The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) is the essential manual for any mental health professional. The DSM-IV manual is published by the American Psychiatric Association, and is used to streamline the way mental health professionals like psychiatrists, psychologists and therapists diagnose a mental health disorder in a child or an adult.

The DSM-IV is the manual which lists the currently accepted criteria for every possible mental disorder. The information the DSM-IV also includes a multitude of information on how to determine a mental health diagnosis. The DSM-IV includes information as to the known causes, symptoms, gender tendency, familial tendency, age of onset, and prognosis based on current treatment options.

The DSM-IV uses a multiple axis approach in diagnosing and determining the severity of a mental illness and how the mental illness is affecting all aspects of the patient’s life. In addition the multi-axis system helps mental health professionals and insurance companies decide the best course of treatment for the individual, and how the patient is responding to the current course of treatment.

The first axis is known as axis 1. In axis 1 mental health professionals list previous or current clinical diagnoses. These diagnoses may include depression, schizophrenia, and anxiety amongst many others.

The second axis or axis 2 is used to note any developmental issues, including personality disorders. Developmental issues which are often diagnosed early on during childhood include mental retardation and autism. While a personality disorder is one that has a longer history of symptoms, which include how an individual reacts to things in life or the world he or she lives. Some examples of personality disorders include paranoid, antisocial, and borderline personality.

Then in the third axis or axis 3, mental health professionals include any physical conditions that may have caused or exacerbated any of the patient’s axis I and II diagnoses. These include physical conditions such as a traumatic brain injury or organic brain syndrome which causes mental illness symptoms to worsen.

Axis 4 includes psychosocial stressors or situational issues such as death of a loved one, being fired or hired for a job, starting or graduating from college, unemployment issues, moving or buying a home, getting married or divorced. All these are situational stressors that can greatly impact any axis I and II diagnoses.

Finally in axis 5 mental health professionals use a GAF score or Global Assessment Functioning Scale to determine a number from 0 to 100 which helps determine to what degree a person is or is not functioning in the activities of daily living. The GAF score is determined for both the present time and the highest level within the previous year. For those under 18, the Children's Global Assessment Scale or C-GAS is used.

Anyone who has been evaluated by a mental health professional on an inpatient or outpatient basis should have been assessed on the multidimensional or multi-axial system. In essence the axis system helps mental health professionals understand how the person is functioning in his or her daily life at home, work, school or socially. Essentially the multi-axis system helps mental health professionals visualize an individual’s progression.

In addition the multi-axis system provides a smoother transition or continuity of care amongst various mental health professionals who are working many different levels in providing individualized care for the individual. If necessary, and if done properly the multi-dimensional axis system streamlines inpatient and outpatient care, and communication between the various medical and mental health professionals. Continuity of care is important to prevent missing or misdiagnosing the person seeking help.