Institutional pressures in psychiatry

Lade Smith, outgoing President of the Royal College of Psychiatrists, has called on the UK government to address the “silent mental health pandemic” (see press release). The government has set up a review to examine what is driving rising demand (see previous post). The College, of course, emphasises the need for more funding, but doesn’t really talk about the need for change, apart from promoting the Community Mental Health Framework and neighbourhood hubs.

As I said in a previous post:-

The current Community Mental Health Framework for Adults and Older Adults to transform mental health services has been too non-specific in providing direction and there has been insufficient progress in its implementation. ... Community Mental Health Teams have become too large and need to be devolved so that there is one in every Primary Care Network (PCN). The PCN mental health teams also need to work alongside non-medical mental health hubs, one of which again should be in each PCN.

I’m not against increasing funding for services, but they do need to become more patient-centred. Psychiatry itself is partly responsible for the increased demand by fostering simplistic solutions to mental health problems. It misleads people about the nature of mental illness by encouraging them to see their problems in terms of brain abnormalities. There does need to be a change in the ideological position of psychiatry but Lade and the College don’t mention that in the press release.