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