2. Yes, the best and most practical test we have is an EEG that, at best, tells you that something wonky is going on in this vague region of the brain. Good for seizure disorders, little else. The other tests we can run are to detect physiological causes of psychiatric symptoms external to the brain, like thyroid disorder, uremia, overdose, etc. Nobody sends a patient down for a routine fMRI. What tests are you referring to?
3. I'm not advocating to wait until we've achieved a complete understanding of the brain, but rather we explore more conservative managements while we get a better understanding of the mechanical workings on the brain. CBT, DBT, psychotherapy, etc, should be actively encouraged by psychiatrists as first-line options for many of these conditions. They simply aren't.
Unlike psychiatrists, I do not believe the DSM criteria can substitute for actual clinical diagnostic skills.
The reason for that is the complexity and uniqueness of projects (Does that study at IBM really apply to my small company? If this is a good way for NASA to make hardware, is it a good way to design android aps?). But also because engineers are focused on doing a job using a body of knowledge they draw from school, experience, and a bit of reading. They are not academic engineers. This is probably a good thing.
Similarly, I think doctors are not academic researchers. They apply treatment algorithms, bending them to the patients specific situation is so far as won't get them sued.
If the algorithm doesn't say EEG, then why would they believe they know better than the professors that signed off on it?
If the insurer requires a diagnosis, they will look in the DSM and find something they could justify at an inquest. Then they will treat the diagnosis, according to the algorithm, fitted to the patient.
I think doctoring has more defined procedures than engineering. These are not academics, and I think expecting them to be is based on an assumption that 'dr means phd'. It doesn't for medical people.
One data point? You're talking about the 'how are we going to treat our current patients' conferences? I've been in a couple of those myself, and you're expecting something weird from them. It'd be like spending the afternoon with engineers and saying "I didn't hear any of them mention any of the laws of thermodynamics!".
I've worked with engineers building hardware, both medical and agricultural, and much of their day-to-day work is based on their innate understanding of the tasks at hand. At critical points in the design process, they will break out their formulas, but when they're discussing the generalities of what to do with their colleagues, they're not citing canonical resources. What you're desiring is a fantasy world.
You can't run any diagnostic tests on patients.
As someone who spent several years as a neuro tech, this isn't true. Some things have some tests. It is a very difficult field of study - possibly the most difficult in all of human experience - and it's true that there isn't a great amount of test coverage over the whole field. But you're mischaracterising it to say there are no tests.
We need better mechanical and abstract understanding of the mind before we douse it in chemicals.
That's a nice throwaway line. You make it sound like the mind is an easy thing to understand, and that it won't take long. And apparently, until we have this complete understanding, we should just say 'fuck you' to the people who are currently in need of help?
Overuse of pharmaceuticals is a problem, but the answer isn't to run screaming into the absolutist opposite direction.