Preventive Psychiatry Can Be Bad for Our Health: Allen Frances on Huffington Post #2
January 20, 2012
Preventive Psychiatry Can Be Bad for Our Health: Allen Frances on Huffington Post #2
Post #131 Shortlink: http://wp.me/pKrrB-1I2
Allen Frances, MD, who chaired the Task Force that had oversight of the development of DSM-IV, publishes the second in a series of Huffington Post blogs on his concerns for the forthcoming DSM-5.
Allen Frances | January 19, 2012
Professor Emeritus, Duke University
Preventive psychiatry may someday be of significant service in reducing the burden of human suffering – but only if it can be done really well. And the sad truth is that we don’t yet have the necessary tools. More people will be harmed than helped if psychiatry stretches itself prematurely to do what is currently well beyond its reach. That’s what is so scary about the unrealistic prevention ambitions of DSM-5, the new manual of mental disorders now in preparation and set to become official in 2013. DSM-5 proposes a radical redefinition of the boundaries of psychiatry, giving it the impossible role of identifying and treating mental disorders in their nascent stages before they have fully declared themselves. Tens of millions of people now deemed normal would suddenly be relabeled mentally disordered and subjected to stigma and considerable risks consequent to inappropriate treatment…
CDC study quoted in Huffington Post blog #2:
Antidepressant use in persons aged 12 and over: United States, 2005–2008. Pratt LA, Brody DJ, Gu Q, NCHS data brief, no 76. Hyattsville, MD: National Center for Health Statistics. 2011 PDF
America Is Over Diagnosed and Over Medicated: Allen Frances on Huffington Post
Allen Frances, Huffington Post #1, January 09, 2012
Government survey finds that 5 percent of Americans suffer from a ‘serious mental illness’
David Brown, Washington Post, January 19, 2012
SAMHSA News Release
Date: 1/19/2012 12:05 AM
Media Contact: SAMHSA Press Office
National report finds one-in-five Americans experienced mental illness in the past year
Substance dependence and abuse rates higher among those experiencing mental illness
A new national report reveals that 45.9 million American adults aged 18 or older, or 20 percent of this age group, experienced mental illness in the past year. The rate of mental illness was more than twice as high among those aged 18 to 25 (29.9 percent) than among those aged 50 and older (14.3 percent). Adult women were also more likely than men to have experienced mental illness in the past year (23 percent versus 16.8 percent).
Mental illness among adults aged 18 or older is defined as having had a diagnosable mental, behavioral, or emotional disorder (excluding developmental and substance use disorders) in the past year, based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association [APA], 1994).
The Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey on Drug Use and Health also shows that 11.4 million adults (5 percent of the adult population) suffered from serious mental illness in the past year. Serious mental illness is defined as one that resulted in serious functional impairment, which substantially interfered with or limited one or more major life activities.
SAMHSA through its strategic initiative on substance abuse and mental illness prevention and recovery is working to assist states, territories, tribal governments, and communities to adopt evidence-based practices; deliver health education related to prevention; and establish effective policies, programs, and infrastructure to help address these problems. Throughout the nation new programs are underway to strengthen the capacity of communities to better service the needs of those suffering from mental illness.
“Mental illnesses can be managed successfully, and people do recover,” said SAMHSA Administrator Pamela S. Hyde. “Mental illness is not an isolated public health problem. Cardiovascular disease, diabetes, and obesity often co-exist with mental illness and treatment of the mental illness can reduce the effects of these disorders. The Obama Administration is working to promote the use of mental health services through health reform. People, families and communities will benefit from increased access to mental health services.”
The economic impact of mental illness in the United States is considerable—about $300 billion in 2002. According to the World Health Organization, mental illness accounts for more disability in developed countries than any other group of illnesses, including cancer and heart disease.
In terms of treatment statistics, the report indicates that about 4 in 10 people experiencing any mental illness in the past year (39.2 percent) received mental health services during that period. Among those experiencing serious mental illness the rate of treatment was notably higher (60.8 percent).
The report also noted that an estimated 8.7 million American adults had serious thoughts of suicide in the past year – among them 2.5 million made suicide plans and 1.1 million attempted suicide. Those in crisis or knowing someone they believe may be at immediate risk of attempting suicide are urged to call the National Suicide Prevention Lifeline 1-800-273-TALK (8255) or http://www.suicidepreventionlifeline.org . This suicide prevention hotline network funded by SAMHSA provides immediate free and confidential crisis round-the-clock counseling to anyone in need throughout the country, everyday of the year.
According to the report, rates for substance dependence were far higher for those who had experienced either any mental illness or serious mental illness than for the adult population which had not experienced mental illness in the past year. Adults experiencing any mental illness in the past year were more than three times as likely to have met the criteria for substance dependence or abuse in that period than those who had not experienced mental illness in the past year (20 percent versus 6.1 percent). Those who had experienced serious mental illness in the past year had even a higher rate of substance dependence or abuse (25.2 percent). “These data underscore the importance of substance abuse treatment as well,” said SAMHSA Administrator Pamela S. Hyde.
“Mental illness is a significant public health problem in itself, but also because it is associated with chronic medical diseases such as cardiovascular disease, diabetes, obesity, and cancer, as well as several risk behaviors including physical inactivity, smoking, excessive drinking, and insufficient sleep,” said Ileana Arias, Ph.D., Principal Deputy Director of CDC. “Today’s report issued by SAMHSA provides further evidence that we need to continue efforts to monitor levels of mental illness in the United States in order to effectively prevent this important public health problem and its negative impact on total health.”
The report also has important findings regarding mental health issues among those aged 12 to 17. According to the report 1.9 million youth aged 12 to 17 (8 percent of this population) had experienced a major depressive episode in the past year. A major depressive episode is defined as a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had at least four of seven additional symptoms reflecting the criteria as described in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association [APA], 1994).
In addition, the report finds that young people aged 12 to 17 who experienced a major depressive episode in the past year have more than twice the rate of past year illicit drug use (37.2 percent) as their counterparts who had not experienced a major depressive episode during that period (17.8 percent).
The complete survey findings from this report are available on the SAMHSA Web site at http://www.samhsa.gov/data/NSDUH/2k10MH_Findings/
The 2010 National Survey on Drug Use and Health is a scientifically conducted annual survey of approximately 67,500 people throughout the country, aged 12 and older. Because of its statistical power, it is the nation’s premier source of statistical information on the scope and nature of many behavioral health issues affecting the nation.
For more information about SAMHSA visit: http://www.samhsa.gov
SAMHSA is a public health agency within the Department of Health and Human Services. Its mission is to reduce the impact of substance abuse and mental illness on America’s communities.
Last updated: 1/18/2012 2:53 PM