Breaking News! This Just In…..

To all of us who are concerned with the state of mental health recovery in this world, what follows is important and amazing news. I just found this as reported at I am shocked and saddened that this is not international news being reported by every media station worldwide.  I want more people to know about this, so I am reporting it and hope that others will follow.

National Institute of Mental Health abandoning the DSM

In a potentially seismic move, the National Institute of Mental Health – the world’s biggest mental health research funder, has announced only two weeks before the launch of the DSM-5diagnostic manual that it will be “re-orienting its research away from DSM categories”.

In the announcement, NIMH Director Thomas Insel says the DSM lacks validity and that “patients with mental disorders deserve better”.

This is something that will make very uncomfortable reading for the American Psychiatric Association as they trumpet what they claim is the ‘future of psychiatric diagnosis’ only two weeks before it hits the shelves.

As a result the NIMH will now be preferentially funding research that does not stick to DSM categories:

Going forward, we will be supporting research projects that look across current categories – or sub-divide current categories – to begin to develop a better system. What does this mean for applicants? Clinical trials might study all patients in a mood clinic rather than those meeting strict major depressive disorder criteria. Studies of biomarkers for “depression” might begin by looking across many disorders with anhedonia or emotional appraisal bias or psychomotor retardation to understand the circuitry underlying these symptoms. What does this mean for patients? We are committed to new and better treatments, but we feel this will only happen by developing a more precise diagnostic system.

As an alternative approach, Insel suggests the Research Domain Criteria (RDoC) project, which aims to uncover what it sees as the ‘component parts’ of psychological dysregulation by understanding difficulties in terms of cognitive, neural and genetic differences.

For example, difficulties with regulating the arousal system might be equally as involved in generating anxiety in PTSD as generating manic states in bipolar disorder.

Of course, this ‘component part’ approach is already a large part of mental health research but the RDoC project aims to combine this into a system that allows these to be mapped out and integrated.

It’s worth saying that this won’t be changing how psychiatrists treat their patients any time soon. DSM-style disorders will still be the order of the day, not least because a great deal of the evidence for the effectiveness of medication is based on giving people standard diagnoses.

It is also true to say that RDoC is currently little more than a plan at the moment – a bit like the Mars mission: you can see how it would be feasible but actually getting there seems a long way off. In fact, until now, the RDoC project has largely been considered to be an experimental project in thinking up alternative approaches.

The project was partly thought to be radical because it has many similarities to the approach taken by scientific critics of mainstream psychiatry who have argued for a symptom-based approach to understanding mental health difficulties that has often been rejected by the ‘diagnoses represent distinct diseases’ camp.

The NIMH has often been one of the most staunch supporters of the latter view, so the fact that it has put the RDoC front and centre is not only a slap in the face for the American Psychiatric Association and the DSM, it also heralds a massive change in how we might think of mental disorders in decades to come.
Link to NIMH announcement ‘Transforming Diagnosis’.


How Is One To Combat Mental Illness Stigma When Our Government Promotes It?

Pupazzo Rosso - Rot Schneeman - Red Snowman

Pupazzo Rosso – Rot Schneeman – Red Snowman (Photo credit: filippo doner)

Have you noticed the level of fear ramping up across our country? The collective cry across our media outlets to DO SOMETHING to prevent mass shootings by those who are mentally ill? The calls for earlier detection and treatment of those with mental illness? I have.

And it scares me. Don’t get me wrong…..I am all for earlier diagnosis and treatment for those of us who suffer from mental illness. I also am alarmed by the apparent increase in mass senseless shootings. But don’t we all know by now that statistics has shown consistently that those suffering with mental illness are NO MORE LIKELY to commit violent acts than members of our world that do not have mental illness? Aren’t we heading back to the Dark Ages by demonizing one group in our society?

Let’s get very honest here. There is good and bad in all of us. We are all a blend of two sides of the coin. Not one of us living on this planet is perfect. Can any of us truly say we have never told a lie? So to stigmatize one of us, we stigmatize all of us. There are people who have committed truly indescribable violent acts, and there will be in the future. But we MUST STOP focusing on the person as evil, and focus on the ACT itself. Hitler is described by many as pure evil, and he absolutely was behind one of the infamous crimes of all times, but I am willing to bet he also told a child he loved them. I say that not in support of the horrific acts he committed, but to point out that we all have some “good” in us.

So with this little rant aside now, I want to share a document with all of you I found on our US Federal Courts website. I am astounded at the level of impugned stigma it promoted. I would love to hear what you think, and if you found it as unsettling as I did.

