Guest post: 'Schizophrenia then and now'

Continuing our recent reflections on how things in mental health have changed Richard Hallam and Michael Bender take the long view of schizophrenia

The cuckoo's nests have closed. What
else has changed in mental health?

The theme of this year’s World Mental Health Day on 10th October is Living with Schizophrenia. For those of us of a certain age, and with a historical bent, it’s also an opportunity to compare services now with those provided when we started out in the 1960s. Recently we’ve had the privilege of editing the diaries and letters of a young man, David, a patient in the mental health system five decades ago. The resulting book offers, we think, a window into the social attitudes of the time and the way mental health problems were treated.

20 years on: Finally our myopic brain obsession is on the wane

Professor John Read, back in the UK after a long period away, is struck by some important changes in the way we view mental health problems

Has how we talk about mental health changed?
Illustration: Mend the Mind

It’s good to be back in the UK after twenty years in New Zealand – well, apart from the weather, the political, economic and spiritual state of England, and the endless phone calls to India to get someone from up the road to install a phone. Amid it all I’m writing my first ever blog! What an antiquated old prof.

As regards mental health research, the difference I notice most is how far people’s thinking has moved on from the old, simplistic, ‘blame-the-brain-for- everything-and-medicate’ idea. 

A national scandal: psychological therapies for psychosis are helpful, but unavailable

Peter Kinderman and Anne Cooke

Can talking therapies be a realistic response
to psychosis and schizophrenia?
Photo: minds2mend.com

For years, drugs were it. If you felt paranoid, heard voices or were diagnosed with schizophrenia, the only thing likely to be on offer was ‘antipsychotic’ medication.  Like all drugs, these have a number of different effects on our nervous system. Some of the effects can be helpful, for example calming us down or making our experiences less intense or distressing.   Others may be less desirable. The unwanted effects – euphemistically called ‘side’ effects – of these particular drugs can be seriously distressing.  For some people, they can be more disabling than the original problem.  Despite the drug industry hype, it’s been a fine balance for many people, and worrying evidence is now emerging that some drugs can cause serious and permanent problems such as brain shrinkage if taken long-term.

Is Life a Disease?

Anne Cooke and John McGowan

The DSM makes a handy lectern
Photo: Maciej Janowicz

As regular readers of this blog know, we are very interested in the pros and cons of psychiatric diagnosis. We try to discuss this issue in an accessible way and reach as broad an audience as possible. It was a great pleasure, therefore, to be invited by Lewes Skeptics (a Sussex branch of the Skeptics in the Pub network) to give a talk about mental illness, diagnosis, and some of the controversies raised by the new version of the psychiatric classification manual DSM-5. We've since been asked to make the talk available more widely, so we've posted it below. It's a video of the slides, accompanied by a soundtrack recorded on the night.

It was interesting to see that the event sold out in a few days. Since we’re hardly big names, we hope this says something about the level of public interest in mental health. The same happened the last time that the Skeptics put on a mental health-related talk (by psychiatrist Joanna Moncrieff), so something clearly strikes a chord. On the night of our talk the room was jammed, the temperature was hot and the controversy even hotter! Actually that last bit isn’t true. The debate was conducted in the most civil and decorous manner - not always easy when passions on this topic can run high.

We’d like to thank Lewes Skeptics (and in particular Eugene Gill) for hosting the event, and for their commitment to promoting public engagement with important topics. If you want to know more follow them @LewesSkeptics on Twitter. We are also grateful to John Warburton man of many parts, two of which were his very strong forearms. The fortitude with which he acted as a human boom for the recording equipment was admirable. Thanks also to the audience. The pub patrons of Lewes are clearly a thoughtful lot.

You can view the video either in the embedded version below or via the direct link on YouTube. 

There is also a recording of the discussion following the talk. The quality is slightly more variable as questioners were sitting in different parts of the room. The Q&A audio is embedded below or you can listen to it directly on Sound Cloud.