The future of critical psychiatry

Abstract

The aim of this paper is to outline an agenda for critiques of psychiatry and other mainstream ideologies of mental health for the 21st century. While the heyday of anti-psychiatry was the period from the 1960s to the 1970s, new critiques of psychiatry, clinical psychology and psychotherapy continued to emerge throughout the last two decades of the 20th century. Some of these – not least those that emerged from the mental health service users’ movement – echoed the themes of earlier critics such as R. D. Laing and Thomas Szasz by questioning the legitimacy of diagnoses and therapeutic interventions. Others focused on anti-racist and/or feminist perspectives. This paper suggests that, in the wake of developments in biological psychiatry and socio-biology as well as clinical advances in psychopharmacology and the rise of Evidence Based Psychiatry, critical psychiatry has a new role. This role is less adversarial than that of the so-called anti-psychiatry of the 1960s and 1970s and less concerned with challenging basic assumptions about the causes of mental distress. The critical psychiatry of the 21st century can best serve the interests of service users by ensuring that service users’ rights to autonomy, fairness and freedom of choice are not overlooked due to a preoccupation with the science of Evidence Based Psychiatry.