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Journal editors decry the paradox of mental health: overtreatment and under-recognition

The editors of the journal PLoS Medicine today published an editorial, “The Paradox of Mental Health: Over-Treatment and Under-Recognition.” Excerpts:

“On the one hand is over-treatment and over-medicalization of mental health issues, often fueled by a pharmaceutical industry interested in the broadening of the boundaries of “illness” and in the creation of more and wider diagnostic categories and thus markets for “selling sickness.” On the other hand exists profound under-recognition of the suffering and breadth of mental health issues affecting millions of people across geographies, which is a global problem.

Over-diagnosis in mental health risks unnecessary tests and treatment, the stigma associated with being labeled mentally ill, and the considerable costs of testing, treatment, and wasting resources that could be better utilized elsewhere

The recent DSM-5 (psychiatry’s Diagnostic & Statistical Manual) process is a lightning rod for these concerns: this month’s update of the psychiatric diagnostic manual has been widely criticized for continuing the tradition of broadening diagnostic categories and adding new conditions that redefine more people as having mental illness and in need of pharmaceutical treatment. That decisions about DSM-5 categories are made by experts with financial ties to the industry that benefits most from a widened patient population, is particularly worrying.”

The piece lists ongoing efforts to address the topic:

It concludes:

“The largest challenge may be to recognize and prioritize mental health globally—with the requisite political visibility, funding, research, and attention—without reducing it to an object for disease mongering, pathologizing, and harmful over-treatment.”

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