Desired outcome

(1)  Each condition considered eligible for psychiatric intervention or treatment is characterized by signs, symptoms, behaviors, and a primary course of development which can be recognized and differentiated by practitioners and laymen alike.

(2)  Each condition is associated with mental and emotional distress or quantifiable dysfunction in significant numbers of people.  Boutique illnesses and their practitioners need not apply.

(3)  Each condition has at least one distinctive treatment protocol which has been proven effective in randomized double blind field trials—in outpatient practice venues.  If you can’t treat it successfully, then it isn’t a diagnosis; it’s a research issue.

(4) While some symptoms will likely overlap between defined disorders, categories should be sufficiently differentiated that each is treated by different means.

[I]f a defined pattern of human distress does not meet all four of these criteria, then reimbursement for treatment should not be subsidized by health insurance.  At most, such patterns might be identified for further research to improve definitions.  

Likewise, the [new standard] should recognize the need not to intervene or to treat mental states that are self-correcting.  Generalized adolescent angst or anxiety may well be one of those states, and there are doubtless many others.

[...]

[The new standard] should also recognize the spectrum of different stakeholder backgrounds among mental health professionals and delineate the training expected of  practitioners as a precondition for certification to treat each condition. This criterion may particularly apply to the assignment of psychiatric or psychological diagnosis labels by physicians who now hold no specific certifications in these fields.


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