Has critical psychiatry failed?

The Critical Psychiatry Network (CPN) was formed in 1999 (see eg. my editorial). The Royal College of Psychiatrists has rejected its application three times to be a special interest group of the college. CPN argues that the wish to find a physicalist basis for primary mental illness is damaging psychiatry (see eg. my article). That’s not always a message most psychiatrists want to hear. They tend to think neuroscience has made major advances which are helping the understanding of mental illness, even though most mental illnesses do not have a neurological cause. There is of course a reason why psychiatry is a separate speciality from neurology. Despite the best efforts of CPN, mainstream psychiatry unfortunately still tends to rely too much on unfounded speculations about the nature of mental illness. It needs to move on from the wish to create a physical disease model of mental illness.

I actually think that institutional psychiatry does not really want to change (see eg. previous post and another). It is more focused on obtaining more money for services than changing its way of thinking about how to do psychiatry (see another previous post). In this sense, critical psychiatry could be said to have failed, as in many respects psychiatry has only become even more biomedical over recent years. Just take child and adolescent psychiatry as an example, where when I first trained medication was hardly used (see eg. yet another previous post). 

Mainstream psychiatry likes to make out that CPN’s criticisms are not quite as damaging as it suggests because it is broader than just taking a biomedical perspective. It will often suggest that its approach is biopsychosocial rather than biomedical. But seeing biological, psychological and social as all more or less equally relevant in all cases and at all times is an ill-defined basis for practice. What matters more is trying to understand the reasons for mental health problems rather than blaming underlying brain processes (see eg. previous post). The message patients tend to hear from psychiatry is that a psychiatric diagnosis means there is something wrong with their brain. Psychiatry needs to change to be explicit that for the vast majority of psychiatric presentations that is simply not the case.