A reply to Kevin Gournay's 'Schizophrenia: a review of the contemporary literature and implications for mental health nursing theory, practice and education’

Abstract

Mental health nurses are being increasingly encouraged to move to a more biologically oriented approach. Authors such as Professor Gournay promulgate the myth that biological psychiatry will soon be able to provide an unambiguous model of the nature of mental disorder. A closer examination of some of the biological research identified by Gournay as moving us closer to this ideal reveals, however, the confused and unconvincing nature of the results so far achieved. In the light of this it seems premature to be advocating wholesale acceptance of the biological model by nursing. Nurses should be made aware of the investigations of the biologists, but, unless they are equipped with the necessary intellectual tools to place such investigations in context, they will continue to be susceptible to the rhetoric of proselytisers such as Gournay.

Releasing the therapeutic potential of the psychiatric nurse: a human relations perspective of the nurse–patient relationship

“…The latter (medical model) perpetuates a reductionist, ‘scientific’ disease model of mental illness is scathing of nurses employing interpersonal theories (Gourney 1995, McCrone 1996). Amidst the subsequent barrage of claims and counterclaims (Barker & Reynolds 1995, Dawson 1997, Barker 2003), retorts and challenges to each of the other's evidence base (Huxley et al . 2000), psychiatric nurses, not unremarkably and perhaps akin to the patients under their care, are finding themselves increasingly confused, disillusioned and disempowered (Sullivan 1998).…”

Evidence-based psychiatric/mental health nursing

“…For example, Dawson reviewed the articles included in Gournay's review and concluded that the evidence for a biological understanding was overstated by Gournay. 7 Barker and Reynolds criticised Gournay's understanding of models and theories. 8 In reply to the concern that Peplau's interpersonal theory did not include, for example, a biological basis for hallucinations, it was pointed out that none of the biological theories pays any attention to Peplau's theory of interpersonal relations.…”

Patients’ experiences of psychosis in an inpatient setting

“…Some authors have criticised it as a diagnostic category (Szasz 1962, 1997), while others have refined the term to mean conditions other than those intended originally (Keen 1999). There have always been contradictory opinions about the nature and causes of schizophrenia, for example, whether the emphasis should be placed upon biological, psychological, interactional or social causes and views (Gournay 1996, Alanen 1997, Dawson 1997, 1998, Keen 1999, Barker et al . 1999).…”