Psychiatric disability assessment: Clarification of problems

The cost of psychiatric disability is not only millions of dollars in benefits but, more important, an enormous amount of suffering and waste of life. In spite of the vastness of the problems, few psychiatrists have a sense of professional competence and most avoid this field. This avoidance is quite understandable considering the complexities, ambiguities, and downright frustration involved in psychiatric disability assessment, not to mention the problems of treatment. The object of this paper is not to tell the psychiatrist how to do a disability assessment, although a few suggestions are offered, but rather to clarify the nature of the anxiety-provoking questions asked of the psychiatrist. Once the psychiatrist understands the source of these anxieties his avoidance behavior may diminish and he may do more and better disability assessments. Once the quality of assessment improves, more rational and effective treatment plans will follow.