Friday, July 05, 2019

How should psychiatry respond to criticism?

Twitter conversation about the session yesterday at the Royal College of Psychiatrists (RCPsych) International Congress 2019 entitled 'The new anti-psychiatry: Responding to novel critiques on the legitimacy of psychiatry' (see previous post) has clarified for me that even though the session had a provocative title, there is a genuine issue about how psychiatry should respond to criticism. We shouldn't be surprised that psychiatry is controversial. The power to detain people against their will on the basis of their health or safety or for the protection of other people because of a mental disorder - criteria which may be open to interpretation - is bound to be challengeable, and safeguards are written into the legislation itself. So there will be people that argue for the total abolition of psychiatry (see eg. previous post).

Abolitionists may be the most extreme critics that psychiatry has to deal with. The nature of mental disorder itself is an issue. I have always argued that critical psychiatry arises out of mainstream psychiatry's tendency to reduce mental illness to brain disease. These are not new issues for psychiatry and were made particularly pertinent when disease was defined by physical pathology from the middle of the nineteenth century. We need more recognition that mental illness does not fit this model. The organiser and speakers in the RCPsych Congress session at least need to be thanked for getting this matter onto the RCPsych agenda, even if the title of the session may suggest a defensiveness, rather than the embracing of criticism.

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