Valid Challenges to the DSM
The following recent report and manuals encourages us to reflect more deeply on problems within the mental healthcare system and the Diagnostic and Statistical Manual of Mental Disorders (DSM)—They profile its failures and suggest cogent, effective alternatives that are now available.
Readers: Please use the comment box below to write your reviews and thoughts.
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Report on Improving Mental Health Outcomes
Authors: James B. Gottstein, Esq.; Peter C. Gøtzsche, MD;
David Cohen, PhD; Chuck Ruby, PhD; & Faith Myers
Published September, 2023 by the authors
“The mental health system’s standard treatments are colossally counter-productive and harmful, often forced on unwilling patients. The overreliance on psychiatric drugs is reducing the recover rate of people diagnose with serious mental illness from a possible 80% to 5% and reducing their life spans by 20 years or so.”—from the Report, (pg.i.)
So begins the Report. The first 20 pages expose the problems. The next 16 pages reveal voluntary, effective, safe and humane approaches to improve mental healthcare. This free report is cogent, well-organized, authoritative. Highly recommended!
https://acrobat.adobe.com/id/urn:aaid:sc:US:feccbf4f-e53c-463f-937e-43d1057dd781 for a free copy
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Indicative Trauma Impact Manual
Authors: Jessica Taylor and Jaimi Shrive
Published Independently: July, 2023 through victimfocus.com
This manual presents the first trauma-informed, non-diagnostic alternative to other manuals of mental health issues and psychiatric disorders. Rather than lists of disorders and medicalized symptoms, this extensive manual provides information about hundreds of trauma responses, emotions, thoughts, behaviors and experiences that have previously been categorized as symptoms of disorders.
The manual equips progressive professionals with evidence-based, anti-oppressive, anti-blaming and non-diagnostic information about a wide range of human emotion, thought, and behavior. Building on the quickly growing consensus that trauma-informed, anti-oppressive practice is vital to the way we understand society, ourselves, and our clients.
Academically minded readers may wish for more references; however, this manual is thought-provoking and useful clearly pointing to the need for mental healthcare workers to be trauma-informed in making assessments and treatment plans. One chapter is dedicated to approaches to supporting traumatized and distressed people.
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The Power Threat Meaning Framework
Authors: Lucy Johnstone & Mary Boyle
First published in 2018 by the British Psychological Society
An attempt to outline a conceptual alternative to the standard diagnostic models (DSM, ICD-10). It is not a single model or approach, but a broad perspective that includes many aspects of current theory and practice, and provides a basis for further development.
The Power Threat Meaning Framework offers a new perspective on why people sometimes experience a whole range of forms of distress, confusion, fear, despair, and troubled or troubling behavior. It is an alternative to the more traditional models based on a medicalized, psychiatric diagnosis.
The Framework applies not just to people who have been in contact with the mental health or criminal justice systems, but to all of us. The Framework summarizes and integrates a great deal of evidence about the role of various kinds of power in people’s lives; the kinds of threat that misuses of power pose to us; and the ways we have learned as human beings to respond to threat. In current standard mental health practice, these threat responses are sometimes called ‘symptoms’.
The Framework also looks at how we make sense of these difficult experiences, and how messages from wider society can increase our feelings of shame, self-blame, isolation, fear and guilt. The main aspects of the Framework are summarized in these questions, which can apply to individuals, families or social groups:
- ‘What has happened to you?’ (How did abuse of Poweroperate in your life?)
- ‘How did it affect you?’ (What kind of Threatsdoes this pose?)
- ‘What sense did you make of it?’ (What is the Meaningof these situations and experiences to you?)
- ‘What did you have to do to survive?’ (What kinds of Threat Responseare you using?)
In addition, the two questions below help us to think about what skills and resources people might have, and how we might pull all these ideas and responses together into a personal narrative or story:
- ‘What are your strengths?’ (What access to positive Power resources do you have?)
- ‘What is your story?’ (How does all this fit together?)
Now in Paperback or free pdf download:
https://explore.bps.org.uk/content/report-guideline/bpsrep.2018.inf299b
Learn More at YouTube:
https://www.youtube.com/watch?v=mh-FQFLkSlo with Ray Middleton, PhD gives the 6 questions in written as well as auditory form. I personally like the intro this man did that is more human and less techy: https://www.youtube.com/watch?v=LqMnuo5nxTg
Lucy Johnstone, PhD, a clinical psychologist in the UK, gives a more full introduction in a 2 hour talk: https://www.youtube.com/watch?v=LqMnuo5nxTg
A Comprehensive and Scholarly Approach
Over the course of five years a group of senior psychologists (Lucy Johnstone, Mary Boyle, John Cromby, David Harper, Peter Kinderman, David Pilgrim and John Read) and high-profile service user campaigners (Jacqui Dillon and Eleanor Longden) developed the Power Threat Meaning Framework as an alternative to more traditional models based on psychiatric diagnosis.
They were supported by researcher Kate Allsopp, along with a consultancy group of service users, carers, and others who supplied examples of good practice not based on conventional diagnosis.