The long awaited DSM-5 has arrived and the controversy rages. Meanwhile, no matter what employers may think about the changes, they have no choice but to deal with the inevitable fallout.
DSM-5 is the "Diagnostic and Statistical Manual of Mental Disorders" as newly revised from the previous DSM-IV. It was formally introduced this week by the American Psychiatric Association and it becomes the authoritative source in North America for diagnosing mental disorders. (An earlier post talked about some of the controversy in the making of DSM-5.)
Why is it important to employers in BC?
First – it is authoritative – for psychiatrists and psychologists, for insurers, and for WorkSafeBC.
Whether or not individual professionals agree or disagree with all or any aspect of DSM-5, they will use it for at least two reasons: DSM-5 is established as the governing authority for determination of mental disorders under the Worker's Compensation Act; and for now, there is no other alternative on which a credible diagnosis can be made so it likely will be relied on to determine if there is a "mental disability", and to set the scope of the duty to accommodate, in human rights law.
Second – it recognizes new mental disorders, and changes the criteria for some existing disorders.
Of particular interest for employers are new disorders such as Caffeine Withdrawal, Cannabis Withdrawal, Mild Neurocognitive Disorder and Premenstrual Dysphoric Disorder, and treating extended grief over the loss of a loved one as depression.
Third – all of that likely will lead to increased costs for sick leave, disability insurance and drug plans.
The concern is that the changes will accelerate the diagnoses of mental disorders. That will justify more sick leave and more disability leave and the use of medication as treatment. That will drive up employer costs for the benefits plans commonly provided.
You can read a summary of the main criticisms of DSM-5. But of course, there are always at least two sides to every story and there is strong support as well.
Does DSM-5 medicalize normal human emotions and behaviour to our detriment, or does it gather advances in psychiatric knowledge and enable previously uncategorized problems to be recognized, studied and effectively treated?
It's an interesting debate and worth following. But whatever employers may think, DSM-5 will have an impact in the workplace.
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