I have worked in what I have come to think of as the mental ill-health industry for approximately 20 years. First as a community based social worker and now in a national psychotherapy service.
Over these years I have worked in many different services and have experienced a lot both personally and professionally. I have grown increasingly sceptical and concerned that the mental ill health industry is doing way more harm than it can ever do good.
In my experience secondary care mental health services are absolutely dominated by the pseudoscientific and downright dangerous medical model as misapplied to mental health.
The medical model in physical medicine has been an unbelievably positive advance. However even here, where there are objective, measurable indications to help with diagnosis and treatment mistakes can still be made.
Despite decades of research running into the cost of multiple billions no such objective measurable tests are available for any of the DSM diagnoses except for some of the dementias.
Despite these glaring deficits in mental ill health services the people working within them often carry on as if it is not a problem and that diagnosis in mental ill health is the same as in physical medicine.
Each edition of the DSM has loosened and broadened the criteria for what constitutes ”diagnoses" we now see before us the ever-growing tendency for self-diagnosis that people are making about themselves and their families everyday.
Mental Ill health services also like to claim that they are"evidence-based" and this claim is made whether were talking about psychiatry or psychotherapy.
I would encourage anyone working in the sector to read all of William M Epstein’s books relating to psychotherapy including - the illusion of psychotherapy, psychotherapy as religion, and psychotherapy and the social clinic, soothing fictions. In addition read all of David Smails works and the Therapy Industry by Paul Maloney.
These and other authors and titles demonstrate clearly that the evidence base and research for psychotherapy is all extremely poor quality. Therefore the claims made by the psychotherapy industry pertaining to being evidenced base are false.
Given the power of cognitive biases and heuristics even when this information is brought to the attention of those working in services there is an inability to engage with the material and wilful blindness is also common place.
It always strikes me as contradictory that psychotherapists often encouraging their clients to question their own beliefs and assumptions are unable to take their own medicine.
I mention these elements in relation to Andrew Sculls excellent book desperate remedies because things simply have not changed.
Each generation whether it be psychotherapy or psychiatry looks back on previous generations, often with horror and wonders how could things have been so dangerous and destructive.
At the same time we look rather smugly at our own generation and what we currently perceive as a more solid grasp of science and evidence based medicine, when nothing could be further from the truth.
Both Smail and Epstein contextualise the mental health industry and look at its cultural role and how it essentially serves power. It does this in multiple ways and works very well in helping to obfuscate myriad cultural disorders while internalising these as personal disorder.
Andrew Sculls Book does a masterful job in terms of telling the history of mental ill health services with many fascinating threads leading to certain outcomes.
The history told is a one of horror, destruction and abuse of human beings, dressed up as professionalism.
I believe the generations to come will look back on this current paradigm of a pill for every ill and diagnostic fantasy as equally horrific and destructive.
We have a completely out of control tsunami of overprescribing of dangerous and largely ineffective psychiatric drugs. The Evidence base for these is thoroughly corrupted and captured by industry. Read Whitaker and Cosgrove psychiatry under the influence for more on this.
The mental ill health industry has worked very hard to create more customers for its products and has linked its nonsense labels to reasonable adjustments in the workplace, school and welfare benefits.
This means that people are incentivised to self identify as mentally ill or the softer and rather obvious and completely normal ‘neurodiversity’ to get some crumbs from the table or to feel some comfort grouping with others with the same labels.
This has helped to create and maintain an incredibly destructive feedback loop where people now covet the label and or drugs. The changes in work, school and welfare would be useful to everyone - work and school are clearly cultural disorders causing havoc for most people.
Research shows most people are either turned off at work or hate what they do, day in day out. School is a literal torture chamber for millions of kids and teachers. Mental ill Health services burn staff out left and right so there’s a good chance that the therapist sitting in front of you is also hanging by an ever thinning thread, pasting a face and sucking it up, until the mask slips and they are crushed.
I am tied to the system for my own financial needs and so I also offer this review by way of apology to all of those harmed by this industry. This sick system keeps us all locked into toxic and harmful jobs - Jobs appear to be an ultimate tyranny where we are controlling and harming each other to sustain ourselves in ever more precarious positions. As some has already pointed out we have value system disorders along with economic and political value system disorders.
The road to hell is indeed paved with good intentions.
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Spitzenrezensionen aus anderen Ländern
Bluecashmere.
'No psychiatric penicillin.'
Rezension aus dem Vereinigten Königreich vom 2. Mai 2022
Joe DiMiceli
A great book, but slow to arrive.
Rezension aus den Vereinigten Staaten vom 5. August 2023david e gordon
Terrific overview of the different approaches to serious mental illness and their defects
Rezension aus den Vereinigten Staaten vom 18. Juni 2022Michael Miner
Great scholarship. No stone left unturned.
Rezension aus den Vereinigten Staaten vom 3. Juli 2022