Allen Frances vs. DSM-5

Screen-shot-2012-06-05-at-12.00.37-PMThe new version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is about to drop, and those of us in the mental health field will have to respond and/or adapt to the changes in some way. In my graduate program, the most prevalent response seems to be annoyance at having to learn a new system. Strangely, I’ve heard very little buzz among students and faculty regarding the many critiques of the new manual that have been sprouting up daily across various media outlets over the past year or so. It’s as if students are resigned to accepting whatever dictates come down from the American Psychiatric Association because, well, “that’s the way it is” and “what can we do about it anyway?” I’m not always the most socially engaged student, so perhaps there’s more engaged critical discussion going on than I’m aware of. I hope so.

Foremost among DSM-5 critics is Allen Frances, the chair of the task force that produced the version of the manual, DSM-IV, that has been in use since 1994. Frances came out of retirement out of a concern that the proposed changes in DSM-5 would lead to a dangerous level of diagnostic inflation, and he’s been blogging, writing articles and books, and giving talks all over the world encouraging people to seriously question the DSM-5’s safety and legitimacy. In a recent opinion piece for New Scientist, Frances summarizes his scathing critique:

In my opinion, the DSM-5 process has been secretive, closed and sloppy – with confidentiality restraints, constantly missed deadlines, botched field testing, the cancellation of an important quality control step, and a rush to publication. A petition for independent scientific review endorsed by 56 mental health organizations was ignored. There is no reason to believe that DSM-5 is safe or scientifically sound.

A more detailed critique (and a mea culpa for the mistakes in DSM-IV) is explored in the following talk, which I find to be very impressive and persuasive:


Psychiatrist and author, Allen J. Frances, believes that mental illnesses are being over-diagnosed. In his lecture, Diagnostic Inflation: Does Everyone Have a Mental Illness?, Dr. Frances outlines why he thinks the DSM-V will lead to millions of people being mislabeled with mental disorders. His lecture was part of Mental Health Matters, an initiative of TVO in association with the Centre for Addiction and Mental Health.

Of course, Frances is not alone in criticizing the DSM-5. See my twitter feed for the most credible and thoughtful (in my view) critiques being published on the web.