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
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.
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
Unfortunately, reasonable accommodation for employees in the workplace continues to be the source of significant litigation and even today we continue to see outrageous examples of employers behaving badly.
We are now beginning to see reported cases involving charges and subsequent fines laid against employers for failing to provide information, instruction and supervision to protect a worker from workplace violence.
On October 13, 2016, the Supreme Court of Canada denied leave to appeal an Ontario Court of Appeal decision which ordered an employer to pay a former employee 37 months of salary and benefits following termination.
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).