Intended for healthcare professionals

Rapid response to:


Parity of esteem between mental and physical health

BMJ 2014; 349 doi: (Published 14 November 2014) Cite this as: BMJ 2014;349:g6821

Rapid Response:

We agree that anti-psychotic medication has been implicated in a number of physical health problems (including obesity), and that biogenetic models of mental illness increase the desire for social distance. In preparing the editorial one of us interviewed the author of the paper cited by Dr Timimi [1]; both points are included in a longer article on parity [2].

We disagree that parity of esteem is a red herring. On the contrary, it has many useful applications. It allows focus on precisely the service provision that Dr. Timimi mentions, without getting bogged down in well-rehearsed, fractious ontological debates about what mental illness ‘is’. Instead, it allows us to ask: ‘what might parity look like in this or that situation, in this or that service?’ It entails minimal ontological commitments, alongside a desire to improve services and attitudes in ways that go beyond a simple injection of cash (welcome though that would be). Far from being polemicizing, ‘parity’ has the flexibility to unite people from different approaches – something that observers may feel is occasionally lacking in psychiatric debates [3].

1. Angermeyer MC, Holzinger A, Carta MG, Schomerus G. Biogenetic explanations and public acceptance of mental illness: systematic review of population studies. BJPsych 2011; 199: 367–372.

2. Parliamentary Office of Science and Technology. Parity of esteem for mental health. (in press).

3. Boyce N. Editorial: Duel Diagnosis. Lancet Psychiatry 2014 ; 1: 245.

Competing interests: Simon Wessely is president of the Royal College of Psychiatrists, which has an interest in parity of esteem.

09 December 2014
Chris Millard
Medical Humanities Postdoctoral Research Fellow
Simon Wessely
Queen Mary, University of London
School of History, Arts II, Queen Mary, University of London, N4 1ES