Rose, Diana;
Rose, Nikolas;
(2023)
Is 'another' psychiatry possible?
Psychological Medicine
, 53
(1)
pp. 46-54.
10.1017/S003329172200383X.
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Abstract
In this paper, we examine a number of approaches that propose new models for psychiatric theory and practices: in the way that they incorporate ‘social’ dimensions, in the way they involve ‘communities’ in treatment, in the ways that they engage mental health service users, and in the ways that they try to shift the power relations within the psychiatric encounter. We examine the extent to which ‘alternatives’ – including ‘Postpsychiatry’, ‘Open Dialogue’, the ‘Power, Threat and Meaning Framework’ and Service User Involvement in Research – really do depart from mainstream models in terms of theory, practice and empirical research and identify some shortcomings in each. We propose an approach which seeks more firmly to ground mental distress within the lifeworld of those who experience it, with a particular focus on the biopsychosocial niches within which we make our lives, and the impact of systematic disadvantage, structural violence and other toxic exposures within the spaces and places that constitute and constrain many everyday lives. Further, we argue that a truly alternative psychiatry requires psychiatric professionals to go beyond simply listening to the voices of service users: to overcome epistemic injustice requires professionals to recognise that those who have experience of mental health services have their own expertise in accounting for their distress and in evaluating alternative forms of treatment. Finally we suggest that, if ‘another psychiatry’ is possible, this requires a radical reimagination of the role and responsibilities of the medically trained psychiatrist within and outside the clinical encounter.
| Type: | Article |
|---|---|
| Title: | Is 'another' psychiatry possible? |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1017/S003329172200383X |
| Publisher version: | https://doi.org/10.1017/S003329172200383X |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | critiques of psychiatry, community psychiatry, biopsychosocial niche, the patient's voice, epistemic injustice, social suffering, structural violence, alternative futures for psychiatry |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > UCL SLASH UCL > Provost and Vice Provost Offices > UCL SLASH > Faculty of S&HS UCL > Provost and Vice Provost Offices > UCL SLASH > Faculty of S&HS > SHS Faculty Office UCL > Provost and Vice Provost Offices > UCL SLASH > Faculty of S&HS > SHS Faculty Office > UCL Institute for Advanced Studies |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10161537 |
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