Frank Blankenship comments on Mad in America about my previous post on "Psychiatry as a cultural system". He suggests there's a simpler explanation for why psychiatrists are resistant to giving up the biomedical model than because it's like a religion - they'd be out of a job!
I do understand his view. I too was schooled in the biomedical perspective that mental illness is brain disease. It's such an ingrained perception in society that people don't think to challenge it. Medical training reinforces this indoctrination (eg. see previous post and my Lancet Psychiatry letter).
I also agree that psychiatrists are worried that non-medical professionals are taking over their job (eg. see previous post). This fear encourages them to adopt a biomedical model by focusing on "what doctors do best".
However, where I disagree is that it is important to remember that medicine is psychosocial as well as biological, if only to ensure that practice is patient-centred. It's not purely a bodily exercise. Even more so, patients go to doctors with physical symptoms which have a psychological origin. Medicine has to adopt a sociopsychobiological approach to provide an integrated perspective in practice (see previous post).
I've also mentioned before my disagreement with Peter Kinderman, who has argued that mental health care should
actually be non-medical, as it is not treating 'illness' as we understand it (see previous post).
From his point of view, doctors should concentrate on the biological aspects of
mental health care and this should be seen as a minority activity within the
field as most psychiatric presentations are psychosocial, not biomedical, in
origin. By contrast, Peter Sedgwick, in the same way as I have been saying, would have regarded Peter's position as
‘psycho-medical dualism’, because psychosocial approaches should not be
separated too much from medicine. Sedgwick adopted a unitary concept of
illness, beneath which is subsumed both physical and mental aspects (Cresswell & Spandler, 2009).
Conceptual conflict exists about the nature of mental illness and this is as
much of an issue for psychiatrists as it is for specialists from other
mental health disciplines. Merely putting psychiatrists out of a job won't solve this dilemma. And, medicine needs the specialty of psychiatry.