Difficulties of psychiatrists identifying with their profession

I’ve mentioned the 1996 article by David Kaiser ‘Against biologic psychiatry’ in a previous post. He described why he found it increasingly difficult for him as a psychiatrist to identify with his profession. Biologic psychiatry seems to have become even more dominant since then with the increasing overmedicalisation of psychiatry (see eg. previous post) and fragmentation and dysfunction of services (see eg. another previous post). Questioning biologic psychiatry’s beliefs and actions does not seem to have served as a wake-up call for psychiatry leading to very much change (see eg. yet another previous post). 

As Kaiser said:-

It seems to me that modern psychiatry is acting out a cultural fantasy having to do with the wish for an omniscient authority who, armed with modern science, will magically take away the suffering and pain inherent in existing as human beings, and that rather than refusing this projection (which psychoanalysts were better able to do), modern psychiatry has embraced the role wholeheartedly, reveling in its new-found power and cultural legitimacy.

Speaking out against biologic psychiatry’s ideology seems to be insufficient. Unless people themselves no longer wish to see their difficulties as biologic and are no longer interested in oversimplistic resolution of them by a pill or a bit of psychological therapy (see eg. previous post), then psychiatry will continue to exploit this situation for its own ends. 

Assessing the risks of psychotropic medication

The executive order establishing the US President’s Make America Healthy Again Commission has caused concern amongst leading psychiatric organisations because it proposes to assess the prevalence of and threat posed by the prescription of selective serotonin reuptake inhibitors (SSRIs), antipsychotics, mood stabilizers and stimulants  (see Psychiatric Times article). As far as these psychiatric organisations are concerned psychiatric drugs are safe, effective and can be life-saving (see joint statement). They urge the Federal Government not to disregard the critical role played by the appropriate use of evidence-based psychotropic medications in the treatment of individuals with psychiatric conditions that carry inherent high risks for suicide or other dangerous or life-threatening behaviors. 

At face value it seems difficult to see why the Commission should not give due consideration to the value of psychotropic medication. If such medications are so safe, effective and life-saving, why should an assessment of their risks cause such concern?

As I have said before, mainstream psychiatry will never accept that psychiatric medications are not effective (see eg. previous post). But it does need to acknowledge the limits and potential disadvantages and harms of such medication. Overstating the case for psychotropic medication is not necessarily in the interests of patients, even if it may suit the institution of psychiatry. Maybe only the politicians can effectively counter such institutional bias.