The Power Threat Meaning Framework: An alternative to psychiatric diagnosis

Remarkable changes with farreaching implications are happening in mental health. Surprisingly though, most professionals, let alone service users, will be unaware of the extent to which the current diagnostic model is under threat.

The senior professionals who draw up the Diagnostic and Statistical Manual of Mental Disorders (DSM) have described the current system for describing people’s difficulties in terms like ‘schizophrenia’, ‘bipolar disorder’, ‘personality disorder’ and so on as ‘totally wrong, an absolute scientific nightmare’ (Belluck and Carey, 2013). Millions of dollars are being poured into developing alternative classification systems, such as the Research Domains Criteria Project (tinyurl.com/yckxl2wx).

However, while according to the New Scientist (2014) ‘Almost everyone agrees that the old system is no longer fit for purpose and that patients deserve better’, the development of a replacement, if and when it succeeds ‘…is going to be a long, slow process.’ In this context, a range of alternatives to diagnosis has emerged. They can perhaps be summarised as various ways of listening to people’s stories – stories that are often obscured by a diagnosis, and that very often involve trauma, abuse, neglect, poverty and discrimination.