Afterthoughts: Power, Diagnosis and the Majority World

Abstract

As I was completing this book, the newest version (fifth edition) of the Diagnostic and Statistical Manual of Mental Disorders (DSM- 5) (APA, 2013) was published. The opposition to DSM 5 raised the question for the general public: ‘[D]oes mental illness really exist’ (Doward, 2013, p. 1)? And the (British) Division of Clinical Psychology (part of the British Psychological Association—BPS) issued a position statement on psychiatric nosology calling for a change of paradigm in thinking about the Euro-American system of psychiatric diagnosis (DCP, 2013). Although, strictly speaking, DSM merely provides a system of categorization devised in the USA for the USA, its main use being as a reference for insurance companies paying practitioners for providing psychiatric and psychological treatment. This massive volume is recognized now as exercising power across the world in propagating western psychiatry: ‘[T]he political dominance of the US means that, as soon as a mental disorder is named in the DSM, that disorder becomes valid in the eyes of the many’ (Burns, 2013, p. 1).