Is postpsychiatry "a new direction for mental health" (1) or is it an
exercise in re-branding of the status quo of British psychiatry? Bracken
and Thomas use complex arguments to arrive at the viewpoint that mental
health problems often cannot be understood within a rigid
medical/biological model and that psychiatrists should consider
psychological, cultural and social factors, including context and meaning.
I would heartily endorse this and support their view that
psychiatrists who only work within a narrow biological framework can
disadvantage and alienate some users of mental health services. However, I
feel that their insights are hardly an earth-shattering revelation. The
vast majority of psychiatrists of my acquaintance realise the need to
understand "social and cultural contexts", place "ethics before
technology" and work to "minimise medical control of coercive
interventions". So is postpsychiatry that radical a departure from the way
most psychiatrists practice in this country, or is it any departure at
all?
The question of how much their individual practice differs from the
norm can be tested in three questions:
1. Do they ever use medication to ease service users' mental health
difficulties?
2. Do they ever admit service users to hospital?
3. Do they ever detain service users under the Mental Health Act?
If they do these things then I would argue that their position cannot
be so different from that of their colleagues and that postpsychiatry
offers little more than "conventional" psychiatry in Britain today because
there is little difference between them.
Or perhaps the psychiatrists I know are, unknowingly,
postpsychiatrists?
1. Postpsychiatry: a new direction for mental health. Patrick Bracken
and Philip Thomas
BMJ 2001; 322: 724-727
Rapid Response:
Is postpsychiatry so radical?
Is postpsychiatry "a new direction for mental health" (1) or is it an
exercise in re-branding of the status quo of British psychiatry? Bracken
and Thomas use complex arguments to arrive at the viewpoint that mental
health problems often cannot be understood within a rigid
medical/biological model and that psychiatrists should consider
psychological, cultural and social factors, including context and meaning.
I would heartily endorse this and support their view that
psychiatrists who only work within a narrow biological framework can
disadvantage and alienate some users of mental health services. However, I
feel that their insights are hardly an earth-shattering revelation. The
vast majority of psychiatrists of my acquaintance realise the need to
understand "social and cultural contexts", place "ethics before
technology" and work to "minimise medical control of coercive
interventions". So is postpsychiatry that radical a departure from the way
most psychiatrists practice in this country, or is it any departure at
all?
The question of how much their individual practice differs from the
norm can be tested in three questions:
1. Do they ever use medication to ease service users' mental health
difficulties?
2. Do they ever admit service users to hospital?
3. Do they ever detain service users under the Mental Health Act?
If they do these things then I would argue that their position cannot
be so different from that of their colleagues and that postpsychiatry
offers little more than "conventional" psychiatry in Britain today because
there is little difference between them.
Or perhaps the psychiatrists I know are, unknowingly,
postpsychiatrists?
1. Postpsychiatry: a new direction for mental health. Patrick Bracken
and Philip Thomas
BMJ 2001; 322: 724-727
Competing interests: No competing interests