What these authors are at least partly reacting against are the reforms, such as so-called New Ways of Working, influenced by the previous National Director of Mental Health, Louis Appleby. In a recent interview, Appleby said "I get uneasy if it starts to sound as if doctors have a natural entitlement to a unique place in mental health care".
There were problems with New Ways of Working, such as not paying enough attention to the continuity between the new services created and a lack of proper emphasis on the expertise of mental health staff, not just medical staff. Department of Health policy has now moved on. However, I too, like Appleby, have concerns about Harrison, Bullmore et al's stance.
The danger is that their position could be seen as saying that psychiatrists are not concerned with the personal dimension, which is actually the primary element of mental health practice. It doesn't actually matter that, for example, non-psychiatrists prescribe medication or become approved clinicians under the Mental Health Act, as long as they are properly trained to do so. This is where the debate should focus.
By the way, before completing my university medical degrees, I first practiced medicine as a licentiate in medicine and surgery of the Society of Apothecaries, which could approve medical training in the UK until 2003. I had been sceptical about the value of medical training for mental health practice and gave up my medical training for 8 years before returning to complete it (see eg. a talk I gave some years ago). A patient-centred medical training is indispensible in modern mental health practice. The problem is that medical training is not always as patient-centred as it should be.
There were problems with New Ways of Working, such as not paying enough attention to the continuity between the new services created and a lack of proper emphasis on the expertise of mental health staff, not just medical staff. Department of Health policy has now moved on. However, I too, like Appleby, have concerns about Harrison, Bullmore et al's stance.
The danger is that their position could be seen as saying that psychiatrists are not concerned with the personal dimension, which is actually the primary element of mental health practice. It doesn't actually matter that, for example, non-psychiatrists prescribe medication or become approved clinicians under the Mental Health Act, as long as they are properly trained to do so. This is where the debate should focus.
By the way, before completing my university medical degrees, I first practiced medicine as a licentiate in medicine and surgery of the Society of Apothecaries, which could approve medical training in the UK until 2003. I had been sceptical about the value of medical training for mental health practice and gave up my medical training for 8 years before returning to complete it (see eg. a talk I gave some years ago). A patient-centred medical training is indispensible in modern mental health practice. The problem is that medical training is not always as patient-centred as it should be.
