I had a response in History Today-see earlier blog-and this is my reply:

I feel Mr Roberts has not actually dealt with the matters I raised but nevertheless his arguments require a response. First, I have to take issue with his recommendation of drug treatment for those experiencing grief as not only are such drugs wholly unsuitable but also likely to cause long term harm. Even British psychiatrists have strongly criticised such practices. The evidence that mental health services have successfully cured anorexia is very debatable, as much of the present decline may be due to changes in the media, which probably initiated the problem with its obsession with female bodies. This may be an instance of the inevitable NHS propaganda whenever the potency of different illnesses fades. NHS websites display a flawless service, with no mention of recent disasters and scandals. Mr Roberts has simply reasserted the medical model.

     My argument concerns the ideas behind the concept of mental illness, methods of treatment and diagnostic processes.  I will begin by pointing out that prevailing notions on mental health/illness have been historically constructed by the medical profession, an autonomous, powerful elite body, at present symbiotically connected to the pharmaceutical companies, without reference to public debate. These notions are rarely critiqued by other bodies, but simply accepted as true. Any medical history, such as those written by Roy Porter or Paul Starr in his Social Transformation of American Medicine, adequately testifies to this disconcerting development. Mental health professionals have, in the process, excluded better, more sophisticated ideas on human mind and personality from public health and public consciousness. Although I believe mental illness exists, I suggest it represents a small percentage of those diagnosed and that the lack of accountability of mental health professionals, particularly psychiatrists, who normally have no knowledge of psychotherapy, counselling, family or interpersonal interactions, leads to arbitrary and subjective decisions.

     The rare instances of independent research into the neurobiological approach of the profession tend not to confirm its validity. Recent research for example, indicates that psychotropic drugs, such as valium and anti-depressants, in 75% of cases have only a placebo effect.  The remaining 25% can be ascribed to falsification. Psychotropic drugs contain and control individuals and, of course, are highly addictive with damaging psychological side effects. Precisely why they should not be given to those who have recently experienced bereavement. Here, the real success story is bereavement centres, not GPs. The above evidence, not produced by the medical profession or pharmaceutical companies, concludes that patient trust and belief in the treatment process provides any beneficial effects.  Ben Goldacre in his recent book Bad Pharma deals with these matters at length, itemising missing or adjusted data.

    Mr Roberts argues that modern life presents different challenges, causing the enormous increase in mental illness. I have come across this argument before but it is rarely followed up with reasons as to why modern life can have this affect. It is merely, it seems, an assumption based upon feelings of regret and nostalgia. Let me again present an alternative view backed up by recent independent research.

     There are now far more mental health professionals, many of which can diagnose mental illness in others. Add to these GPs, and the number is considerable and growing. Once an individual is thus labelled, both the diagnosis and prognosis is fixed. A patient might have for example just been made bankrupt, feeling their life is spiralling out of control, and go to their GP, the only source they are told that will help them, to be instantly prescribed psychotropic drugs. In the statistics, they are now part of the growing body of mentally ill. Since the last World War, GPs have taken on roles once assumed by kin, communities, and religious representatives. Not only that, but many other groups offering help, such as SANE and MIND, propagate the medical model. They do not tend to challenge its basic paradigms.  Outside of the medicalisation process, it is difficult to find other forms of help for life’s difficulties. With the influx of Moslems and those with other cultures and beliefs, it will be interesting to see if this process continues and if instead people learn once again to seek advice and help within the community, bypassing the medical profession when confronted by misfortune.

     Dr Peter Breggin, an American psychiatrist, decades ago suggested that prescribed drugs actually caused the strange behaviour of those labelled mentally ill. Jeremy Reed’s Bitter Blue confirms the nightmare effects of tranquillisers. It is therefore highly likely that many people with short or long term periods of mental instability are affected by psychotropic drugs given by GPs for all kinds of social and emotional upsets.

     Let me now throw anecdotal evidence into this discussion. A fellow lecturer of mine, who also has worked and works within the mental health field, confided to me, without prior knowledge of my own conclusions on the subject, that mental health treatment appeared to be an attack on creativity. Her words not mine. She also noted how professionals identified themselves as normal and their patients as abnormal, and the importance of this artificial division to the former. For them, their patients were substantially different. Another, much older, colleague of mine confided in me about the entire (probably an exaggeration) occupants of a housing estate prescribed psychotropic drugs in the 1980s during a period of mass unemployment. She surmised if this was treatment or a strategy to prevent social unrest. Last year, a student of mine lost her sister. In her distress, she went to her GP who prescribed anti-depressives. My colleagues and I directed her instead to a bereavement centre and by doing saved her sanity.

     Mr Roberts scolds me for being offensive to patients and service providers in my short review. Let me counterbalance this complaint with an examination of recent behaviour of GPs and the NHS in this area.

    For several generations, GPs have prescribed the aforementioned dangerous psychotropic drugs, such as valium and ativan, to their patients for a variety of reasons. Over this period of time they failed to notice the addictive and psychological effects they had on their patients. When the alarm was raised by outside groups, neither GPs, nor the NHS as a whole, made any attempt to wean patients off their addiction. No facilities were set up for that purpose. When confronted, they blamed their patients. The government of the time stopped court action, claiming the payouts would cost the state too much in view of the number of claimants. Was this because the medical profession is such a powerful, independent group or because many claimants were from the lower sections of society and largely powerless within our society? You will not find any reference to medical drug addiction on NHS web sites, or, to be fair anything there that reflects negatively on the profession at all.

     To conclude: as can be seen in the works of Roy Porter, ideas of mental illness have been formed by an autonomous assembly in concert with its own development as a powerful, elite group during a period of scientific and medical professional triumphalism: the ideas of this group are rooted in 18^th century notions of rationality, which requires those deemed irrational to be contained and controlled: in the present day drugs are the most effective way of doing this: as the experience and evidence of the efficiency of taking  drugs is controlled by pharmaceutical companies and the medical profession, the drugs employed may be causing inestimable long term harm.