Critical Psychiatry

Psychiatrists commonly suggest that patients diagnosed as mentally ill have a brain disorder. In particular, they may propose that mental disorder is a biochemical imbalance which can be corrected by psychotropic medication. This "biomedical model" of mental disorder is no more than a hypothesis. The consequence of such a hypothesis is that patients tend to be treated by physical methods.

Critical psychiatry repudiates the biomedical hypothesis. Instead it proposes attempting to understand mental health problems in personal and social contexts. Speculation about the biological basis of mental disorder does not add to that meaning. The biomedical model is so dominant in modern psychiatric practice that any criticism appears threatening. This is why it is important for psychiatrists to recognise that there has always been a strand of thinking in psychiatry that has not relied on the biomedical model.

The tendency to objectify the mentally ill can make psychiatry part of the problem rather than the solution to mental illness. Cultural critiques of psychiatry, such as those by RD Laing and Thomas Szasz, have been undermined by regarding them as anti-psychiatry. Critical psychiatry remains part of psychiatry and yet recognises its excesses. In particular, it does not seek to justify psychiatric practice by postulating brain pathology as the basis for mental illness.

Some of the best articles explaining the basis of Critical Psychiatry are only available on the internet. Links to four articles by David Kaiser are at http://www.critpsynet.freeuk.com/Kaiser.htm. They were originally published by Mental Health Infosource, an internet based continuing medical education resource.

The Critical Psychiatry Network was formed in Bradford in January 1999. Its website (http://www.criticalpsychiatry.co.uk) has links to various documents produced by the group and other information about critical psychiatry.




One of the strengths of the internet is that it provides a voice for marginalised groups like mental health users, who may find it difficult to get their views into print. User/survivor websites contain a spectrum of critical views from reformist to hardline opposition to psychiatry. For example, People Who (http://www.peoplewho.org/) is for people who experience mood swings, fear, voices and visions. It is produced by Sylia Caras, who is a user representative on the board of the World Federation for Mental Health.

The internet also provides an additional medium for those known through print publications. For example, the Thomas Szasz Cybercentre for Liberty and Responsibility (http://www.enabling.org/ia/szasz/) contains a wealth of resources about Thomas Szasz. Another example, is the site of the International Centre for the Study of Psychiatry and Psychology (http://www.breggin.com/) founded by Peter Breggin, author of Toxic Psychiatry.

The Critical Psychiatry Website (http://www.uea.ac.uk/~wp276/psychiatryanti.htm) provides resources to other sites and a selection of articles critical of psychiatry. It also gives information about e-groups and bulletin boards. There are links to a selection of psychiatric system survivor sites.