Allen Frances, "godfather" of DSM-4, on problems with DSM-5 and current mental health care [View all]

Last edited Sun Mar 17, 2013, 10:06 AM - Edit history (1)

Dr. Frances chaired the committee that supervised the production of the DSM-IV, this is a transcript of an interview with him conducted by Rob Kall, some time in 2012, the transcript was published at OpEdNews. 3/15/2013.

http://www.opednews.com/articles/1/Transcript-Problems-With-by-Rob-Kall-130315-772.html

In the 5 page transcript he self-identifies as a staunch critic of the soon to be released DSM-5, but, imo, his strongest criticisms in this interview are on how mental health-care, particularly treatment involving medication, is practiced in the US.

No summary of transcript of a half-hour conversation is going to be adequate to capture everything, but his main concerns with the DSM-5 seem to be, that the DSM expands/loosens definitions of illness this extends the pathological range of symptoms into what has previously been considered subclinical and not needing treatment.

Rather than considering some sort of conspiracy by authors of the DSM-5 & pill-pushers, Frances predicts these bad outcomes from the DSM-5 as a consequence of the way mental health-care is currently conducted in the US.

While driven by a desire by the psychiatric industry to catch mental illness early and possibly prevent the damage these illnesses do to the lives of the persons they afflict, he is concerned about a movement toward over-diagnosis and over-medication, particularly of children.

He sees a troubling interaction between pharmaceutical companies and primary care. According to Frances most of the prescriptions written for psychiatric medication occur outside of psychiatry. Primary care physicians (PCPs), mostly without the expertise Frances thinks is necessary are doing most of the prescribing. These PCPs are under pressure to move patients quickly through the exam room, and satisfy their patients' expectations with too-quick diagnoses and prescriptions of psychiatric medications. Frances feels the loosening of diagnosis criteria will result in overdiagnosis, overmedication, and undo harm from medications and social stigma applied to those diagnosed as mentally ill.