For many, therapy is essential to maintaining their mental health, but the anti-psychiatry movement argued otherwise. Hollie Finn (LVI) delves into their arguments, and the complicated relationship between class and healthcare.
Most would agree that being a doctor isn’t for everyone: a career in the medical profession follows strict criteria that only a limited number of people can meet. The social responsibilities that come with being a doctor trump those of almost any other profession. Living in the 21st century, mental health is a field of medicine that is increasingly prevalent in society. There has been an increase in mental health related inpatients, research and clinical trials, and the world is seemingly becoming more educated on these invisible illnesses. The way in which doctors choose to uphold their roles can make or break a person’s healthcare experience. In my opinion, the role of medicine within society depends not only on the different branches of treatment, but is inextricably linked to the history that explains how we have come to have the system we know and love today.
The anti-psychiatry movement first arose in the 1960s in the USA and Europe. It is a movement based on the view that psychiatric treatment does more damage to a person than good. Ronald D. Laing was known as the ‘nucleus’ of this movement, and his most famous theory states that society is the main culprit for any form of mental illness, claiming that schizophrenia is a ‘sane reaction to an insane world,’ and that ‘in effect, society is sick.’ His beliefs did not disregard the importance of treating mental distress, however he did question the concept of mental illness as a medical phenomenon. The main principle behind the movement was to eliminate the dehumanising nature of traditional approaches at the time, and reduce the ‘societal inequality’ between doctors and their patients. This social inequality was predominantly found among the lower classes as they were unable to afford healthcare before the NHS was founded in the UK in 1948 in the UK, but quality of patient care was still hardly equal for those of differing wealth and class. Social inequality within medicine is still a huge problem in countries where private, insured healthcare is the only option, such as the USA.
Interestingly, the philosophical views associated with inequality are much more relevant to psychiatry than any other field of medicine. Psychiatry is a speciality where doctors have a legal responsibility to assess and manage risks for the patients’ own good, but also to ensure the safety of a community. It is because of this legal obligation that some people deemed psychiatrists unethical, as they technically have the right to provide social control, take away a patient’s liberty and forcefully treat them against their will. One may argue that the impact of social deprivation and patronisation (which is often linked with the work of a psychiatrist) on mental health is more harmful than leaving a mental health condition untreated. Some people also feel that talking to a professional about emotion, rather than physical symptoms, makes a person much more vulnerable and prone to judgement. This is another reason why the anti-psychiatry act came into place when it did. In fact, there remain a small group of Scientologists today who still associate themselves with this historical act, and who describe themselves to be ‘self-saved survivors,’ as they believe they were able to defeat the manipulation of psychiatric science.
In the context of social medicine, Rudolf Virchow and John Ryle are both considered founding fathers. Social medicine is the study of the medical needs of society, and the integration of medicine within society. It includes social factors such as public health, aspects of disease prevention and the clinical examination, diagnosis and treatment of patients. Virchow (born in 1821) campaigned vigorously for social reforms and contributed to the development of anthropology as a modern science. Upon creating his new concept of social medicine, Virchow founded ‘Medical Reform,’ magazine to promote his views on the subject. He states that: ‘physicians are the natural advocates of the poor,’ enforcing this idea that doctors have a societal duty to treat and help patients, regardless of their social background. After Virchow’s death in 1902, John Ryle picked up where he left off. In 1943, he was appointed to the first chair of social medicine in the UK, in which he worked to separate the concepts of public health from social medicine.
The main principle behind social medicine is to understand how social and economic conditions can lead to a healthier society. These include education, income, poverty, transport, housing and environmental influences. But how does targeting these factors prevent illness?
The quality of life index takes into account factors from six different categories: leisure, health and wellbeing, safety and security, personal happiness, travel and transportation, and digital life. In emergency situations, the main goal of a doctor is to save the patient’s life. But overall, this goal represents a very small proportion of the medical effort that goes into making sure the patient is able to leave the hospital: happy and healthy. One of the greatest social responsibilities of any healthcare unit is ensuring that a patient does not pose a risk to themselves after any physical or emotional damage. Physically, this can be accomplished after running a few tests. But mentally? One of the only ways to do this is by utilising a psychiatrist. But could this treatment prove to be detrimental in the long term?
By Hollie Finn (LVI
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