Where is the media coverage of the DSM V vote?

Last Sunday I awoke to a news story in our local paper, The Berkshire Eagle, about the vote by the American Psychiatric Association the previous day approving massive revisions for DSMV, the newest version of the Diagnostic and Statistical Manual of Mental Disorders. The article stated:

Board members were tight lipped about the update, but its impact will be huge, affecting millions of children and adults worldwide (italics mine.)

Figuring that this would be big news, I asked my husband if we could delay our morning hike while I wrote a blog post about it. I was sure there would be an active public discussion on the subject.

But I was wrong. Mainstream media had virtually nothing on the story. There was not one word about the DSM vote in the New York Times.  The Boston Globe similarly did not cover the story. There was a brief mention on NPR's Morning Edition on Monday. Boston.com  had my piece as well as an article about Asperger's being dropped from the new version.

There was news on the blogs. Most striking was from Allen Frances, MD, professor of psychiatry at Duke University, who was chair of the DSM IV task force. On his Huffington Post blog he wrote:

This is the saddest moment in my 45 year career of studying, practicing, and teaching psychiatry. The Board of Trustees of the American Psychiatric Association has given its final approval to a deeply flawed DSM-5 containing many changes that seem clearly unsafe and scientifically unsound. My best advice to clinicians, to the press, and to the general public -- be skeptical and don't follow DSM-5 blindly down a road likely to lead to massive over-diagnosis and harmful over-medication. 

While he defends his colleagues against accusations that they have been influenced by big pharma, he  writes that:

The APA's deep dependence on the publishing profits generated by the DSM-5 business enterprise creates a far less pure motivation. There is an inherent and influential conflict of interest between the DSM-5 public trust and DSM-5 as a best seller... The current draft has been approved and is now being rushed prematurely to press with incomplete field testing for one reason only -- so that DSM-5 publishing profits can fill the big hole in APA's projected budget and return dividends on the exorbitant cost of 25 million dollars that has been charged to DSM-5 preparation.

When MGH psychiatrist Joseph Biederman was found guilty of violating conflict of interest rules in accepting large amounts of money from the pharmaceutical industry, the news was announced on July 2nd 2011, a Saturday of a holiday weekend. A number of bloggers suggested that this timing was deliberate: an effort to bury the story.

Some may suggest that the weekend DSMV vote and lack of media coverage is related to the power of the APA and big pharma to squash controversy. For the sake of children, families and adults who struggle with mental illness, I hope that there is a more benign explanation.

Using media to promote change while celebrating Brazeltons 95th

I had the privilege this week to participate in the 95th birthday celebration of pediatrician T. Berry Brazelton on the occasion of  the  annual Touchpoints National Forum.    I even got to sit at the table with Dr. Brazelton for the birthday lunch!  We watched a wonderful animated video about his life, created by Exceptional Minds, an animation studio for young adults on the autism spectrum. We listened to songs written about and for Dr. Brazelton, sang "Happy Birthday" and shared birthday cake.

I had been invited by Kevin Nugent, director of the Brazelton Institute, to present at a workshop entitled "Can we Use Media to Support Parents?"Much to my delight, Dr. Brazelton attended our workshop. One of my co-presenters was Lisa McElaney, president of Vida Health Communications. I learned from her about a brilliant evidence-based program called All Babies Cry, a collection of DVD's produced with the aim of preventing child abuse in infancy.  Dr. Brazelton was fully engaged and enthusiastic, asking probing questions.

Recently Dr. Brazelton was presented with the  Presidential Citizen's Medal by President Obama.  The essence of Dr. Brazelton's gift is his tremendous respect for children, parents and the people he works with. His Neonatal Behavior Assessment Scale brought to light a newborn baby's  extraordinary capacity for communication. In his work with parents he brings a nonjudgmental strength-based approach to his interactions.  Respectful listening among colleagues is central.

At first I wasn't sure what direction to take with my presentation. Unlike my fellow presenters, I am not a media professional. But then I realized that it gave me a wonderful opportunity to think about why I write for the media.  Just five years ago, I was simply a small town doc in Western Massachusetts.

As I reviewed the events of these five years, I saw that an overarching goal of all of my writing is perfectly aligned with the work of Dr. Brazelton. My aim is to promote a stance of listening with nonjudgmental curiosity. That includes listening to children and to parents, as well listening as among professionals who may approach work with children and families from different paradigms.

As part of my presentation, I told stories about pieces I have written that aim to crossing paradigms and  promote new ways of thinking. It all started with my first op-ed piece for the Globe in 2008, provocatively titled Mind Altering Drugs and the Problem Child, in the wake of the explosion of diagnosis of bipolar disorder in young children.  Continuing as a blogger for Boston.com, I had a similar aim with posts such as Diagnosing ADHD under Age 6: A Mistaken Idea, Could Sensory Processing Disorder be the Primary Problem?, and even The Poop Wars: Why Miralax is Just a Bandaid.

It was a thrill of a lifetime to share this celebration with Dr. Brazelton and then to be able to present my work to him. He is a great model and a true inspiration.