Presenter: Dr. Colleen Martinez
View the webinar’s corresponding slide presentation here
Dr. Martinez discusses the history of the Diagnostic and Statistical Manual of Mental Disorders (DSM), and gives an overview of changes in the most recent version, the DSM 5. She discusses how clinicians use the DSM 5 to determine diagnosis, how diagnoses are used in treatment, as well as some limitations of DSM 5 diagnosis.
Comments(8)
KelleyT says:
March 16, 2017 at 11:00 amI’m an adult in therapy now, and I don’t know if my therapist has diagnosed me. How can I find out?
Colleen Martinez says:
March 17, 2017 at 2:03 pmAsk your therapist. Sometimes therapists are reluctant to talk to their clients about diagnosis because they don’t want the client to feel labeled or stigmatized. But, in reality, as I discussed in the webinar, if insurance is paying for your psychotherapy you have likely been diagnosed. I would suggest saying that you just learned about DSM diagnosis and you’d like to know if you have been diagnosed and if so, what is the diagnosis. This will be a good opportunity for you and your therapist to talk about how they came up with that diagnosis, and if you agree with their conclusion. Open, direct communication is healthy and can benefit your relationship, so you may find this conversation even helps your therapy process.
KelleyT says:
March 16, 2017 at 11:01 amI hope you can clarify something for me related to electronic medical record keeping. If you are depressed due to bereavement, seek psychiatric help and receive a DSM dx, does that dx automatically follow you to your primary care doc? Or would it only become part of your primary record if you provide the information?
Colleen Martinez says:
March 17, 2017 at 2:20 pmGood question! Any medical records, including mental health records, can only be shared with your consent. If you have not provided written or electronic permission to share information between providers, no information can be shared. If you have provided written, or electronic permission for a mental health professional to share your records with another provider, then your diagnosis will likely be shared.
Even if you have provided permission in the past, you can specify if and when you do not want information shared. That is your right. However, once providers have gotten your written permission, it is your responsibility to inform them if you change your mind.
Additionally, it is often helpful for this kind of information to be shared. We now know that depression can impact our physical functioning, and physical functioning can effect our mood, so it can be very helpful and appropriate to have this information shared among providers. Ultimately, however, the decision is yours and I encourage you to discuss your concerns about disclosure with your providers and definitely make them aware of your decision on sharing records.
Finally, this is made more complicated when you are seeking treatment from providers who work in systems. For example, some medical professionals work in groups with other specialists. When you sign consent forms for these providers, it is often in the fine print of the very long form you sign that they have your permission to share all of your records with other specialists in the group that treat you. Therefore, you may have given permission to share information among providers without really being aware of that. In the end, I suggest that if you have concerns about who has access to your mental health diagnosis, you should talk with your mental health provider. They can tell you about their policies and practices.
KelleyT says:
March 16, 2017 at 11:03 amAre the various categories in the DSM broken down related to the age of the patient?
Colleen Martinez says:
March 17, 2017 at 2:26 pmThe DSM IV-TR, the previous version of the DSM, did have a chapter on disorders first seen in childhood and adolescence. DSM 5 is organized differently, and now there is no such chapter. Now, chapters in the DSM are organized by similar symptoms, risk factors, and treatments. For example, there is a chapter on depressive disorders and a chapter on anxiety disorders. People of any age can meet the criteria for these disorders. The chapter on neurodevelopmental disorders may be frequently visited by clinicians who work with children, because ADHD and Autism Spectrum Disorder diagnoses are there, but these also may be diagnosed in adults.
KelleyT says:
March 16, 2017 at 11:58 amMy child has been diagnosed with a DSM disorder. Do I have to tell her school ?
Colleen Martinez says:
March 17, 2017 at 2:36 pmExcellent question, that I am glad you asked. The answer is no. You do not have to share information about your child’s mental health diagnosis at all. If you have obtained evaluation, diagnosis, or treatment for your child, you decide who has access to any of those records. I recommend that you talk with the clinician who made the diagnosis about the possible benefits and risks of sharing this information with your child’s school. It is often helpful for some school staff to be aware of a student’s mental health issues. However, there may be times when you do not want information shared. This decision should be made by you and the clinician. Depending on your child’s age, it may also be helpful to get their input.
However, if a school district has contracted or paid for the evaluation, diagnosis, or treatment of your child, the district may have the right to access some information. If this is the case, I encourage you to ask the clinician what information they will share.