Are kindly and efficacious mental health services possible?

Prof. David Pilgrim writes (in the Journal of Mental Health):

“The above question was explored by Peter Sedgwick in his classic text PsychoPolitics at the very moment when ‘anti-psychiatry’ was giving way to ‘critical psychiatry’ and the emergence of a New Social Movement of disaffected patients (Sedgwick, 1982). Although he expressed many reservations about the excesses of those hostile to orthodox psychiatric theory and practice, he also largely sympathised with the reasons for their concerns (Pilgrim, 2016). For those of us who have been around these debates for decades, it sometimes feels as though little if anything has really changed.

I am reminded of the film Groundhog Day, as we go round and round the same block about service quality. I think that what we mean by a ‘good mental health service’ comes down to several foundational points of contention, such as the scientific legitimacy of psychiatric diagnosis, the cost-effectiveness of routinized medicinal psychiatry, the desirability of recovery and the recurring matter of the coercive social control of troubling conduct by those who are sane by common consent.

Mental health professionals offer a service to whom and about what? An inherent problem for services is that they are trying to reconcile different interests in society. Sometimes, these are synergistic but at times they are not. The right of some people to act unintelligibly, without constraint and the right of others to remove them from society is an example. Mental health services regularly consider the expressed needs of identified patients and their significant others and the general public and so this organisational challenge is enormous …”

You can read more here.

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