Decolonizing psychiatric diagnosis: Turning the Diagnostic and Statistical Manual of Mental Disorders on its head

The conception of this article came to us at the end of a land-based healing program informed by Indigenous approaches to wellness. In this article, we dismantle psychiatric diagnosis, particularly the Diagnostic and Statistical Manual of Mental Disorders (DSM). Drawing on Frantz Fanon's notion of sociodiagnosics, we put DSM diagnostic categories under a sociogenic microscope. We assert that the DSM and psychologizing discourses are cultural products born out of coloniality, which continue to serve as tools for the subjugation of iyiniwak (Indigenous peoples), a phenomenon termed psycholonization. After setting our intentions and describing Fanon's sociodiagnostics, we will examine various disorders and symptomatology from a decolonial lens. By using the very language of the DSM, we make visible and "diagnose" the colonial logics and ideologies inherent in these categories. This includes addiction to, and obsessions with, excessive material wealth and power, which has justified the dispossession of iyiniwak land and now is causing a climate crisis that threatens humanity and all our relations. We assert that these colonial logics and ideologies are pathogenic not only for iyiniwak but also for settlers and all people. In the second section, we recenter vastly different worldviews that underpin Indigenous approaches to "assessment" and "diagnosis," including a nonlinear understanding of time, listening to and engaging wisdoms, and the acknowledgment of diversity and divergence as a given that is celebrated and honored. We end this article by addressing the importance of conceptual humility to rectify epistemic violence that is at the core of jagged diagnostic worldviews colliding. (PsycInfo Database Record (c) 2025 APA, all rights reserved).