1 Boring Old Man

Why Social Workers Should Oppose DSM-5
^{Because they bring a missing and much needed perspective}
DSM5 in Distress: Psychology Today
by Allen J. Frances, M.D.
April 5, 2012

^{Social workers make up by far the largest single constituency among all the potential users of DSM-5, a plurality of over 200,000 mental health clinicians. Until recently, they have been silent while psychologists, counselors, psychiatrists, the press, and the public have all strongly opposed DSM-5. Things are changing. Recently, two prominent social workers have stepped forward to explain why it is important for their profession to take a stand on DSM-5. Jack Carney, DSW, is a social worker with over forty years in the public mental health system as clinician and program director. Dr. Carney writes:}

^{"Where are the social workers? Where are the NASW and its local and state-wide chapters? Over 12,000 individuals mental health professionals have publicly declared their concern at the planned 2013 publication of the DSM-5. They’ve signed the petition launched six months ago by the Society for Humanistic Psychology requesting that the DSM-5 Task Force delay publication of the new DSM and subject it to an independent scientific review. Fifty-one professional organizations have also endorsed the petition. It is extremely puzzling that the National Association of Social Workers and its local affiliates are not to be found among them."}

Yesterday, I posted a blurb from the Lancet [Psychiatry’s identity crisis] that said, "But more fundamental still, it is time for the specialty to stop devaluing itself because of its chequered history of mental asylums and pseudo-science, and to realign itself as a key biomedical specialty at the heart of mental health." I thought that was backwards. I think the chequered part of our history is actually right now. I expect most people think that. Those old guys with their asylums, psychosurgery, insulin coma therapy were certainly operating in a primitive sphere. And I expect the pseudoscience he’s talking about was psychoanalysis circa 1920. But those old guys weren’t working for drug companies, publishing advertisements as scientific articles, or jury-rigging a diagnostic system to increase drug sales. They just didn’t know what to do and were flailing about. And the notion that psychiatry’s current flight path will "realign itself as a key biomedical specialty at the heart of mental health" is laughable.

^{"What can social workers do? We can raise our voices individually and as a profession. Write to the DSM-5 work groups and APA Trustees and to the NASW leadership. Sign the American Psychological Association’s 32nd Division’s petition. Work with clients on a sliding scale so that you can forego the diagnostic process when it is unnecessary. Volunteer in your community to help those who suffer. There are many, many wonderful nonprofit groups that provide direct, compassionate, mindful services to families. And, if we cannot use our voices to alter the trajectory of DSM-5, we may be forced to take political action at the state and congressional levels and to organize a boycott of DSM-5."}

I’m not much of a television watcher, but I do have favorites – those things on the history Channel or the Discovery Channel about some culture that’s come and gone. I watched one not so long ago about Easter Island that went into a lot of detail about how those amazing statues came to be built. It took a lot of trees to roll those monuments into place, so the islanders denuded the island in the process of building the statues to protect them from the unknown evil in the seas. It’s an often told story – destroying important things in the service of some contemporary and misdirected campaign. By the time ships discovered Easter Island, a few half starved cannibals were all that was left of a people that used up its resources building idols. The ones that remained welcomed what came from the sea with open arms.