Dr Allen Frances was chair of the task force writing the DSM-IV, but subsequently became an outspoken critic of the rapid expansion of mental health diagnoses in DSM-5, and what he sees as the over medicalisation of behaviours that fall into the normal range of human life. Dr Frances offers a US perspective on issues such as treating ADHD and Autism, the pros and cons of early diagnosis, the appropriate role of drugs in mental health, and strategies to bring public mental health care to the greatest numbers of people.