9/30/2014

New book: A prescription for psychiatry

Thank you for the opportunity to bring my new book to your readers.

The idea that our more distressing emotions can best be understood as symptoms of physical illnesses is pervasive and seductive. But in my view it is also a myth, and a harmful one. In ‘A Prescription for Psychiatry’ I explain how our present approach to helping vulnerable people in acute emotional distress is severely hampered by old-fashioned, inhumane and fundamentally unscientific ideas about the nature and origins of mental health problems and argue that we need wholesale and radical change, not only in how we understand mental health problems, but also in how we design and commission mental health services.

I argue that we should turn from the diagnosis of illness and the pursuit of aetiology and instead identify and understand the causal mechanisms of operationally defined psychological phenomena. Our health services should sharply reduce our reliance on medication to address emotional distress. We should not look to medication to ‘cure’ or even ‘manage’ non-existent underlying ‘illnesses’. We must offer services that help people to help themselves and each other rather than disempowering them: services that facilitate personal ‘agency’ in psychological jargon. That means involving a wide range of community workers and psychologists in multidisciplinary teams, and promoting psychosocial rather than medical solutions. Where individual therapy is needed, effective, formulation-based (and therefore individually tailored) psychological therapies should be available to all. When people are in acute crisis, residential care may be needed, but this should not be seen as a medical issue. Since a ‘disease model’ is inappropriate, it is also inappropriate to care for people in hospital wards; a different model of care is needed.

Adopting this approach would result in a fundamental shift from a medical to a psychosocial focus.  It would see a move from hospital to residential social care and a substantial reduction in the prescription of medication. And because experiences of neglect, rejection and abuse are hugely important in the genesis of many problems, we need to redouble our efforts to address the underlying issues of abuse, discrimination and social inequity. This is an unequivocal call for a revolution in the way we conceptualise mental health and in how we provide services for people in distress. But I believe it’s a revolution that’s already underway.

A Prescription for Psychiatry: Why We Need a Whole New Approach to Mental Health and Wellbeing by Peter Kinderman (ISBN: 9781137408709) is published by Palgrave Macmillan.

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About me: I am professor of Clinical Psychology and Head of the Institute of Psychology, Health and Society at the University of Liverpool in the UK. In addition to this book, I have recently launched a free, online, open-access course exploring our understanding of mental health and well-being.

Follow me on Twitter as @peterkinderman




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