Written by Eliot Sorel, MD – Author of 21st Century Global Mental Health
In the preceding days, prior to this launch, an intense discussion and debate took place in the United States and across the world regarding the merits of DSM 5 and how it compares with an envisioned different diagnostic model, namely the Research Domain Criteria (RDoC) that would be developed in the ensuing years and be based on a thorough understanding of the human brain’s complex functioning.
Anticipating this controversy, when we conceived our text, 21st Century Global Mental Health for graduate public health students and the primary care team, three years ago, we dedicated two chapters in Section One, to address the two models in detail. These chapters, two and three in my book, can be accessed free of charge on my publisher’s website at www.jblearning.com by all those interested in learning more about these two diagnostic systems. Do bear in mind that only one, DSM 5, is now in existence and will be utilized in contemporary clinical practices and elsewhere. RDoC is an evolving, aspirational model that will likely be developed once we have a clearer and more comprehensive understanding of the brain’s functioning.
It is expected that President Obama’s brain initiative, Brain Research through Advancing Innovative Neurotechnologies, once fully implemented and operational may be catalytic to the development and implementation of the RDoC model. DSM 5 and RDoC are not necessarily antithetical, as they are currently portrayed in the media and elsewhere. In fact they may be complementary and a possible synthesis of the two is, at least theoretically, conceivable.
Following the launch of DSM 5 on May 18th in San Francisco, another major global mental health event took place on May 24, 2013 when The World Health Organization’s (WHO) World Health Assembly approved the Comprehensive Mental Health Action Plan (CMHAP) 2013-2020. It is a major health policy accomplishment that partially corrects the United Nations’ General Assembly “unfortunate exclusion” (September 2011) when it dealt with Non-communicable diseases (NCDs) for the first time in the UN Assembly’s history. At that time, mental disorders, the NCDs representing the largest global burden of disease, were not included on the UN agenda. The CMHAP predicates the integration of mental health with primary care. This provision has positive and intrinsic value of strengthening health systems as well as the value added of enhancing access to care and decreasing shame, stigma and discrimination.
Strengthening health systems, enhancing access to care, diminishing shame, stigma and discrimination are subjects we conceived three years ago when we began writing our book and we thoroughly address them in Sections Four and Five of our text 21st Century Global Mental Health published a few months ago and accessible at www.jblearning.com.