Psychiatry and/or recovery: a critical analysis

Abstract

This perspective paper aims to present a personal viewpoint on the impact of psychiatric discourse on the principles of recovery in mental health care. Mental health services espouse these principles, yet psychiatric discourse remains the dominant model. A critical analysis will examine how psychiatry maintains this dominance. The aim is to examine how psychiatric discourse constructs both the nature of mental distress and its treatment, and how it maintains its power as the dominant authority and its relationship to recovery principles. The paper concludes that psychiatric discourse is the antithesis of recovery principles and that its authority is perpetuated through co-opting a medical explanatory model, claiming expertise in the ability to predict social risk, and maintaining a tightly controlled echo chamber. A way forward involves the dismantling of the hierarchical service delivery model based on psychiatric discourse and replacing it with a more horizontal service delivery model in which the lived experience of mental distress is central. Regular audit of services needs to prioritize recovery principles. The implications for mental health nursing are considered.

An audit and analysis of electro convulsive therapy patient information sheets used in local health districts in New South Wales Australia

“…The message conveyed is that depression is a biochemical disease. Despite decades of costly research, there is no substantive evidence that ‘mental disorders’ are diseases in the medical sense (Crowe, 2022). Numerous studies have failed to confirm a neurobiological or genetic cause or association with mental illness (Border et al., 2019; Borsboom et al., 2019; Curtis, 2021; Marsman et al., 2020; Nour et al., 2022; Winter et al., 2024).…”

A voice of experience: Positive and negative experiences of mental health from a service user's/lived experience perspective

“…To finish with, following on from the article of Crowe (2022), some interesting questions are these: Is traditional psychiatry in its last stages and on the way out in the future? Will it be replaced by newer, alternative and more holistic approaches of treating mental health?…”

We have to cancel psychiatric nursing and forge a new way forward

“…It is curious that despite the lack evidence to support psychiatry's scientific legitimacy and paternalistic practices, psychiatric discourse continues to maintain its authority and power (Crowe, 2022). The fact that a burgeoning and vocal psychiatric survivor movement exists, with claims of abuse from psychiatrists and mental health services, and that exposure to psychiatric treatments has left people harmed and traumatised (Adame et al., 2017), should prompt humbled reflection from nurses on how their ‘care’ and practices have contributed to this stance.…”