Subsequent studies have confirmed that patients in the developing world are much more likely to recover from severe mental illness than patients in the richer countries, well served by psychiatrists and clinical psychologists.
That is from Richard P. Bentall's Doctoring the Mind: Is Our Current Treatment of Mental Illness Any Good? You can think of this book as an updated, more traditionally empirical, less polemic version of Thomas Szasz. It makes large claims which are difficult to evaluate. Ultimately I don't find that it offers a persuasive alternative framework for thinking about either mental illness or "mental illness." Nonetheless the book is stimulating, it relies on substantive argument, and it will induce skepticism about a lot of what passes for treatment these days. Here is one review of the book, here is another.
His previous book, “Madness Explained”, offers a lot more in terms of an alternative vision although it’s heavily CBT influenced which isn’t to all tastes.
Hmmm. From the reviews, it sounds that Bentall doesn’t condemn use of drugs to relieve symptoms when people are facing difficult times; he merely thinks the tendency to always attribute thinks to a deeper physiological imbalance (probably genetic) inappropriately encourages long-term, even lifetime use of the drugs. Does he attribute that exclusively to drug company conspiracies? I would have thought that another factor encouraging this sort of thinking (which I agree is too widespread) is the widespread hysterical attitudes to recreational mind-altering drugs, which probably makes doctors feel they need to emphasize the physiological as much as possible (since using drugs to alter physiology isn’t as suspect).
You’re right, dearieme; it was a poor choice of words. I should have said “drug company nefariousness” or perhaps a more neutral “drug company self-interest” if I were feeling inclined to be charitable for some reason. No need to suggest that they’re secretly colluding in this instance. There do seem to be possible cases of secret collusion between drug companies (companies being suspiciously slow to offer generic versions of one another’s drugs and charging suspiciously high prices for generics) but those aren’t relevant here.
Does he offer the possibility that the less developed world is a saner environment?
The reviewers claim that the author denies a biological basis for mental illness. That is insane.
As for the third world results, I am reminded of the South were you are told that your Aunt is not crazy, she is eccentric, we do not send her to psychiatrist, we keep her in the attic.
If you act psychotic in the third world, you are shunned and starve to death.
Or become the village shaman/witch doctor.
I misjudged you, Tyler. I had expected you to explain the results with a model showing single-payer psychiatry is Pareto efficient.
Also, as regards mental illness in less developed countries. http://frontierpsychiatrist.co.uk/global-psychiatry/
I’ll have to read this. Unfortunately, due to the prevalence of mental issues in my family and the failure of conventional treatments in resolving those issues, I know a bit about it (knowledge that I would rather have avoided, but oh well). That residents of developing nations are more likely to recover does not surprise me at all. As confirmed by the research on vitamin D, they spend more time outdoors exercising. They are less likely to be sleep-deprived then people who are privileged to stay up ’til the wee hours with electric lights and entertainment (before the invention of the electric light bulb, people averaged 10 hours a night of sleep). Sleep deprivation is increasingly recognized as a main driver of depression. Exercise is a big help.
It is also time to open up to the thesis that some mental issues are not *ultimately* rooted in brain biochemistry. While it is undeniable that biochem plays a role, it is no longer clear that it is a *causal* role in every case. The imbalances one sees in a depressed, compulsive, or anxious person could be a result, not a root cause. Early childhood experiences and later trauma that is not properly processed–unexpressed grief, for example–seem to be able to train the brain to misfire. Some people are more likely to be thrown off kilter than others. Consistent with this, some of the most effective cutting edge therapies for depression and anxiety are talk therapies aided by technology, like neurofeedback and EMDR. But for those to succeed, the word on the street at the therapist conferences is that they want you off the anti-depressants if possible, which can suppress healthy emotional function as well as unhealthy emotional function. Nine out of ten psychiatrists either do not know this (it is after all outside their field), or will not tell you. Once the discipline got it into its head that they had it all figured out, they stopped learning. Unfortunately it means that when their theories do not pan out and their treatments fail, they have no plan B.
@Solveig:
“Nine out of ten psychiatrists either do not know this (it is after all outside their field), or will not tell you.”
It is outside the field of psychiatry to know the impact of psychoactive drugs on emotional function???
What on earth is *within* the field of psychiatry?
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