A London Philosophy Club talk by Peter Kinderman:
The Ethics of Psychiatric Diagnosis. Polly Mortimer
Peter Kinderman is pretty much a hero of mine, along with his colleague Richard Bentall. Kinderman is Professor of Clinical Psychology and Head of the Institute of Psychology, Health and Society at the University of Liverpool, and Bentall is a Professor there. Kinderman started with his conclusion: that it was now is the time to take action. The disease model is inappropriate and the current realm of ‘diagnosis’ fails on validity, utility, biology and humanity. We should be concentrating on helping people live their lives better and fulfilling their potential, not treating problems as illnesses.
He took us back to a debate in the Commons a while back where a number of MPs revealed their own mental distress. This disclosure was met in a positive manner, thus paving the way for differing approaches to the whole field. He did however, also quote concerning statistics regarding the increase in suicides in this time of economic uncertainty; it has been found that a thousand suicides per year could be as a result of depression caused by economic hardship. In also informed us that there has been a 30% increase of calls to helplines in the last few years.
Carefully unpicking the diagnoses that are commonly bandied around, he found
them devoid of meaning. What is needed is a bespoke response to clients’ needs. There are reasons for mental distress – natural human consequences of trauma and adversity. We are all mad at times. But the trend now is to medicalise normality.
I agree with Kinderman: what is needed is alternatives to the disease models. He put forward lots of suggestions: parenting tutors, narrative approaches, a colleagues scheme, Think First for offenders, and a plea to treat things for what they are. This is underpinned by a psychosocial formulation approach. A huge change must take place and it involves many different agencies: teachers, professionals, textbooks, judges, insurance companies, pension firms, among others.
As we are at a crossroads with the revision of DSM underway, I believe it is an ideal time to proceed with change. This can happen by signing petitions, and those in the frontline talking and taking action. The stranglehold of the pharmaceutical companies needs to be released and a new framework of understanding reached. Solutions can be developed – working on the cause of the distress. Work with nurses will be crucial; they can initiate relaxation, exercise, early warning systems etc.
I found the talk extremely refreshing and sensible and left hoping that change was in the air and the disease model will be consigned to history. Long overdue!