Sunday, April 08, 2012

What kind of therapy is psychiatry in need of?

Editorial in The Lancet refers to press release from the American Psychiatric Association (APA) about recruitment to psychiatry, a subject which I have commented on in a previous post. It suggests that psychiatry needs to "realign itself as a key biomedical specialty at the heart of mental health", without explaining what it means by this. 

The APA medical director (who did not excel in his response to a hunger strike by survivors in 2003 - see my article) says that this is an exciting time for psychiatry because there have been "more scientific developments in the field than ever before". Of course there is plenty of scientific work going on in psychiatry but he might ignite more interest by questioning what it is really being achieved. Nor are APA promotional videos such as 'The faces of psychiatry' and 'Real psychiatry: Doctors in action' going to stimulate young doctors when they make such trite statements as mental illness is "a misnomer" as it is really brain disease and that mental illness is "no different from heart disease and  hypertension" without any discussion of the issues.


George Dawson, MD, DFAPA said...

I have been critical of this release and and two other articles by Ronald Pies in the Psychiatric Times. I have also listed what I see as a more reasonable road map. I think that there is a natural progression to the biomedical, but consciously moving toward it is not a solution. The evidence of course is that we have already moved through that iteration in the 1980s led by several academic centers. Some of those leaders at the time envisioned the field as peripheral consultation and hospital based. We now know that model is too restrictive.

The main problem with organized psychiatry is a complete lack of political savvy. The APA in particular is ineffective in terms of responding to political rhetoric. They are using a model where you can ignore your detractors and try to put out your own positive message. That works with antipsychiatry cults, but not when the critics are seemingly more legitimate.

The problem is compounded by the current political structure of the APA with an antiquated chain of command and a preference for academics who may be more immune to these issues than psychiatrists on the front line.

What medical student in his/her right mind would choose a specialty that is a routine target in the media? The APA does not seem to recognize that basic problem.

Anonymous said...

"That works with antipsychiatry cults, but not when the critics are seemingly more legitimate."

Seemingly???? Are you seemingly serious? Are you seemingly suggesting that ALL critics of psychiatry are not really legitimate, just seemingly so? I think you are seemingly an idiot. But that's just my seeming two cents.

Ben Mullings said...

The link to the press release mentioned is now broken. From what I gather, this is now the correct hyperlink (to the PDF version):

DBDouble said...

Thanks, Ben, link restored.