What is mental health treatment in the federal
probation and pretrial services system?
Mental health treatment is a risk management tool
that helps U.S. probation and pretrial services
officers supervise, or monitor, defendants and
offenders in the community. Mental health
treatment may include such services as
psychological/psychiatric testing and individual,
family, or group counseling by a psychologist,
psychiatrist, or other licensed practitioner. It also
may include medication.
Who receives mental health treatment?
Mental health treatment is ordered either by the
U.S. district court or by the U.S. Parole
Commission as a condition of releasing individuals
under federal supervision to the community. These
persons either are on probation, parole, or
supervised release after being in prison, under
pretrial supervision while awaiting a court
appearance, or conditionally released after
incarceration at a Bureau of Prisons mental health
What is the purpose of mental health treatment?
Mental health treatment gives officers the means to
directly address the individual’s mental health
condition. For offenders under post-conviction
supervision, treatment helps officers enforce the
conditions imposed by the court or Parole
Commission, control the danger defendants and
offenders may pose to society, deter criminal
behavior, and promote law-abiding behavior. For
defendants under pretrial supervision, treatment
helps officers reasonably assure that these
persons appear in court and that society is
protected from potential harm.
When is a defendant or offender considered to be
suffering from a mental health disorder?
According to the Guide to Judiciary Policies and
Procedures, a defendant or offender is considered
to be suffering from some form of mental disease
or defect when the individual’s behavior or feelings
deviate so substantially from the norm as to indicate
disorganized thinking, perception, mood, orientation,
and memory. Mental health disease or defect may
range from the mildly maladaptive to the profoundly
psychotic and may result in unrealistic or aberrant
behavior, grossly impaired judgment, inability to
control impulses or to care for oneself or meet the
demands of daily life, loss of contact with reality, or
violence to oneself or others.
How do officers identify mentally disordered persons?
Individuals may come to the probation or pretrial
services office already diagnosed with a mental
disorder. Or, officers may identify these persons
through information in case files, interviews with the
individuals and their families and friends, or
consultation with mental health professionals.
How many mentally disordered persons do U.S.
probation and pretrial services officers supervise?
Currently, of the more than 98,000 persons under the
supervision of U.S. probation and pretrial services
officers, almost 9,000 are mentally disordered.
Although the number of mentally disordered
defendants and offenders under supervision is
relatively small, the persons in this particular group
can be especially challenging to supervise.
How is supervising these individuals difficult?
Compared to the average defendant or offender, the
mentally disordered person under supervision
routinely needs more intensive monitoring, is
potentially more dangerous, and often requires
specialized or individualized treatment. What these
individuals may suffer from ranges from anxiety and
depression to more serious disorders such as bipolar
disorder, schizophrenia, or pedophilia. Many of them
are dually diagnosed, having both mental health and
substance abuse problems. Because of the
complexity of these cases, the federal probation and
pretrial services system has designated some of its
officers as mental health specialists. More often
than not, these specialists have a background in
mental health and, in some cases, are licensed
clinical social workers or psychologists. The mental

health specialists are skilled in identifying mentally
disordered offenders, in brokering community
treatment services, and in working with treatment
What role do officers play in supervising mentally
disordered defendants and offenders?
The Guide to Judiciary Policies and Procedures
clearly sets forth officers’ duties to conduct
prerelease or presentence investigations for the
court and to supervise defendants and offenders in
the community. Officers play a crucial role in
assessing dangerousness and the risk defendants
and offenders may pose to themselves and others.
Fulfilling such responsibilities requires officers to
maintain knowledge of the persons under their
supervision, make correctional treatment available
to them, enforce the conditions of release imposed
by the court or Parole Commission, and report
violations of these conditions according to
established standards and procedures.
Who provides mental health treatment to
defendants and offenders?
Counselors, clinicians, and other professionals in
the community provide treatment under an
agreement with the United States courts. The
Director of the Administrative Office of the U.S.
Courts, under 18 U.S.C. § 3672, has the authority
to “contract with any appropriate public or private
agency or person for the detection of and care in
the community of . . . a person suffering from a
psychiatric disorder . . . .” Blanket purchase
agreements or purchase orders are awarded
through a competitive process. The officer serves
as coordinator of treatment services, matching the
defendant or offender with appropriate treatment
providers, monitoring the person’s progress in and
compliance with treatment, controlling procurement
funds, and overseeing the various treatment
What services do mental health contractors
No single treatment approach will help every
person who requires mental health treatment. To
be able to address defendants’ and offenders’
individual needs, officers must solicit for various
services, including:
& Psychological/psychiatric
evaluation and testing
& Individual, group, and family
• Sex offender-specific individual or
group therapy
& Psychosexual evaluations for sex
& Polygraph testing for sex offenders
& Substance abuse counseling
• Medication
& Transportation to and from
treatment facilities
& Emergency financial assistance for
food or clothing
& Clinical consultation between
officers and mental health
professionals to discuss
supervision issues
What are the benefits of mental health treatment?
Mental health treatment helps defendants and
offenders in many ways. It helps individuals address
issues that may have led to their problems with the
law. Treatment gives these individuals the tools to
handle life’s stresses and to function better in the
community. Treatment helps officers monitor the
danger defendants and offenders may pose to the
community and provides a way to ensure that
persons under supervision comply with the general
and the special conditions of release the court or
Parole Commission imposed.
What if treatment is not successful?
While officers may try various treatment approaches
and increasingly severe sanctions with mentally
disordered defendants and offenders, they may find it
necessary to initiate revocation proceedings if these
persons do not comply with the conditions of release.
Often, officers must initiate such proceedings
because these individuals pose a potential threat to
Federal Corrections and Supervision Division
Administrative Office of the U.S. Courts
September 2000