As I said, for example in my 2002 article, there is an overemphasis on psychiatric diagnosis. Nonetheless, the current diagnostic system still needs to be referenced when discussing mental health system reform, if only to avoid confusion. Over the longer term language can change. Certainly it has done so in the past, for example reflected in repeated revision of the DSM manual (see eg. previous post).  As I have also said, the UK mental health system has become too dysfunctional and fragmented (see eg. previous post). The problem is not just insufficient funding. Throwing more mon ..read more

I very much like the definition of neurodiversity used at the spotlight conference in Bradford last year:- Neurodiversity is the term used to describe the wide variety [of] different ways human beings think, learn, communicate and exist in the world. It is an umbrella term - a word that sums up lots of different things and helps us reframe conditions such as autism, ADHD, dyslexia as differences rather than deficits. As I mentioned in my last post, a recent report on autism in children and young people, one of the main components of said neurodiversity (see previous post), by the N8 Re ..read more

Nuffield Health has highlighted the need for a radical rethink on neurodiversity services (see eg. Sky news report) by its publication of data on waiting lists for assessment for ADHD and autism (see blog post). Increased public awareness of autism, ADHD and other neurodivergent conditions has led to more people seeking support and, as a Guardian report says, the “NHS faces [an] ‘avalanche’ of demand for autism and ADHD”. What’s required is a needs-based rather than diagnosis-led service, as has been argued for autism in children by a report produced by a collaborative programme of work betwe ..read more

The Government has responded to the Joint Committee on the draft Mental Health Bill (see previous post). Tim Spencer-Lane has summarised in a Linkedin post which recommendations from the Scrutiny Committee were rejected and which were accepted by the government. As I said in a tweet, the response is disappointing but not surprising. As I keep saying, current reforms of the Mental Health Act (MHA) do not go far enough (see previous post). I also think that the opportunity should be taken to reform the Mental Health Tribunal (see another previous post) and formalise the role of a triage AM ..read more

Discussion on the Critical Psychiatry Network email list has firmed up my views about antidepressant withdrawal. As I point out on my Antidepressant Discontinuation Reactions webpage, there is confusion about the technical meanings of terms like drug dependence and drug addiction. Dependence and addiction in common parlance, though, tend to mean difficulty in managing without the drug. This is a psychological problem, and can also have a physical cause.   As I also say in a previous post, The National Institute for Health and Care Excellence (NICE):- clearly states that antidepressants ..read more

The Times has an article about ADHD but does not make clear that that there is no evidence that ADHD is a neurodevelopmental condition affecting the prefrontal cortex of the brain, which is what the article says is the case. Nor does it really make sense to say that ADHD is executive brain dysfunction (see previous post). These types of misunderstanding that ADHD is a brain disorder pervade public consciousness, even though they are wrong.  The Times article quotes the consultant psychiatrist apparently behind the website Parenting Matters as saying there is no increase i ..read more

Peter Simons has an excellent blog post on Mad in the UK. He makes the case that the apparent benefit of antidepressants in clinical trials is an artefact and that any apparent improvement in depression is due to the placebo effect, not any active effect of the antidepressant. The effectiveness of treatment is assessed in randomised controlled trials comparing active drug with placebo (see my OpenMind article). Participants are randomly assigned to two groups in the basic design,  in which they are given either the active drug or given a placebo, which is supposed to be inert and indisti ..read more

I mentioned the scandal at the Edenfield Centre in a previous post. The independent review of the parent organisation, Greater Manchester Mental Health (GMMH) NHS Foundation Trust, by Professor Oliver Shanley is excellent, in my view. What was striking was the level of distress the inquiry found amongst patients, families and staff. The report made clear that patient care at GMMH has, at times, been poor, and the work of BBC Panorama has made this very clear. At the same time, the inquiry found there are a great many members of staff who are passionate, evidently talented and highly committed ..read more

I agree with a lot of what Jon Jureidini says in The Conversation (see article) about why so many Australians in particular, and people globally, are taking antidepressants. However, as I've always said about Jo Moncrieff (eg. see my review of her book The bitterest pills), who is one of the principle proponents of the critique of antidepressants expressed by Jon, I do find niggling overstatement in the narrative. Certainly too much antidepressant prescribing reflects the overmedicalisation of society (see previous post). I think that antidepressants may just be another example of doctor ..read more

The tragedy of the Nottingham homicides and other attempted murders by Valdo Calocane has highlighted the role of the police and mental health services in preventing such incidents (see eg. Times article). The police have admitted they could have done more to locate him as he was wanted for arrest after assaulting a police officer, but have argued that even if he had been arrested that it was highly unlikely he would have received a custodial sentence (see another Times article). The police also said that he would probably not have engaged with mental health services if re-referred to them, a ..read more