DSM 5 will have a big impact on how millions of lives are led and how scarce mental health resources are spent. Getting the right diagnosis and treatment can be life enhancing, even life saving. Incorrect diagnosis can lead to the prescription of unnecessary and potentially harmful medication and to the diversion of services away from those who really need them and toward those who are better left alone. Preparing DSM 5 should be a public trust of the highest order.
But DSM 5 is also an enormously profitable commercial venture. DSMs are perpetual best sellers (at least one hundred thousand copies sold every year) netting the American Psychiatric Association yearly profits exceeding five million dollars.
From the very start of work on DSM 5, APA took unprecedented steps to protect its commercial interest- but in the process betrayed its obligation to the public trust. Work group members were recruited only on condition that they first sign confidentiality agreements - thereby squelching the free flow of ideas that is absolutely necessary to produce a quality diagnostic manual. 'Intellectual property' has been the priority - a safe, scientifically sound DSM 5 has been the victim.
DSM 5 commercialism and heavy handed censorship have recently assumed a new and troubling form. APA is exercising its 'DSM 5' trademark to unfairly stifle an extremely valuable source of information. Suzy Chapman, a patient advocate from England, runs a highly respected and authoritative site providing the best available information on the preparation of both DSM and ICD. Her writings can always be relied upon for fairness, accuracy, timeliness, and clarity. The site has gained a grateful following with over 40,000 views in its first two years.
Ms Chapman recently sent me the following email describing her David vs Goliath struggle with the APA and its disturbing implications both for DSM 5 and for internet freedom:
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