Don't Worry About that Health Privacy Thing, Unless You Are One of the 50% of Americans Who Will Have Mental Illness

Most Will Be Mentally Ill at Some Point, leads the New York Times headline concerning a comprehensive study of mental health among a broad cross-section of Americans. The study will appear in the June issue of Archives of General Psychiatry. Depression, alcohol abuse and phobias led the list, and most of those studied had developed their problem(s) at a young age, particularly those with impulse-control and anxiety problems.

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For me, the key ethical issue here is the way that the psychiatric profession (specifically the American Psychiatric Association) keeps expanding the number of diagnoses in its Diagnostic & Statistical Manual (DSM) to the point that it can now diagnose 50% of the population over their lifetime. The purpose of this, of course, is to enhance revenue and insurance reimbursement. In fact, as Paula Caplan demonstrates so apty in her book on the DSM, "They say You're Crazy," the creation of new diagnoses is based on politics and the personal and professional biases and agendas of individual members of the committees that revise the DSM. (Remeber, 30 years ago, homosexuality was a "mental illness.") This just goes to show that so-called "mental illness" is more about social constructs than it is about medicine.

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