Psychiatric medicine is in crisis | Stella O'Malley | Battle of Ideas 2024
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- Опубліковано 10 лют 2025
- From the Battle of Ideas Festival 2024
DEBATE: From WPATH to the Cass Review: the crisis in medical ethics
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Full programme: www.battleofid...
Speaker: Stella O'Malley
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As a practicing psychiatrist I'd disagree with the suggestion that good psychiatry is incoherent.
Otherwise, I'd absolutely agree we need to be able to say no to people and accept some people don't get better, or at least aren't helped by what we've got to offer. In no other speciality in clinical medicine are you expected to cure every patient and not one of them should ever die. I've got patients who have spent years stuck on 'acute' inpatient wards. Their problems for various reasons aren't helped by the treatment available. The legal, social care and clinical systems in the UK don't allow us to accept some people don't get better and so they remain stuck indefinitely in a system that insists they must get better.
Sadly, modernising the mental health act and the Calocane enquiry are set to make it even harder to exit the dream world in which modern psychiatry can and should fix everybody's problems and make everyone a nice non-violent non-suicidal person. Modern psychiatric care can and does help a lot of people with a lot of problems, but we need to allowed to be honest about the limitations to that.
It doesn't matter what area of civilization you're looking at - economics, medicine, architecture, you-name-it - when the college-educated experts move in and take over, the situation gets worse. Psychiatry is yet another example. This civilization is utterly insane. It's an anxiety-ridden madhouse.
Just use an Outcome Measure - if the client doesn't improve within 2-6 week, mix it up, be honest with client and collaborate to find a way forward, ask some new people to get involved. This is the best response to non-improving clients, i.e. clients experience dependency or deterioration. This is an easy and simple practice - so why does the recovery industry avoid it. Isn't it obvious?
Stella. Brilliant!
It seems like therapy these days doesn't promote resilience or internal loci. I just don't see how it's possible to heal without these things. It makes me sad for my younger friends who have bought into the hype that others and the world need to change in order to be healthy and happy.
The main problems with the mental health industry, as someone who has spent a lot of time using it, are: the treatments aren't very good, and the practitioners aren't very good. Many a time I've wondered whether I've been sitting on the right side of the desk. It's a profession that really attracts oddballs.
Most psychiatry could be replaced with a simple algorithm along the lines of: try medicine A; if no result increase dose; if no result and max dose reached try medicine B; repeat.
I'd love to know how many decades it will take before the industry sorts its shit out. Hopefully brain scans can inject a little scientific rigor into treatment - as someone said "psychiatrists are the only doctors that don't examine the thing they treat" (the brain).
So where do these impaired people end up - prison or on the street?
Sadly, currently, yes.