The Diagnostic and Statistical Manual of Mental Disorders (DSM), an authoritative classification tool in mental health care, has long been criticized for its neglect of social determinants and its rigid categorization of mental distress. As the field moves towards recovery-oriented, person-centered models, the DSM’s role is increasingly questioned.
In a recent article, Lars Veldmeijer of Utrecht University Medical Center and colleagues suggest reimagining the DSM as a “boundary object” and conversation piece to better serve the evolving needs of mental health care.
While some researchers argue to discard the manual entirely and seek alternatives, Veldmeijer and his team, including renowned psychiatrist Jim van Os and critical psychologist Sanne te Meerman, argue that discarding the DSM entirely would be detrimental due to its deep entrenchment in the mental health system. Instead, they advocate for using the DSM to facilitate a shared language between patients and professionals. Emphasizing participatory design, they call for the involvement of individuals with lived experience in co-creating spectra of distress, thus promoting a more inclusive and flexible framework. Their proposal aims to shift the power balance towards shared ownership and dialogue, marking a significant step towards a more person-centered approach in mental health care.
They write:
“Transforming psychiatric diagnoses by reconsidering and redesigning the DSM as a boundary object and conversation piece could be a step in the right direction. This would shift the power balance towards shared ownership in a participation era that fosters dialogue instead of diagnosis. We hope this hypothesis and theory paper can give decisive impulses to the much-needed debate on and development of psychiatric diagnoses and, in the end, contribute to lived experience-informed psychiatric epistemology. Furthermore, as a product of an equal co-production process between various disciplines and types of knowledge, this paper shows it is possible to harmonize perspectives on a controversial topic such as the DSM.”
Rethinking the DSM: From Classification System to Conversation Piece?
www.madinamerica.com/2024/08/rethinking-the-dsm-from-classification-system-to-conversation-piece/
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