July 10, 2013

The Diagnostic and Statistical Manual of Mental Disorders, or DSM, is often referred to as psychiatry’s Bible; it is the authoritative text used by North American psychiatrists and psychologists to diagnose mental illness. At the end of May 2013 the version of the DSM previously in use, the DSM-IV, was replaced by the DSM-5, the first entirely new edition of the DSM in nearly 20 years. New diagnostic definitions and new disorders included in the DSM-5 could significantly influence legal determinations relevant to the workplace, e.g. who is considered to have a disability under human rights legislation and who is entitled to workers’ compensation or disability insurance benefits. In this session, Dr. Perry Sirota, a prominent forensic psychologist, will explain the changes to the DSM, and leading labour lawyers will discuss how these changes may affect your workplace.

    • The DSM and workplace law: How important is the DSM to workplace law in Canada? What workplace legislation explicitly references it? How heavily do adjudicators rely on the DSM when making legal determinations? Is the clinical diagnosis of a DSM mental disorder sufficient to establish a disability under human rights legislation? Entitlement to workers’ compensation benefits, short-term disability benefits or long-term disability benefits? To what extent do adjudicators rely on DSM diagnoses to determine whether a worker should be awarded mental distress damages? Has the DSM been found to be a useful tool in determining whether an employee with a disability, for example, an addiction, should be disciplined for misconduct? What about determining whether someone has the mental capacity to sign a release?
    • Introduction to the DSM-5: Who is qualified to diagnose individuals with mental disorders using the guidelines in the DSM? Do these professionals need further training before using the DSM-5? Has the DSM-5 been simplified or does the DSM-5 add complexity that may lead to the over-diagnosis of mental disorders? How much merit is there to the criticism that some criteria are unduly vague or subjective? How has the DSM-5 changed the general definition of mental disorder? What are some of the major changes to the criteria for diagnosing already recognized disorders such as Major Depressive Disorder and Generalized Anxiety Disorder? Are there any new disorders in the DSM-5? Are personality disorders treated differently in the DSM-5 than they were in the DSM-IV? Given that some diagnoses in the DSM-5 rely on certain cultural expectations, is the DSM-5 an appropriate tool for diagnosing all employees in Canada’s multi-cultural workplaces? Are there any competing guidelines to making mental health diagnoses accepted by the Canadian medical and psychological communities? Is it ever preferable to use these alternate guidelines?
    • Applying the DSM-5: Do references to “the most recent edition” of the DSM in workers’ compensation legislation in Alberta and British Columbia mean that, as of the publication of the DSM-5, diagnoses made with the DSM-IV have been superseded? Is there a transition period? Does the removal of the “bereavement exclusion” from the diagnostic definition of major depressive disorder mean that employers will have a duty under human rights legislation to accommodate employees whose sadness associated with a death in the family lasts longer than two weeks? Will the addition of Mild-Neurocognitive Disorder, which involves modest decline in cognitive function/memory, result in older workers more frequently seeking accommodation under human rights legislation?