Fall 2001, Vol. 2, Issue 2.
A review of This is Madness Too: Critical perspectives on mental health services, by Craig Newnes, Guy Holmes and Cailzie Dunn (Eds.). Llangaron, UK: PCCS Books, 2001 (ISBN 1 898059 37 3, £14.00). Email: email@example.com .
This follow-up volume to This is Madness (Newnes, Holmes and Dunn, 1999; for reviews see Carson, 2001, and McCubbin, 2001) uses the same format that was so successful the first time around. A mixture of professionals, academics and service users (sometimes as co-authors, and sometimes in the same person) have come together to provide, in sixteen chapters, an essential snapshot of current critical thinking on mental health. This is anti-psychiatry for the new millennium, more broadly-based and more sophisticated than the original version but certainly no less needed.
"This is Madness Too" pursues the same themes of separation of the social control and the therapeutic functions of psychiatry, abandoning the medical model, challenging the power of the pharmaceutical companies, promoting service user views and expertise, and tackling the social and political roots of mental distress. It has also added chapters on children, learning difficulties and eating distress, and draws at several points on the work of psychiatrists from the Critical Psychiatry Network, a recently formed British group which argues that a social, not biomedical, model is appropriate for a multi-cultural society which is riven by deep inequalities.
The content is as varied as the contributors. There is a memorable introductory chapter on British mental health policy by Peter Beresford and Suzy Croft (The governments overall approach to mental health policy raises serious concerns because it appears to be neither evidence-based, consistent, workable nor even rational.). There are summaries of important recent work from high-profile figures such as Peter Breggin (on Ritalin and ADHD) and David Healy (on the SSRI suicides).
There is also thought provoking new (or new to me) writing by Viv Lindow, a leading figure in the service user movement, who argues forcefully that survivor research is essential to challenge and change current practice. She provides an overview of considerations such as methods and procedures, ethics and personal issues, which is invaluable both for survivor researchers and those who wish to support them. Peter Lehmann covers the neglected subject of coming off neuroleptics, although without referencing Peter Breggin and David Cohens (1999) guide to putting this into practice, Your drug may be your problem. I also particularly enjoyed Pete Sanders and Keith Tudors proposals for de-medicalising and re-politicising counselling, and Jan Wallcraft and John Michaelson on developing a survivor discourse to replace the current language of psychopathology.
The potential problem with the format is that the selection of topics inevitably seems too limited, and the quality is a little uneven. I would personally love to read a critical account of the concept of evidence-based medicine, or a cautious perspective on the new assertive outreach and crisis intervention/early intervention teams, or the rise of new disorders such as body dysmorphic disorder and PTSD.
The other potential problem with the format is that it can seem disjointed or incoherent. The editors have tried to avoid this, not entirely successfully, by grouping the chapters under four main themes. To some extent, the variety is both (as with the earlier volume) part of the books charm, and a reflection of the enormous energy that is pouring into the critical psychiatry movement from many different directions.
There is an ongoing tension, as in the earlier volume, around such dilemmas as: Is therapy useful or just another form of mystification? Do we want better-trained psychiatrists or none at all? Should professionals and service users work together? Is there a place for psychiatric drugs? Can psychiatry be reformed, or only abolished? These questions are not answered, but at least they are posed. In short, the book offers something for everyone to debate, question, passionately agree or violently disagree with. Whatever your own stance, go out and buy it. You might not like all of it, but you certainly wont regret it.
Lucy Johnstone is currently Lecturer on the Clinical Psychology Doctorate at the University of the West of England, Bristol, and also works part-time in the U.K. National Health Service (NHS). She is a chartered clinical psychologist and chartered counselling psychologist and spent eleven years working in the NHS before moving to an academic post. She has lectured and published widely in the area of critical approaches to mental health. She is a member of the International Advisory Council for the International Center for the Study of Psychiatry and Psychology, U.S.A. The second edition of her book (revised), Users and Abusers of Psychiatry: A Critical Look at Psychiatric Practice (Johnstone, 2000), came out last summer. She can be reached at <firstname.lastname@example.org>
Breggin, P., and Cohen, D. (1999). Your drug may be your problem: How and why to stop taking psychiatric medications. Reading, MA: Perseus.
McCubbin, M. (2001). This is madness: A critical look at psychiatry and the future of mental health services (book review). Ethical Human Sciences and Services, 3, 55-58. Table of contents and ordering info. available HTTP: http://www.springerjournals.com/ehss/tables_of_contents/vol3_1.htm
Newnes, C., Holmes, G., and Dunn, C. (1999). This is madness: A critical look at psychiatry and the future of mental health services. Llangarron, UK: PCCS. Email: email@example.com.