Skip to main content

A Prescription for Psychiatry

In today's post, Peter Kinderman introduces his new book ‘A Prescription for Psychiatry: Why We Need a Whole New Approach to Mental Health and Wellbeing’, which is published by Palgrave Macmillan.

I am professor of Clinical Psychology at the University of Liverpool and President-Elect of the British Psychological Society. My research interests are in psychological processes underpinning wellbeing and mental health. I have published widely on the role of psychological factors as mediators between biological, social and circumstantial factors in mental health and wellbeing. I have been awarded (with colleagues) a total of over £6 million in research grant funding (from the Medical Research Council, the Economic and Social Research Council, the Wellcome Trust, the NHS Forensic Mental Health Research and Development Programme, the European Commission and others). My most recent grant, awarded in 2015, was for a total of over £1m from the Economic and Social Research Council (ESRC), to lead a three-year evidence synthesis programme for the ‘What Works Centre for Wellbeing’, exploring the effectiveness of policies aimed at improving community wellbeing. You can follow me on Twitter as @peterkinderman.




My most recent book, A Prescription for Psychiatry, offers a radical new ‘manifesto’ for mental health and well-being. It argues that services should be based on the premise that the origins of distress are largely social. The guiding idea underpinning mental health services needs to change from an assumption that our role is to treat ‘disease’ to an appreciation that our role is to help and support people who are distressed as a result of their life circumstances, and how they have made sense of and reacted to them.


This also means we should replace ‘diagnoses’ with straightforward descriptions of problems. We must stop regarding people’s very real emotional distress as merely the symptom of diagnosable ‘illnesses’. A simple list of people’s problems (properly defined) would have greater scientific validity and would be more than sufficient as a basis for individual care planning and for the design and planning of services. This does not mean rejecting rigour or the scientific method – quite the reverse. While psychiatric diagnoses lack reliability, validity and utility, there is no barrier to the operational definition of specific psychological phenomena, and it is equally possible to develop coherent treatment plans from such a basis.

All this means that we should turn from the diagnosis of illness and the pursuit of aetiology and instead identify and understand the causal mechanisms of operationally defined psychological phenomena. Our health services should sharply reduce our reliance on medication to address emotional distress. We should not look to medication to ‘cure’ or even ‘manage’ non-existent underlying ‘illnesses’. We must offer services that help people to help themselves and each other rather than disempowering them: services that facilitate personal ‘agency’ in psychological jargon. That means involving a wide range of community workers and psychologists in multidisciplinary teams, and promoting psychosocial rather than medical solutions. Where individual therapy is needed, effective, formulation-based (and therefore individually tailored) psychological therapies should be available to all. When people are in acute crisis, residential care may be needed, but this should not be seen as a medical issue. Since a ‘disease model’ is inappropriate, it is also inappropriate to care for people in hospital wards; a different model of care is needed.

Adopting this approach would result in a fundamental shift from a medical to a psychosocial focus. It would see a move from hospital to residential social care and a substantial reduction in the prescription of medication. And because experiences of neglect, rejection and abuse are hugely important in the genesis of many problems, we need to redouble our efforts to address the underlying issues of abuse, discrimination and social inequity. This is an unequivocal call for a revolution in the way we conceptualise mental health and in how we provide services for people in distress. But it’s a revolution that’s already underway.

Popular posts from this blog

Delusions in the DSM 5

This post is by Lisa Bortolotti. How has the definition of delusions changed in the DSM 5? Here are some first impressions. In the DSM-IV (Glossary) delusions were defined as follows: Delusion. A false belief based on incorrect inference about external reality that is firmly sustained despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. The belief is not one ordinarily accepted by other members of the person's culture or subculture (e.g., it is not an article of religious faith). When a false belief involves a value judgment, it is regarded as a delusion only when the judgment is so extreme as to defy credibility.

Rationalization: Why your intelligence, vigilance and expertise probably don't protect you

Today's post is by Jonathan Ellis , Associate Professor of Philosophy and Director of the Center for Public Philosophy at the University of California, Santa Cruz, and Eric Schwitzgebel , Professor of Philosophy at the University of California, Riverside. This is the first in a two-part contribution on their paper "Rationalization in Moral and Philosophical thought" in Moral Inferences , eds. J. F. Bonnefon and B. Trémolière (Psychology Press, 2017). We’ve all been there. You’re arguing with someone – about politics, or a policy at work, or about whose turn it is to do the dishes – and they keep finding all kinds of self-serving justifications for their view. When one of their arguments is defeated, rather than rethinking their position they just leap to another argument, then maybe another. They’re rationalizing –coming up with convenient defenses for what they want to believe, rather than responding even-handedly to the points you're making. Yo...

A co-citation analysis of cross-disciplinarity in the empirically-informed philosophy of mind

Today's post is by  Karen Yan (National Yang Ming Chiao Tung University) on her recent paper (co-authored with Chuan-Ya Liao), " A co-citation analysis of cross-disciplinarity in the empirically-informed philosophy of mind " ( Synthese 2023). Karen Yan What drives us to write this paper is our curiosity about what it means when philosophers of mind claim their works are informed by empirical evidence and how to assess this quality of empirically-informedness. Building on Knobe’s (2015) quantitative metaphilosophical analyses of empirically-informed philosophy of mind (EIPM), we investigated further how empirically-informed philosophers rely on empirical research and what metaphilosophical lessons to draw from our empirical results.  We utilize scientometric tools and categorization analysis to provide an empirically reliable description of EIPM. Our methodological novelty lies in integrating the co-citation analysis tool with the conceptual resources from the philosoph...