –I guess that it was as a result of my having written the book about what I learned when I served on two of Allen Frances’s DSM-IV committees — the disregard for both what the science really shows and for the suffering caused by diagnosis — that has, over many years, led many whose lives were destroyed by diagnosis, whether from the DSM or the ICD, to contact me. And thinking back over much of what various people posted and emailed yesterday, I find myself hoping that more people who sincerely seem to consider the ICD a less dangerous alternative would hear more of the stories of harm. Once heard, those tragic stories live in one’s heart forever.

    –In light of the discussions yesterday, I decided to make an effort in a different way to find out whether the ICD enterprise has a procedure for filing complaints when people have been harmed by its use (as we filed complaints ethics complaints last year with the APA because of harm from the use of the DSM … something about which I wrote in two articles at madinamerica.com as well as on my Psychology Today blog). I also made an effort to find out what the World Health Organization does with the income from sales of the ICD. Their medical officer wrote back promptly but only referred me to other websites that did not in fact include any of that information. So I have written to him again and will post here whatever he replies if I hear back from him again. It is proving to be tough to find out about the internal workings of the ICD and thus for therapists who want to use the ICD to be fully informed about what they are doing and whether their patients, should they suffer harm because of getting ICD labels, would even have the most minimal recourse of filing a complaint about it. (I realize, of course, that the WHO might be as utterly cold and unresponsive if such complaints were filed as the APA has been about complaints about harm from the DSM, but it seems important to learn as much as we can.) If anyone who reads this knows anyone who has been an inside in the ICD enterprise and can put them in touch with me, I would appreciate that. I think it is healthy for people concerned about adding to the suffering of people who seek help in the mental health system to be able to toss ideas and suggestions back and forth and to have different perspectives. But I feel strongly that it is important for us to do this from a base of as much knowledge as possible. So I hope to learn from others what they know, and I will be grateful for that.

    –I hope that our awareness of the massive power of the systems that are supposed to help people in need but end up too often harming them will not lead us to aim only to try to disarm or dismantle one small part while we look away from the harm caused by the rest. Yes, it is daunting to aim to do it all, but if we do not make the effort, who will?

  9. One more crucial point that has not been mentioned in this article or the comments yet: The whole enterprise of psychiatric diagnosis is — at least in the U.S. — _totally_ unregulated. That means that it is even less regulated than the financial giants who have so damaged the economy. I hope that everyone who reads this will consider signing the Call for Congressional Hearings about Psychiatric Diagnosis, which was posted more than a year ago at http://www.change.org/petitions/everyone-who-cares-about-the-harm-done-by-psychiatric-diagnosis-endorse-the-call-for-congressional-hearings-about-psychiatric-diagnosis This is a follow-up for such a petition that I created many years ago, but it has been difficult to get members of Congress to pay attention to this need. I hope that people will contact their Senators and Representatives to urge them to support this call. It is just another of the many ways it will be necessary to come up with in order to dismantle a damaging system or at the very least provide sorely-needed safeguards, because now, there are none.

  10. Whatever alternative coding is used for insurance reimbursement, an effective boycott of the DSM-5 would put a dent in APA finances and might get them to sit up and listen to critics (after the silverbacks stop pointing fingers at each other).

Leave a Reply