Our everyday lives are increasingly intertwined with psychiatry and discussions of mental health. Yet the dominant medical discipline of psychiatry remains surrounded by controversy. Is mental distress really an illness like any other, treatable by drugs? Can psychiatrists differentiate between mental disorders normal eccentricities, anxieties or even sadness? Should the power of psychiatrists be challenged by the knowledge of those with lived experience of mental ill health?
In this penetrating analysis, Nikolas Rose critiques the powerful part that psychiatry has come to play in the lives of so many across the world. A series of chapters, each tackling an area of dispute head on, opens wide the terrain of debate addressing issues such as advances in brain science, the politics of Western psychiatry's spread across the globe, and recent evidence of social adversity's role in producing mental ill health. The answers we find to these pressing questions will shape the psychiatric futures that are being brought into existence. Ultimately, this book proposes a radically different future, no less evidence-based or rigorous, and indeed far more attuned to the realities of mental health, and argues that, as a branch of social medicine, another psychiatry is possible.
Chapter One: What is psychiatry?
Our psychiatric lives
Everyone's little helpers
Psychiatry defines the boundaries
What mental disorder is
Psychiatry as a political science
The politics of psychiatry
Critical psychiatry today
Chapter Two: Is there really an 'epidemic' of mental disorder?
'The burden of brain disorders'
Counting the costs
From 'mental' disorders to 'brain disorders'
So is there an 'epidemic'?
Chapter Three: Is it all the fault of neoliberal capitalism?
Our unhappy present
The factory of unhappiness
So is it all the fault of neoliberal capitalism?
Chapter Four: If mental disorders exist, how shall we know them?
Diagnosis as a social phenomenon
Solution One: Define the phenotype
Solution Two: Find the biomarker
Solution Three: Straight to the brain
Solution Four: Beyond diagnosis
From diagnosis to formulation
Chapter Five: Are mental disorders 'brain disorders'?
Proven by psychopharmaceuticals?
Discovered in the genes?
Visible in the brain images?
So are mental disorders brain disorders?
Chapter Six: Does psychopharmacology have a future?
How did we get here?
The drugs don't do nothing, but
The pipeline is empty!
Chapter Seven: Who needs global mental health?
Grand challenge: no health without mental health?
Beyond the conflict?
All our futures?
Chapter Eight: Experts by experience?
Mental patient movements
From 'on our own' to 'nothing about us without us'
The politics of recovery
A new epistemology of mental distress
Have we moved beyond the monologue?
Chapter Nine: Is another psychiatry possible?
Manifestoes for the future
Seven answers to seven hard questions
Another psychiatry, another biopolitics
'Nikolas Rose brings a remarkable wealth of scholarship and experience to seriously difficult questions about mental health - and his inspiring answers suggest original and enlightening solutions. Rose's brilliant analyses provide stunning revelations about practical ways mental distress can be alleviated. Everyone with any stake in psychiatry and mental health should read this book.'
Emily Martin, New York University
'In another landmark volume, Rose presents the culmination of decades of critical questioning about the reach of psychiatry's long arms into all our lives, whether we live with mental distress or not. His "Seven Hard Questions" are ones we need to keep asking.'
Sarah Carr, University of Birmingham
"If you want a scholarly and thought-provoking critique of current psychiatry, then this is the book for you."
Tom Burns, Times Higher Education Supplement
"Even-handed, meticulously researched, offering a wealth of historical detail explaining how psychiatry has got to where it is today."
"Rose's writing is logical and straightforward, and he is able to convey complex arguments and nebulous ideas in a way that will be clear to most readers."
Journal of Mental Health
Nikolas Rose is Professor of Sociology and Head of the Department of Social Science, Health and Medicine at King's College London.