... to think that psychiatry is a bit of a con ...?

[Rommell]

... hidebound as it is by cultural and societal norms. Yet it posits that the criteria it creates are truths as to who is 'well' and who is not. How can a person's mind, their psyche, their being be 'ill' anyway? Plus if it really were possible for a drug to produce 'correct' thinking, then the person who created it would be ruler of the world.

[PlentyOfPubeGardens]

I actually agree with her about the funding. Where I work (community setting) we are seeing people who are far more unwell / not coping / experiencing mental distress than just a couple of years ago when they would have been, if not in hospital, at least receiving a higher level of support than we can provide.

[candycoatedwaterdrops]

The heavy-duty ones certainly sedate, but how on earth can a pill work against what is called 'psychosis'?

Gosh, you are terribly ignorant. If you are genuinely interested and not just being goady, do research and you'll find out how anti-psychotics work.

[HarveySchlumpfenburger]

As a service user I agree with her about the funding too. And about the lack of permanent jobs.

Hugely difficult to build up any type of doctor/patient relationship when you never see the same psychiatrist twice. Our MHT only ever seem to employ locums. Not sure whether that's their choice or they can't get anyone to stay.

[70hoursaweekandcounting]

Ahhh Is mental illness an illness ? That old chestnut - have u read the work of Thomas Sasz ? - I think that anything that makes you function at a lesser level than you should be capable is an illness and therefor needs treatment

[neverthebride]

I can understand what your concerns are but psychiatry DOES change alongside wider societal and cultural beliefs.

What was considered a 'mental illness' a hundred years ago such as homosexuality are simply not seen as mental disorders now and that's because psychiatry developed ALONGSIDE society.

Many mistakes have been made in psychiatry in the past and yes, some are now but that doesn't make it an invalid branch of medicine. Our knowledge on many conditions develop over time and that goes for all branches of medicine.

Diagnosis, treatment and indeed general attitudes towards autism, ADHD and other developmental disorders are unrecognisable compared to what they were even 30 yrs ago - none of these can be 'confirmed' by physical testing either. They're diagnosed by a qualified individual using certain diagnostic criteria and expertise but no blood test or x-ray can confirm it. M.E was considered a psychological disorder until we found out it isn't. AIDS was a 'gay plague' till we discovered it wasn't, we thought you could catch it from sharing cutlery till we knew better.

There ARE discoveries in genetics every day which are identifying genetic markers for neurobiological disorders including mental illnesses. If it was all a fabrication by society or psychiatry itself, there would be no genetic evidence.

Absolutely, mistakes happen and misdiagnosis happens but to suggest psychiatry is 'just a con' is simply not a valid argument.

[BOFster]

I don't know about the statistics for the efficacy of medication in the case of schizophrenia, but I do know that my beloved school friend would not have lost her dad when her desperately-ill younger brother went off his meds and thought his parents were satanic imposters and attacked them with a kitchen knife.

I also very much agree with the psychiatrist who posted about the shockingly low funding for MH services: for some years now, it has been all about Couldn't Care Less In The Community, and the situation has deteriorated even further recently. There is something ridiculous like just six inpatient beds for the whole of the north west of England- I know more than one person who urgently needs that level of care and supervision, and dread the day of hearing the worst, because they simply aren't getting it.

[Nicola19]

I also work with mentally ill offenders in a secure hospital and i think Dinky is spot on in her post. Antipsychotics do seem to have low outcomes in trials but you know what? 100% of my 18 patients' lives are vastly improved by taking their medication regularly, without, things are intolerable for them due to paranoia, auditory hallucinations and other symptoms. Psychiatry all seems very real to me as a concept so i think i will continue to acknowledge the illnesses and prescribing the meds.

[Rommell]

neverthebride, yes, psychiatry changes the parameters according to changing social and cultural norms - that is the point. So what is said to be an illness now may not have been said to be an illness 100 years ago and vice versa. So is it an illness? And homosexuality was only quite recently removed from the DSM - in the 70s, I think 1971. This, as I said, makes me uneasy.

BOFster, yes those statistics are correct. 25% success rate. And then there's the side effects, which should not be minimised - they can be quite life-limiting. Also, is it really the medication working? As far as I can make out, prescription of mh drugs is an inexact science - would those people have got better anyway, given time? Because it does take a lot of time for the drugs to have an effect other than making one sleep all day. Re the move towards treating people in the community, although it was first introduced as a cost-saving measure, I think there is a lot to recommend it. Being an inpatient in a psych ward is a deeply traumatic experience, especially when one is told a dire prognosis of a life lived on medication, backed up by the very real threat of violence aka compulsion re that medication.

