De-medicalising mental illness

Drop the Disorder: Challenging the Culture of Psychiatric Diagnosis by Jo Watson (PCCS Books; £18.00), reviewed by Rebecca Regler.

This groundbreaking text suggests that we should radically rethink and challenge the culture of psychiatric diagnosis. It approaches the topic from a range of perspectives including chapters from counsellors, clinical psychologists, survivors, activists and academics. The book builds on the work of the ‘Drop the Disorder’ events and social media groups, which host critical discussion around the biomedical model of mental health.

An overarching theme of the book is the proposal that we should move away from asking the question, ‘what is wrong with you?’ to asking, ‘what happened to you?’ This moves the lens from pathology and symptoms towards trauma and adversity, focusing on how our experiences shape our thoughts and behaviour. The notion that we all experience distress on a spectrum shifts the power away from a ‘them and us’ divisive concept (where one in four experience mental health difficulties) towards a four in four, inclusive ‘only us’ concept. The authors say we should listen and bear witness to people’s stories, finding meaning which can often be obscured by diagnostic labels.

Of course, some people do find their diagnosis helpful, feeling that without it their distress would not be perceived as validated or real. The authors acknowledge that distress is a very real experience and argue that contextualising it in life stories and finding meaning can actually validate it further. The book makes it clear that people should be given an informed choice in accepting their diagnosis and how their distress is conceptualised. The authors understand that very few people could actually ‘give up’ their diagnosis due to the way mental health and welfare services are set up: a diagnosis allows access to certain spaces that offer help.

It would require significant systemic change to de-medicalise mental ‘illness’ but the authors suggest three steps that individuals can take to help reduce the use of biomedical language: 1) use everyday words, 2) emphasise the context of ‘symptoms’ and 3) use speech marks around diagnostic language. They suggest that these seemingly small acts can build up to collective action for radical change.

This unique contribution to the psychology literature remains accessible through compelling narratives, poetry and artwork. This is not just a book; it is a call to action to advocate for a paradigm shift in modern mental health care. It offers an alternative framework for understanding distress and promotes hope for recovery.

Reviewed by Rebecca Regler, MSc student in Mental Health Recovery and Social Inclusion, University of Hertfordshire

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