Tuesday, April 23, 2013

The APA, over-labeling, and advocacy...



I think that this is an important topic.  Apparently, the DSM V (Diagostic and Statistical Manual) is coming out. The APA (American Psychiatric Association) is responsible for this publication. As is true with many things, this issue has become somewhat political. The APA has added additional disorders to the DSM.  For example, ‘skin-picking’ is added as a disorder.  And, of course, so is hoarding and something called “Internet disorder”.  Here are two of the resources that I used in writing this blog:  http://huff.lv/115xIo3 and a corresponding article http://bit.ly/Yytot5.  


The various experts in this video make some very logical points.  They talk at various times about 'pathologizing' things. For example, is viewing grief as pathology a realistic view?  They discuss the fact that pharmaceutical companies benefit, as do psychiatrists, when something is viewed as pathology.  They talk about how the APA benefits financially from printing each additional publication of the DSM. They debate whether increasing the number of things seen as pathological really leads to better treatment for people suffering from mental illness. Because these experts represent their opinions better than I can, I invite you to go to the links and access the discussion. It really does give you much food for thought. It exams whether the fact that the APA has expanded what is and isn’t illness will hurt the mentally ill in the long run.  And I think that is an important question. 


But it also raised some other interesting points.  One of the most important is that health care generally IS a political and financial issue.  I see the reasons that we debate about how available healthcare should be. It is possible that with mental illness that debate is impacted by the fact that we don’t always recognize the validity of different diagnoses.  And the fact that this country is involved in a debate about how well a free market cares for those on the bottom of the economic ladder. But the most important thing I heard on this video was the person who said that consumers have to be trained to recognize and describe what is actually going on in our bodies.  We need to learn how to advocate for ourselves.  We need to be able to describe to medical professionals how our symptoms impact our lives.  The fact is that medical decisions and access to treatment are political and financially influenced.  We have to make our voices heard.  We have to look at the impact of not providing treatment on the community as a whole.  And we have to be willing to make some noise.  

For some of us, that is difficult and close to impossible.  So, I guess that the other option is that caretakers of those suffering from chronic and severe mental illness need to do the advocating.  Obviously, sometimes even this isn’t possible.  What do you think?  How can we be responsible for advocating for our own needs in spite of the political ramifications and personal difficulties?  How do we advocate?  For those able to advocate, I see the following options:  1.We can vote for politicians understanding our needs. 2. We can take steps, as much as possible, to communicate with our doctors. 3. We can keep the issue alive and in front of the general public.  Is there something that is missing?  What do you see?     

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