DSM versus non-DSM diagnosis, Part 1.
In Canada the Mental Health System is based on two components, one is the DSM diagnosis and the other is the non-DSM diagnosis. DSM stands for Diagnostic and Statistical Manual of Mental Disorders. If an individual comes into contact with the Canadian Police Department and he/she has an official DSM diagnosis, then, depending on the severity of the crime, the police officers will make a decision. The decisions will be one of three options. First, if the crime is a violent and/or a sex crime – the individual with SMI (Serious Mental Illness) will go to jail, second is a middle of the road crime, in this case an individual with SMI will either go to jail or get taken to the Medical Emergency unit, third if the crime is a mild to low-level crime, then if the individual with SMI has family, friends and loved-ones to support him/her then the police officer may opt for psycho-social rehabilitation in the community, community services, referral to see his/her medical doctor to evaluate his/her current psychological state and/ or a full-release back into the community. A current day police officer in Canada has the ability to use his/her own sound judgements in deciding the fate of an individual with serious mental illness – to an extent. It is based on Police Judgement. A strong and very powerful tool in the Justice System in Canada today. It seems that within this ability to judge situations, the police officer would be rendered powerless over situations if he/she did not have this tool, and a police officer’s duty is to up-hold peace and public safety – hence to be in control versus being helpless.
In contrast to the official DSM diagnosed mentally ill individual is the non-diagnosed Mentally Ill individual. These are individuals would often fall through the cracks in Western society. If an individual has symptoms of Mental Illness, such as hallucinations, delusions and a loss of contact with reality – but who has never gone to see a psychiatrist, for whatever reason, this type of individual often finds him/herself without options. The police may recognize the symptoms of serious mental illness within the individual and the police may or may not opt to take the individual with serious mental illness, non-DSM diagnosed to see a medical doctor, however with a non-DSM diagnosis there is no guarantee that a doctor will see him or her. The Medical Model, like any system, is a pretty water-tight system, however the ideal nature of any system falls short when there are cut-backs, limited financial resources, not enough well-trained Mental Health specialists on staff and a vast demand and not enough Mental Health trained staff to help all the individuals (DSM diagnosed and non DSM diagnosed). As a result the most promising individuals, the individuals who are already DSM diagnosed seem to be receiving priority treatment. The current Canadian Mental Health system and the current Canadian Police Forces are both water-tight systems which I believe to be very congruent, transparent and very positive systems. On paper both systems seem to be the best method of care. It is in my opinion that even though both the Justice System and the Medical system seem to be good on paper, that there is some human components within these system flow-charts that render the idealism of both systems to be a false positive.
Written by Annuska van der Pol, BA, PDD-IMHA
Mental Health and Addictions Practitioner
TCM, P.O. Box 8825, Victoria, British Columbia, Canada
Photo,”Foggy Afternoon in Oak Bay,” Sept. 6th, 2013, Oak Bay Avenue / Monterey Avenue, Canada
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