Anti-psychiatry in 2019, and why it matters

Abstract

AIM: To describe recent trends in the publication of material hostile to psychiatry, and to consider implications for psychiatric practice. METHOD: Using a standard definition of anti-psychiatry (opinion hostile to the practice of psychiatry, typically emphasising social causation and challenging the legitimacy of psychiatry as a medical specialty), relevant themes were identified from within our own discipline, and elsewhere in the academic health and social science literature (1). RESULTS: A key example was chosen for analysis, namely the 2017 Report of the UN Special Rapporteur (2). The Report repeatedly challenges biomedical psychiatry, describes the medical model as “ineffective and harmful" and, remarkably, appears to regard it as a primary cause of human rights abuse faced by the mentally ill. These arguments align with those of the global anti-psychiatry movement, elements of which are well represented among those endorsing the Report; an RANZCP Fellow makes the astonishing claims that the psychiatric profession regards all mental illness as biological and that the biomedical model of mental illness “doesn’t exist” (3). CONCLUSION: Because of its manifest bias against the conceptual and therapeutic role of biomedicine, the 2017 Special Rapporteur’s Report fails to provide the balance and leadership required to address the vast global burden of untreated mental illness. By advocating demedicalisation, such anti-psychiatric rhetoric threatens to undermine effective patient care, notably including necessary compulsory treatment. In contrast to its claims, anti-psychiatry can reinforce stigma, compounding its risks to those experiencing mental distress. REFERENCES: 1. Dharmawardene V, Menkes DB (2019) Responding to the UN Special Rapporteur's anti- psychiatry bias. ANZJP 53:282-283 2. UN Human Rights Council (2017) Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. Available at: http://ap.ohchr.org/documents/dpage_e.aspx?si=A/HRC/34/32 3. McLaren Nhttps://www.ncbi.nlm.nih.gov/pubmed/30873843 (2019) Criticizing psychiatry is not 'antipsychiatry'. ANZJP. Epub ahead of print 15 March