Saturday, March 30, 2013

DSM-5, Classification of Mental Disorders and Massachusetts Law

The American Psychiatric Association (A.P.A.) has announced that the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is scheduled for release in May 2013. The history of the attempt to classify mental disorders goes back to the mid-nineteenth century, described by the A.P.A on their website. Classification has always been a work in progress. This new edition of the manual, DSM-5, has been the work of many minds. Something of the process of putting the manual together is revealed in a December New York Times article, “A Tense Compromise on Defining Disorders.”
How is the DSM used in the Courtroom? Obliquely. In an article in Psychology Today called “The Law and the Good Book”, Attorney Jim Silver says “courts, experts and lawyers talk about the DSM a lot, but the law just does not see itself as bound by the DSM in making decisions in mental health cases.”
For example, 69 Mass. App. Ct. 326 states “[The defendant] argues that in order to establish a mental abnormality, the Commonwealth had to prove that he suffered from a mental abnormality included in the DSM-IV. We note, however, that the . . . statute makes no reference to this manual, nor does it set forth any requirement that the statutory definition of mental abnormality be limited to the abnormalities outlined in the DSM-IV.”
A cautionary statement in the DSM-IV reads “The clinical and scientific considerations involved in categorization of these conditions as mental disorders may not be wholly relevant to legal judgments…that [by inference] take into account such issues as individual responsibility, disability determination, and competency.” That said, the legal community awaits the release of the DSM-5 and we will see it cited in court opinions.