Postpsychiatry Mental Health in a Postmodern World

How are we to make sense of madness and psychosis? For most of us the words conjure up images from television and newspapers of seemingly random, meaningless violence. It is something to be feared, something to be left to the experts. But is madness best thought of as a medical condition?Psychiatrists and the drug industry maintain that psychoses are brain disorders amenable to treatment with drugs, but is this actually so? There is no convincing evidence that the brain is disordered in psychosis, yet governments across the world are investing huge sums of money on mental healthservices that take for granted the idea that psychosis is an illness to be treated with medication. Although some people who use mental health services find medication helpful, many do not, and resist the idea that their experiences are symptoms of illnesses like schizophrenia. Consequently they areforced into having treatment against their wishes. So, how do we make sense of this situation? Postpsychiatry addresses these questions. It involves an attempt to rethink some of the fundamental assumptions of mental health work, showing how recent developments in philosophy and ethics can help us to clarify some of the dilemmas and conflicts around different understandings of madness.Throughout, the authors examine the conflicting ways in which politicians, academics, and mental health professionals appear to understand madness, and contrast this with voices and experiences that are usually excluded - those of the people who use mental health services. They then examine thepower of psychiatry to shape how we understand ourselves and our emotions, before considering some of the basic limitations of psychiatry as science to make madness meaningful. In the final section of the book they draw on evidence from service users and survivors, the humanities and anthropology,to point out a new direction for mental health practice. This new direction emphasises the importance of cultural contexts in understanding madness, placing ethics before technology in responding to madness, and minimising 'therapeutic' coercion.

Patrick Bracken is a graduate of the National University of Ireland who did his early medical and psychiatric training in Southern Ireland. In the years 1987-1991 he worked for the Medical Foundation for the Care of Victims of Torture in Uganda and subsequently worked for the Medical Foundation in London. His M.D. degree was awarded for research with a rural village in the notorious 'Luwero Triangle' of Uganda. His interest in the psychological effects of violence has continued and he has carried out a number of consultancies for Save The Children in West Africa and most recently with refugees from Bhutan living in Nepal. Philip Thomas is a writer and Senior Research Fellow in the Centre for Citizenship and Community Mental Health, in the School of Health Studies, University of Bradford. Until recently he was consultant psychiatrist with Bradford's Assertive Outreach Team, and had worked as a full time consultant for over 20 years in the NHS, in Manchester, North Wales and Bradford. His academic interests include critical social and cultural psychiatry and philosophy. He is also interested in narrative and the problems of representation in medicine and literature. He has developed alliances with survivors of psychiatry and service users, locally, nationally and internationally. He is well-known for his academic and clinical work on the experience of hearing voices, arguing that these, and other experiences of psychosis, are understandable in the context of the person's life story and current life circumstances.