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‘Wake-up call’ for psychiatrists

28 June 2008

Depressed boy

Psychiatry in Britain is facing "an identity crisis", according to an article in the July 2008 issue of the British Journal of Psychiatry.

The authors of the article, including some of Britain’s most eminent Professors, among them lead author Professor Nick Craddock of the School of Medicine, claim that the quality of patient care is under threat from recent changes in the NHS. In particular, recent welcome improvements in psychosocial care have had the unintended consequence of undermining medical approaches to diagnosis and treatment.

The result is a ‘creeping devaluation of medicine’, that is damaging the ability of psychiatrists to deliver excellent psychiatric care.

The experts are calling for better understanding and recognition of the key role of psychiatry in the management of people with mental illness. Priorities include:

  • Maintaining and improving skills, facilities and resources to ensure psychiatric services provide excellence in diagnosis and medical as well as psychological and social care.
  • Recognising the important and close relationship between psychiatric and non-psychiatric illness and ensuring that physical as well as psychological and social factors are fully taken into account in assessment and management.
  • Ensuring that patients referred by their general practitioner receive a thorough, broad-based assessment by a highly trained professional in order that the most appropriate management is implemented at the earliest opportunity.
  • Striving for services and interventions based on robust and unbiased evidence rather than political idealism or a rigid adherence to particular schools of thought.

Professor Craddock, of the School’s department of psychological medicine, said: "The relentless moves to downplay the importance of medicine in NHS psychiatry already disadvantages many patients and actually increases, rather than reduces, the stigma of those with mental illness.

"There is a very real risk that as the understanding of complex human diseases steadily increases, recent moves away from biomedical approaches to psychiatric illness will further marginalise patients in comparison with those suffering from physical illness."