[Rommell]

^Antipsychotics do seem to have low outcomes in trials^

They have low outcomes in actual patients as well, and yet they are not only prescribed but forcibly administered in a setting that has more in common with a prison than a therapeutic environment, because psychiatrists say that someone is 'ill', not through doing a physical diagnosis but by talking to them and deciding that their thoughts and behaviour do not cohere with cultural and societal norms.

[Nicola19]

Oh, lordy be!

[Mitchy1nge]

well there's a lot of evidence for clozapine at least, isn't there

although I just asked someone how anti-psychotics work because I've sort of forgotten and he says they work by helping patients not to care

but nothing is particularly helpful for very entrenched delusions

[Nicola19]

'Physical diagnosis..'

Nope, don't know of any signs on physical examination for schizophrenia, ya got me there!

[Rommell]

Language too strong for you? I think that the phrase 'forcibly administered' is actually quite a mild descriptor for the act of six burly psych nurses pinning you to the floor, pulling your trousers and pants down and injecting you with a psychoactive substance against your will.

[Nicola19]

Fortunately it rarely gets to that point, OP, because many patients put their preference for antipsychotic treatment in their advance statements and are well invested in the need for their medication.

[NotTodayJosephine]

Phyciatrists are bloody clever and have studied for years and years and years.

First they have to study to become doctors which is 5 years hard work at Uni with non of the normal long holidays and short days that most Uni students have, then they have two years as a junior Doctor. Then to become a phyciatrists they do ANOTHER 6 years specialist training INFO HERE

...but, hey, what do they know they are too busy trying to con people.

[HarveySchlumpfenburger]

What do you think the options are instead of 'forcibly administering' a drug OP? Say in the case of someone who is a great risk of causing serious harm to themselves or other people because of paranoia or delusions. I'm not sure they are much better.

[PlentyOfPubeGardens]

It's worth remembering that nobody has an advance statement for the first time. Did that happen to you OP? If so I'm very sorry, it must have been extremely traumatic

[candycoatedwaterdrops]

Spent much time on a psychiatric ward lately, Rommell? What you described is VERY rare indeed. Staff are trained in de-escalation techniques that only fail when a person is incredibly unwell and an immediate risk of danger to themselves or others.

[BOFster]

I'm sure that the side-effects can indeed be very debilitating, but the drugs are very effective for some people who would otherwise be extremely ill and distressed: that's why people taking them are often so desperate to be well, and believe they no longer need their medication, that tragic consequences can ensue.

As I posted above, this contributed to my friend losing her dad, who died protecting her mum, and her sick brother, who was indefinitely detained as a result, in (I think) the same facility as Ian Brady. It would never have happened if his parents had had the medical support for him that they so urgently required.

[BOFster]

(I want to emphasise, however, that the vast majority of mentally ill people pose more of a threat to themselves than to other people, obviously. But leaving some mental illnesses unmedicated can have the most terrible consequences, nonetheless.)

[BOFster]

Oh, and I missed a word out in that longer post, sorry. But I have to stress that it is the combination of the drugs' efficacy (leading to complacency), plus the unpleasant side effects, PLUS reading twaddle like "psychaitry is bunkum", which contributes to some people coming off medication which is absolutely essential to their health.

That's why I feel it's irresponsible to state that psychaitry is abusive and fundamentally wrong-headed, when you know little of the medicine but are just over-simplifying sociological arguments: it can cost lives.

[Rommell]

BOFster, the incidence of violent crime committed by people with an mh diagnosis is actually slightly lower than the incidence in the general population. They are much more likely to be the victims of crime though. I am really sorry to hear about your friend's dad.

PlentyOfPubeGardens, thank you. I really appreciate that. I think I might sign out of this thread for the night though as I specifically did not want to talk about myself but to garner ideas and generate discussion. I will be back though so please do keep on talking to each other - I think, even with all of the noise there's been on here, some really interesting points has been made.

[BOFster]

I do realise that, Rommell, but I am still convinced that medication is immeasurably helpful for many people.

[exWifebeginsat40]

i am a mental health service user. i take anti-depressants and anti-psychotics.

they level my mood and most of the time i don't want to kill myself now. organic mental illness is a medical fact that cannot be glossed over with emotive language and scare tactics.

the big-pharma conspiracy theories do more harm than a thousand psychiatric diagnoses and therapy.

just my opinion. what would i know, eh? i'm under the chemical cosh.

except i'm not. i'm eternally grateful for medication and therapy that is keeping me alive.

[happybubblebrain]

Well done to the OP for starting this thread, it needs discussing as much as possible. Lives are at stake. Unfortunately, so are livelihoods, which I suspect is why her first threat was deleted.

Peter Gotzsche is my new hero. He says expertly everything I have belived for years now. Thanks for the link - PlentyOfPubeGardens. I think everyone should watch it through, he makes so many logical points.