The Critical Psychiatry Network
The Critical Psychiatry Network is a group of psychiatrists who first got together in 1998 to discuss changes to the Mental Health Act proposed at that time. The group consists of about 80 psychiatrists, mostly based in the UK, but there is also an international Critical Psychiatry Network of psychiatrists from around the world. Members have a broad range of opinions about the nature of psychiatry and mental health care, and there is no unanimously held position on what the Network stands for, but the Network has developed consensus statements on topics such as the use of low dose neuroleptics and withdrawal from neuroleptics. Members also share a number of general concerns.
Many members believe that mental disorder is fundamentally different from physical or bodily disease, and that trying to approach mental disorder in a medical framework strips it of its meaning, and dehumanises attempts at treatment. There is of course a long list of radical, dangerous and degrading procedures that have historically been applied to mental patients, including lobotomy and insulin coma therapy. The medical model justifies such procedures because it assumes that mental symptoms arise from underlying brain diseases, which can be reversed or removed through the right physical intervention. Many members of the Critical Psychiatry Network draw the lesson that instead of trying to eradicate or ameliorate a disease, psychiatry should consist of helping people to understand their distress, to find better ways of coping with it and to address the difficult social situations they are often in. This approach may involve drug treatment, but only as far as the service user finds this useful.
Many members of the CPN have worked closely with service user groups and advocacy organisations to promote more user focused models of care, which are now increasingly accepted under the rubric of the Recovery Agenda. The importance of understanding the subjective experience of mental disorder has also been central to CPN’s mission, and as such many members have collaborated with service users and other advocates to bring this perspective into the public domain.
In common with many other professionals, members of the CPN have been troubled by the increasing influence of the pharmaceutical profession throughout medicine, but especially in psychiatry as patients can be compelled to take medication under the terms of the Mental Health Act. A few years ago, conferences of biological psychiatry resembled extravagant trade fairs, and there is accumulating evidence of the influence that the industry has over research and publication. CPN have contributed to this debate, urging the Royal College of Psychiatrists to adopt more stringent conflict of interest policies, and there has been some success in that the College has reduced its reliance on sponsorship for its annual conference. In 2008, it even held the conference without any industry funding at all.
Members of the Critical Psychiatry Network have also opposed the extension of coercive powers enshrined in the Mental Health Act. The medical model of mental disorders facilitates the social control of people whose behaviour is difficult or troubling, because it represents this control as “treatment.” Since it is assumed to be a medical process, this “treatment” is never subject to the sort of democratic scrutiny that it requires. The introduction of Community Treatment Orders represents a significant further curtailment of the rights and liberties of people diagnosed with psychiatric conditions and members of the Network have been concerned about the proliferation of these Orders since their introduction.
The Network meets twice a year, and holds occasional conferences, often linking with service user organizations for these. Members are keen to collaborate further with service user groups on issues of mutual concern. We can be contacted via the website.
Jo Moncrief Chair CPN
Rhodri HuwsSecretary CPN