Our fairly recent reliance on prisons and homelessness as solutions to mental illness was the common fashion 200 years ago but now seems anachronistic and indecent in a society that has the tools and can afford to do much better.
The horizon for breakthroughs in understanding mental disorders keeps drifting decades further into the future. The more we know, the more we know how little we know. It seems unlikely there will be any grand slam home runs or walks -- just singles and lots of strikeouts.
Recognition of mental illness as a profound public health problem that affects productivity and, therefore, a threat to the economy of nations; and that in a world where economies are rapidly becoming "brain-based."
Rep. Murphy proposed the "Helping Families in Mental Health Crisis" Act to reorient the mental health system away from it's focus on serving the largest numbers of the highest functioning and back towards providing treatment for the most seriously mentally ill.
While I've never been convicted of a crime, I have spent my fair share of time in private mental hospitals, wherein I've witnessed what may well be our nation's last great bastion of tobacco, tar and nicotine.
NIMH director Insel now agrees with treatment reform activists that many people diagnosed with schizophrenia and other psychoses could be better served by a more selective and limited use of drugs and more diverse treatments.
If DSM diagnosis doesn't inform treatment, what good is it? The answer is one, to facilitate the exchange of money between payers and providers, and two, to create silos for focused research. With the NIMH announcement, scratch number two.
May has been a dispiriting month for psychiatry and a sad and worrying time for our patients. Three of the leading mental health organizations have squabbled among themselves -- promoting silly and competing 'paradigm shifts' while ignoring the unmet needs of our patients.
We still have to rely on DSM to diagnose illness, but thanks to Dr. Insel the end of that state of affairs is a step closer. The identification and treatment of mental illness is about to leave the realm of psychiatry and enter the science of neurology.
I have been arguing for many years in books like Rethinking Depression that the DSM ought to be repudiated. In recent months this idea has been gaining tremendous momentum and just recently the National Institute of Mental Health essentially repudiated the DSM.
We have entered a truly remarkable silly season of interacting absurdities committed by the American Psychiatric Association, the National Institute of Mental Health, and the British Psychological Society. May, it turns out, is the cruelest month for mental health.
For what we need to do in mental health research, the DSM approach is not appropriate. Even if it is still the best way to diagnose disorders and deliver treatment and knit the mental health care system together, it must begin to be supplanted by a new science-based framework.
The flat out rejection of DSM-5 by National Institute of Mental Health is a sad moment for mental health and an unsafe one for our patients. The APA and NIMH are both letting us down, failing to be safe custodians for the mental health needs of our country.