Category: psychiatry

04 May

21 Comments

Paradigms lost: NIMH, McGorry & DSM-5’s failure

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Prozac

In a couple of weeks I will be in San Francisco for the American Psychiatric Association’s annual meeting, at which the latest edition of the APA’s diagnostic “bible”, the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5, will be released. From the look of the program, you’d think this is much like when previous versions were released — gathered delegates will get to hear lots of explanation of how the manual will work, how it was developed, and what evidence was used to validate diagnoses. There are very few papers that could be considered even remotely dissenting. Continue Reading

Filed Under: Featured, psychiatry

17 Jun

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Allen Frances speaking on psychiatric overdiagnosis this Tuesday in Sydney

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Professor Allen Frances, head of the American Psychiatric Association’s DSM-IV project in the 1990s, has become the most prominent psychiatric critic of the DSM-5. He has written for a wide range of mainstream publications on this topic (including The New York Times) and has a regular blog at Psychology Today called DSM-5 In Distress, to which I contributed last year.

He’s currently visiting Australia and was interviewed in yesterday’s Sydney Morning Herald on the controversy over psychiatric diagnosis of toddlers.

He’ll be speaking in Sydney on Tuesday night at the Garvan Institute of Medical Research in Darlinghurst, at an event organised by St Vincent’s Hospital. RSVP to MentalHealth@stvincents.com.au to ensure a seat. Entry is by gold coin donation. More details are on the flyer below.

He will also be speaking on “paranoid parenting” at a dinner/talk event the next night, with details here.

Filed Under: Featured, psychiatry

10 May

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A Dangerous Method: Cronenberg, psychoanalysis and science

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David Cronenberg

Film review cross-posted from our Overland blog.

A lot has been written about David Cronenberg’s masterful A Dangerous Method (2011) in terms of what it tells us about the strengths and weaknesses of the psychoanalytic movement, about the growing conflict and eventual rupture between Sigmund Freud (Viggo Mortensen) and Carl Jung (Michael Fassbender), and about therapist-patient relationships that go wrong. Does the film’s title refer simply to the then- (and still-) controversial ‘talking cure’, or perhaps to how Freud and Jung saw each other’s divergent ideas, or to Jung’s transgression in developing a sexual relationship with analysand Sabina Spielrein (Keira Knightley)?

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Filed Under: Featured, psychiatry, science

08 Dec

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Breivik update: Politics, terrorism and psychiatry

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Candle-lit vigil in Oslo, soon after the 22 July massacre

Since my last piece for The Drum, the IPA’s Chris Berg has produced an attack on our book, On Utøya: Anders Breivik, Right Terror, Racism and Europe. We haven’t formally responded, but many of the comments below his article deal with his frankly desperate and unconvincing attempt to exonerate the Islamophobic and anti-multicultural Right from creating the context in which far Right violence is more likely.

In the meantime I was asked to write a short piece about the Breivik diagnosis for weekly medical industry paper Psychiatry Update. I’m reposting here as it includes newly available detail about the psychiatric report, and because Psychiatry Update is only available to registered healthcare practitioners (you can follow its tweet stream here: @PsychUpdate).

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Filed Under: fascism, psychiatry

03 Dec

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The Breivik diagnosis: Fascist ideology wrapped in a straitjacket, political implications denied

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Comments now closed on this article at The Drum, so reposting here for your commenting pleasure!

Two court-appointed psychiatrists have found confessed Norwegian mass murderer Anders Breivik legally insane and unfit to stand trial. The full text of their 243 page report is yet to be released, but if public statements are representative of its contents, there is good reason to suspect their assessment may tell us more about the socially embedded nature of psychiatric diagnosis and the prevailing political climate in Norway than any claim it was the result of some kind of cold, hard, value-free science.

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Filed Under: fascism, psychiatry

30 Nov

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Rewind: Depoliticising Utoya — Anders Breivik as ‘madman’

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It was not entirely unexpected that two prosecution-appointed psychiatrists would find Norwegian fascist mass murderer Anders Breivik insane and unfit to stand trial, diagnosing him with Paranoid Schizophrenia. The diagnosis — so far only backed by a few, unconvincing details from their as-yet unreleased report — runs counter to the voluminous information, available in the public domain, about Breivik and his belief system, including his notorious Manifesto 2083.

I am writing an initial response for ABC’s The Drum, which will probably be online tomorrow. In the meantime, here is an essay abridged from the e-book On Utoya: Anders Breivik, right terror, racism and Europe, which originally appeared on The Drum last month. The e-book was edited by Elizabeth Humphrys, Guy Rundle and myself, published in late October, and is available for download from Amazon here.

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Filed Under: fascism, psychiatry

24 Sep

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The McGorry-Hickie reform controversy: Why has mental health become so political?

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Yesterday one of Australia’s most prominent psychiatrists, Professor Ian Hickie, wrote an op-ed piece in the SMH titled, “Ignore the critics, public need to back fresh start in mental healthcare”. It is part of a growing controversy around the Gillard government’s apparent big boost to mental health funding in this year’s Budget, in particular around the adoption of the Headspace model of youth early intervention and the downsizing of the Better Access psychology scheme.

In response I wrote this letter to the editor (second one here):

Filed Under: health, psychiatry

09 Nov

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Beyond anti-psychiatry? The politics of mental illness

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Me in today’s Overland Journal blog, on the crisis in psychiatry:

Biological psychiatry is currently facing pervasive challenges to its hegemony. Mental illness has gained massive recognition and medical treatments for such disorders are virtually ubiquitous. At the same time, the field is beset by scandals around kickbacks from drug companies, embroiled in divisive arguments over its diagnostic bible (the DSM-V) and finding it ever harder to provide conclusive scientific proof of its effectiveness. The psychiatric profession is facing a crisis of confidence bigger than at the height of the antipsychiatry movements of the 1960s and 70s.

In the middle of this comes a compelling critique of some of psychiatry’s key claims by Richard Bentall, a UK clinical psychologist working within the NHS. In Doctoring The Mind: Why Psychiatric Treatments Fail, Bentall provides a lucid and accessible account of the meagre successes and substantial failures of psychiatry, following on from his earlier Madness Explained. Unlike many critics of the discipline, he remains committed to a scientific understanding, which he calls ‘rational antipsychiatry’.

Filed Under: health, psychiatry

19 Oct

5 Comments

NSW government takes rights of mentally ill patients backwards

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My article from Monday’s Crikey. The scary part was finding out that patients in other states have even more limited rights to automatic review of detention. When I was a junior doctor in Queensland I was turned off psychiatry training in part because of the non-existent external review processes for detained patients… and back then there was little pressure on beds, so patients had long admissions.

The ‘severe erosion’ of rights of mentally ill patients

by Sydney psychiatrist Dr Tad Tietze

A young man, until recently a law student, is wrestled into the emergency department by two police officers. He is distressed, agitated and acutely paranoid. Convinced he is being tracked by local underworld figures, he believes they have hospital staff in their pay. As the psychiatrist taking on his care, I have to make a decision that has profound implications for him: should I detain and forcibly treat him even though he has done nothing to harm himself or others?

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Filed Under: health, psychiatry, state