Integrating Social Determinants of Health Into Clinical Formulations: The Need for a Biaxial System in the DSM and Psychiatry

Abstract

Although social determinants of health (SDOH) have a significant impact on health outcomes and many are already included among the "Other Conditions That May Be a Focus of Clinical Attention" in the DSM-5, general awareness of these codes and the importance of using them to communicate SDOH has not occurred. This Open Forum proposes that the DSM-5 adopt a biaxial system of assessment to enhance their consideration and reporting. A biaxial approach, the authors argue, when combined with financial incentives, will increase the likelihood of SDOH reporting and potentially improve care.

Keywords: Diagnosis/Classification (DSM); Electronic Health Record; Financing/Funding/Reimbursement; Insurance; Social Determinants of Health.