The conflict over true causes of mental illness
THE Critical Psychiatry Network (CPN) is an association of British psychiatrists who caution against the over-medicalisation of mental ill-health and reliance on psychoactive medicines.
“Critical psychiatry offers a critique of the now widely-accepted view that mental illness is a brain disease, consisting of a chemical imbalance or other specific abnormality, and that this abnormality can be effectively treated with prescribed drugs,” the organisation said earlier this year.
“There is no evidence that people with depression have any specific abnormality. There is no evidence antidepressants ‘work’ by correcting this hypothetical abnormality.”
It too roots mental illness in social factors and causes. “The problem with looking at mental disorders as if they were a sub-species of physical illness is ... it obscures the role social problems such as poverty, insecure employment, precarious housing, social isolation and loneliness play in the genesis and perpetuation of mental health difficulties.”
Dr Derek Tracy, of the Royal College of Psychiatrists, says there is nothing wrong with the idea that trying to get to grips with people’s past life is important. But the widely-recognised diagnoses do help many patients, he says.
“Psychiatrists appreciate that no diagnostic tool can be perfect, but a diagnosis allows many people to better understand their mental health problems as well as help guide the treatment they receive.
“Psychiatrists are trained to look beyond the diagnosis to explore wider and deeper factors important in a person’s life, to help aid their recovery in a holistic way.”
Jo McFarlane, who has suffered from mental health problems, recognises many patients are among those who may feel uneasy about the an attempt to change the way things are done. “People can become very ‘attached’ to their diagnosis,” she says.
This is understandable, she says, because of the stigma which sees mental health as binary – if it isn’t your brain chemistry that is causing problems it is your own behaviour: so-called ‘blame’ or ‘brain’.
“People feel ‘if what I have isn’t an illness it will be seen as my fault’. But it isn’t that, it’s about putting it in the context of what happened to them, their life stories.”
She says no-one is denying the pain people like herself have suffered. “I’ve had multiple suicide attempts,” she says. “That distress is very real. It is life-threatening. But I no longer believe it is a medical condition.
“This is the elephant in the room. There are vested interests at play. Governments are happy with the status quo too. After all, if someone is bipolar, wouldn’t it be better if that was about brain chemistry, rather than poverty, austerity and neglect?”