As I’ve journeyed through understanding just some of the issues around mental ill-health, various kind health and social care professionals have pointed me towards various books to increase my understanding. As a young PC I really didn’t think very hard about the “validity” or the efficacy of mental health treatments and interventions. One assumes that whilst there are constant debates about funding and equity, we nevertheless have a developed mental health system which is underpinned by universities engaged in research and that many of them are acknowledged to be at the forefront of international research in mental illness. My alma mater, Cardiff University undertake pioneering work in the Neuroscience and Mental Health Research Institute around bipolar disorder and dementia, amongst other things. Their patron is Stephen Fry, also an honorary fellow of the university, and there are various lectures and resources on the website that you will find extremely interesting.
And then someone told me about Professor Richard BENTALL: professor of psychology at the University of Liverpool. I sent off for two of his books – Madness Explained and Doctoring the Mind – and over the course of a few weeks, I ploughed through them. They very accessible books given that they come loaded with explanations about scientific research methods, genetics and psychology and I stopped studying science at 16. When I got to the end of them, I just started over and read them again before wondering, “Bloody hell – what if he’s right?!”
BENTALL makes a various claims, but a few I found utterly astounding, hence I had to read it more than once:
- That recovery from major mental health disorders may well be better in developing countries without the trappings of a developed mental health system;
- That the science upon which major claims are made about the efficacy of various treatments including anti-psychotics, anti-depressants and electro-convulsive therapies is often quite poor;
- That psychiatric treatment through drugs brings no long term benefits to patients and that short-term benefits can often be outweighed by side-effects.
He has also written the occasional article for the Guardian, most recently arguing that there is too much coercion in mental health care and he debated the validity and relevance of psychiatric classifications with Professor Nick CRADDOCK from Cardiff University following controversy about the soon-to-be-published DSM-5 – this is the Diagnostic and Statistical Manual from the American Psychiatric Association.
Here’s an obvious point: I haven’t got a barking clue whether Richard BENTALL is right or wrong; my GCSEs in maths, chemistry and biology do not take me far enough. But what I do know, is that the claims he’s making in his book could be tested – the data upon on which he makes them are available, the sources clearly referenced. When I read or listen to accounts predicated by psychiatrists of the ‘medical model’ of mental illness, I am usually left with more questions than I started with and I’m often left with the quandary that we take for granted the existence of distinct disease concepts based not upon an understanding of causes but by symptoms that we’ve grouped together and we go from there.
So I would like you to imagine I’m an eight year old and tell me: why is Richard BENTALL wrong? For that matter, why are the other authors and academics who’ve argued against psychiatric taxonomy wrong, like Allan HORWITZ who wrote “Creating Mental Illness“?
I’d love to learn more about this and the reason I’m interested, is that it strikes me as fundamentally linked to how our society responds to mental ill-health where overlaps occur with the criminal justice system – remember what Professor Jill PEAY said in Mental Health and Crime (2010) … professional work at the interface of mental health and criminal justice is amongst the most difficult that either set of professionals will do:
The arguments that BENTALL and several others put forward are challenging for the criminal justice system. We have a political preference and a social inclination to divert from justice offenders experiencing mental ill-health where this is not inconsistent with the protection of the public and based on assumptions about diagnosis, treatment and recovery. So what does it say about efficacy if the science that underpins this assumption is as poorly conceived as BENTALL claims; and what about equity to other offenders who were prosecuted for their actions because no medical model of social / legal deviance has translated them from the criminal justice paradigm to any other metaphysical sphere?
Just thinking out loud … and I’m not trying to focus on Professor BENTALL specifically: but to use him and his writings as a metaphor for the whole non-medical model argument. If someone thinks they’ve got it all wrong, please let me know why because with all the books thrown at me so far, it seems BENTALL’s argument about actually listening to people living with problems in the real world whilst rejecting much, but not everything, about the medical seems more sensible than anything else I’ve read.
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