Defending Psychiatry From Reckless Attacks

The Alliance for Human Research Protection is attempting to draft me as an unwilling soldier in its dangerous campaign to discredit psychiatry and to discourage psychiatric patients from staying in treatment and taking medication. In a recent posting, they make the ludicrous claim that Dr Frances' "publicly expressed criticism of psychiatry's grandiose ambition--demonstrated by its ever expanding list of unvalidated disease designations and reliance on demonstrably harm-producing chemical interventions--essentially validates the criticism expressed by the Alliance for Human Research Protection for more than a dozen years."

No. I must strongly disclaim this incorrect and misleading attribution. At a fundamental level, I could not have a more opposite view of psychiatry than that expressed by the Alliance. My critique of diagnostic inflation and over treatment in no way "validates" the Alliance and its reckless antipsychiatry rhetoric.

Here is the difference. I believe psychiatry is a noble and extremely helpful profession. My concern is that it has strayed beyond its suitable boundaries- leading to too much diagnosis and treatment of people who are not really ill or too mildly ill to require an intervention. My goal is to keep psychiatry doing what it does best and what only it can do really well- treating the clearly ill who definitely need help.

The Association makes no distinction between this absolutely necessary role of psychiatry and its recent overshoot toward excessive diagnosis and treatment. It is vigorously engaged in a determined effort at throwing out the precious baby with the bath water. Psychiatry is seen as a toxic evil and the Alliance deems itself a crusader, charged with the role of protecting the victims. This is a wildly inaccurate and simply terrible message for the millions of people who desperately need and benefit greatly from psychiatric help. So again, no- I do not validate the Alliance in any way and would encourage patients to ignore its ill founded, strident and potentially dangerous criticisms of psychiatry and its medications.

Psychiatry is imperfect, but essential. And it is not alone in its problems. All of American medicine is currently engaged in a frenzy of over diagnoses, over testing, and over treatment. We spend twice as much on health care as other countries and have only mediocre outcomes to show for it. This does not, and should not, lead to cries that all of medicine is toxic and is best avoided. Medicine and psychiatry both stand greatly in need of targeted reformation, not blind and undiscriminating attack.