This article examines problems in the clinical utility of the diagnosis of schizophrenia including reliance on questionable data, arbitrary criteria and categorization, inadequate precision for assessment and treatment evaluation, and omission of information on causal current and historical environmental factors. Some alternatives to the "Diagnostic and Statistical Manual of Mental Disorders", fifth edition ("DSM-5") are briefly considered including continuous recording of individual client's specific problems and goals, and functional assessments and functional analyses. The article discusses how biomedical assumptions implicit in the DSM-5 diverts mental health workers' attention from social adversity factors contributing to the development of psychotic behavior and available psychosocial interventions for this disorder, thereby perpetuating biomedical dominance of mental health services.