There is no shortage of criticism about the loosening of boundaries in diagnosing mental illness and the role of the key classification document, the DSM, or the Diagnostic and Statistical Manual. A document that arose from a crisis in the legitimacy of the profession almost four decades ago in the United States now threatens to be the very cause of a similar crisis all over again after the release of its latest edition, DSM V.

Most psychiatrists in Australia do not take the document too seriously -- it is largely seen as something appropriate to satisfy insurance providers in the US. But my colleagues still use its labels when advising governments, courts or employers about disability, crime or compensation. Some include a footnote in their reports the DSM is an imperfect system that was never meant to be used for such broad purposes.