Neither fools nor rogues

A quote from a recent paper by psychiatrist Dr Paul Mullen on the difficulties with diagnostic manuals for mental illness, such as the DSM and ICD.

Mullen argues that the definitions of mental illnesses are designed in an open-minded way to aid diagnosis and stimulate debate but end up trapping us into a narrow definition of mental distress:

Those who create these manuals are neither fools nor rogues. They know that classificatory systems grow and develop. They welcome research, debate, and change. They are often painfully aware of the compromises and hopeful approximations which go to create the final authoritative text.

But this intellectual honesty does not translate into the practices and ideologies which DSM and ICD sustain in the cities of psychiatry and psychology. In today’s field of mental health if you seek research funding or publication, you are forced into the languages of DSM or ICD.

To claim rebates for clinical work or to present expert testimony to courts and tribunals, increasingly, the language of these diagnostic manuals is imposed upon you. To even contribute to the professional debates on nosology you are constrained within the premises which sustain the manuals.

Link to PubMed entry for paper.

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