Mad in America: Rethinking Mental Health

This week on MIA Radio we interview Dr. Duncan Double. Duncan is a Consultant Psychiatrist at the Norfolk and Suffolk NHS Foundation Trust. He is founder of the Critical Psychiatry Network and also runs a critical psychiatry blog. He edited the book Critical psychiatry: The limits of madness published in 2006 and has written a number of journal articles and book chapters.

We talk about Duncan’s experiences as a critical psychiatrist working within a bio-medically oriented profession.

• How reading Freud as a teenager led Duncan to his interest in psychiatry.
• That, early in his training, he found it difficult to take to the overly physicalist aspects of what he was expected to learn.
• How he became interested in the work of RD Laing and Thomas Szsaz.
• How he left his studies for a time, working with drug users in London, studying for a psychology degree and working in banking.
• The formation of the Critical Psychiatry Network in January 1999.
• How critical psychiatrists take a different perspective from mainstream psychiatrists who tend to believe that mental illness is a brain disease.
• That critical psychiatrists are not so interested in arriving at a single word diagnosis, instead the focus is on understanding the person and why they have presented with the problems they have in the context of their life situation.
• That critical psychiatrists aim to minimise the use of coercion and have been against the introduction of community treatment orders.
• That the emphasis in treatment is on helping people improve their social situation and to be as independent as they want to be.
• How Duncan felt about a period of suspension which arose partly because of his different practices, being less concerned about formal diagnosis and using less medication than other psychiatrists.
• That critical psychiatry is still looking for more acceptance from the mainstream.
• That Duncan welcomes the more recent emphasis on recovery in mental health services.
• That Duncan does use medication but is very aware that the evidence for psychiatric treatment is biased for methodological reasons, for example, the difficulties having properly blinded placebo-controlled trials.
• That good science is often being sceptical about the evidence.
• That people can form attachments to their medication, so it is not surprising that people may become dependent on it and therefore may have discontinuation problems.
• Duncan’s critical psychiatry blog which he would like to invite readers to visit and that he would like to develop an Institute of Critical Psychiatry.

Critical Psychiatry Blog

Critical Psychiatry Website

The Critical Psychiatry Network

Critical Psychiatry: The limits of madness (2006)

My tutor said to me, this talk is dangerous

What is Critical Psychiatry?