Has the WHO given psychiatry scientific respectability?

Jack Nicholson being treated with electro-convulsive therapy (ECT) in 

One Flew Over the Cuckoo's Nest (1975)

Every day, we hear of yet another reason to get worried about our mental health and about whether or not we are suffering from a mental illness without realising it. The media's covering far more about it than ever before.

Students are under severe stress at our universities, children are suffering stress from social media, and, according to the iPaper a few days ago, the hoarders among us have serious reason to start worrying about clutter: ‘Perhaps we’ve watched, fascinated and repulsed, at TV shows such as Britain’s Biggest Hoarders, which feature homes stuffed to the gunwales with, well, stuff...

‘…This week, it was classified as a mental disorder by the World Health Organisation, which explained that “accumulation of possessions results in living spaces becoming cluttered to the point that their use or safety is compromised. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.” (my italics)

Mental Disorder half a century ago:

Writers like  Erving Goffman and R.D. Laing were writing books that questioned what were then common definitions of mental health and illness – long before the 1975 film One Flew Over the Cuckoo's Nest or my own 1978 book Discovering Suicide'.

What these had in common was that they not only questioned the way mental health and illness were defined, but were also critical of psychiatrists and the way they (and their associated staff) treated and managed patients suffering from the 'illness'.

The medicalisation of social problems 

In the 1960s and 1970s, sociologists and others were arguing that using a medical model to define and explain different forms of deviant behaviour (like delinquency, crime, alcoholism, mental illness, suicide, etc.) was a convenient way of defending and preserving the status quo. After all, if these were illnesses, society could hardly be blamed for causing them. So in that sense, medicalisation involved adopting an essentially conservative model of social problems.

Psychiatry was (and still is?) the lowest status of all among medical specialisms

While doing a PhD on suicide in the late 1960s and early 70s, I came into contact with quite a lot of psychiatrists, some of whom were working in mental hospitals, and others working in research units. 

What surprised me then (and still surprises me today) was how quickly they became qualified in their chosen specialism: after graduating in medicine, it only took one postgraduate year to qualify in psychiatry - which involved spending relatively little time learning about social and psychological factors compared with time spent learning about what drugs should be used to treat which types of mental illness. 

As for defining types of mental illness, that was a blurred issue for psychiatry. Don't expect much clarity when it comes to questions like what's the difference between neurosis and psychosis, what do schizophrenic and paranoid mean, why is something that used to be called manic-depression now called bi-polar disorder?

Perhaps the biggest weakness of psychiatry is that (unlike cardiology, oncology or brain surgery) it lacks a killer disease that its specialists can actually cure. 

Other weaknesses will be discussed in later blogs.

Meanwhile, we should take our hats off and acknowledge psychiatry's PR triumph now that the WHO has classified hoarding as a mental disorder...

MENTAL HEALTH CRISES?

Every day, we hear news of yet another reason to get worried about our mental health and about whether or not we are suffering from a mental illness without realising it. 

Students are under severe stress at our universities, children are suffering stress from social media, and, according to the iPaper yesterday, the hoarders among us have serious reason to start worrying:

‘Perhaps we’ve watched, fascinated and repulsed, at TV shows such as Britain’s Biggest Hoarders, which feature homes stuffed to the gunwales with, well, stuff...

‘…This week, it was classified as a mental disorder by the World Health Organisation, which explained that “accumulation of possessions results in living spaces becoming cluttered to the point that their use or safety is compromised. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.”

This is all very well, but takes me back more than 50 years, when writers like RD Laing and Erving Goffman were writing books that   questioned what were then common definitions of mental health and illness – long before the 1975 film One Flew Over the Cuckoos Nest, and my 1978 book Discovering Suicide: Studies in the Social Organization of Sudden Death.

What these had in common was that they not only raised serious questions about the way mental illness and health were defined, but were also critical of psychiatry and the way they treated and managed patients with the illness.

our mental health and about whether or not we are suffering from a mental illness without realising it

Students are under severe stress at our universities, children are suffering stress from social media, and, according to the iPaper yesterday, the hoarders among us have serious reason to start worrying:

‘Perhaps we’ve watched, fascinated and repulsed, at TV shows such as Britain’s Biggest Hoarders, which feature homes stuffed to the gunwales with, well, stuff...

‘…This week, it was classified as a mental disorder by the World Health Organisation, which explained that “accumulation of possessions results in living spaces becoming cluttered to the point that their use or safety is compromised. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.”

This is all very well, but takes me back more than 50 years, when writers like RD Laing and Erving Goffman were writing books that   questioned what were then common definitions of mental health and illness – long before 1975, the film One Flew Over the Cuckoos Nest

Today's iPaper included a feature under the heading:

I’m a hoarder and I’m glad that it has been classified by the WHO as a mental disorder

It was about self-confessed hoarder Laura Horton, who is writing a play about hoarding and included an extended discussion of the 'problem which began with:

How many of us, when peering into a relative’s disorganised garage, or catching sight of a few pairs of shoes under a colleague’s desk, have laughingly accused them of being a hoarder? Perhaps we’ve watched, fascinated and repulsed, at TV shows such as Britain’s Biggest Hoarders, which feature homes stuffed to the gunwales with, well, stuff. If being a hoarder isn’t a punchline, it’s entertainment. It’s not entertainment – it’s a mental disorder But hoarding is neither. This week, it was classified as a mental disorder by the World Health Organisation, which explained that “accumulation of possessions results in living spaces becoming cluttered to the point that their use or safety is compromised. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.”

Brexit's all Greek to me

Like many others (or should that be like everyone in the UK?), the first time I heard the word 'brexit' was sometime before the referendum in June 2016.

At the time, I remember having many conversations bemoaning the fact that Cameron and his colleagues had failed to come up with anything like as punchy a name as brexit for referring to enthusiasm for remaining in the EU.

Nor had their chums in PR and advertising.

Yet 'brexit' has now been in the Oxford English Dictionary since December, 2016 - 6months after the referendum.

On looking into where, when and from whom it came there's an irony about it's use by everyone from David Cameron, Teresa May ("Brexit means brexit"), through those who campaigned vigorously for it like Johnson, Farage, Gove, Duncan Smith, Grayling, etc. etc. etc.

The irony is that the word was not coined by any of them but by someone in favour of remaining in the European Union:

The man who coined ‘Brexit’ first appeared on EURACTIV blog

By Matthew Tempest | EURACTIV.com Jan 10, 2017

The word ‘Brexit’ was coined by EURACTIV, according to the latest edition of the Oxford English Dictionary, way back in 2012, in a blog post by Peter Wilding.

The decision came in an update to the third edition of the dictionary, put together by some 50-60 lexicographers, and was put online last month. It gives the definition of the word as: “the (proposed) withdrawal of the United Kingdom from the European Union, and the political process associated with it”.

He wrote about "Brexit" in May 2012, eight months before the then Prime Minister David Cameron had announced he would be holding a referendum.

"Unless a clear view is pushed that Britain must lead in Europe at the very least to achieve the completion of the single market then the portmanteau for Greek euro exit (Grexit) might be followed by another sad word, Brexit," he predicted.