A new version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders has come out every decade or so (it varies widely) since 1952. It hasn’t substantially changed since 1994, but the next revision is slated to come out in 2013. It’s a pretty big event, as the book’s diagnostic criteria are used around the world to determine who is diagnosed with mental disorders.
“Anything you put in that book, any little change you make, has huge implications not only for psychiatry but for pharmaceutical marketing, research, for the legal system, for who’s considered to be normal or not, for who’s considered disabled,” said Dr. Michael First, a professor of psychiatry at Columbia University who edited the fourth edition of the manual but is not involved in the fifth.
“And it has huge implications for stigma,” Dr. First continued, “because the more disorders you put in, the more people get labels, and the higher the risk that some get inappropriate treatment.”
Clark Kauffman of the Des Moines Register reports on the allegations of abuse and regulatory failures at “a network of labor camps staffed by mentally retarded men.” Henry’s Turkey Service was run by a Texas family who “deployed at least 600 mentally disabled men to nine bunkhouses in six states.” After connecting it with an operation shuttered by regulators in tiny Atalissa, Iowa, Kauffman visited the family’s last such bunkhouse, deep in rural Texas.
He also looks at the history and regulatory failures around the bunkhouse in Atalissa. When it was closed, “many Iowa officials expressed amazement that a labor camp made up of disabled men had somehow managed to escape government oversight and public notice” but Kauffman’s review of government and corporate records shows that many of the agencies were fully aware of its existence for years. He reports that some agencies refused to investigate because they didn’t think they had jurisdiction, some documented violations but didn’t take action and other agencies “simply failed to share valuable information with others who might have been willing to act.”