Anti-psychiatry, sometimes spelled antipsychiatry, is a movement based on the view that psychiatric treatment is often more damaging than helpful to patients, highlighting controversies about psychiatry. Objections include the reliability of psychiatric diagnosis, the questionable effectiveness and harm associated with psychiatric medications, the failure of psychiatry to demonstrate any disease treatment mechanism for psychiatric medication effects, and legal concerns about equal human rights and civil freedom being nullified by the presence of diagnosis. Historically critiques of psychiatry came to light after focus on the extreme harms associated with electroconvulsive treatment or insulin shock therapy. The term "anti-psychiatry" is in dispute and often used to dismiss all critics of psychiatry, many of who agree that a specialized role of helper for people in emotional distress may at times be appropriate, and allow for individual choice around treatment decisions.
A psychiatric or psychotropic medication is a psychoactive drug taken to exert an effect on the chemical makeup of the brain and nervous system. Thus, these medications are used to treat mental illnesses. These medications are typically made of synthetic chemical compounds and are usually prescribed in psychiatric settings, potentially involuntarily during commitment. Since the mid-20th century, such medications have been leading treatments for a broad range of mental disorders and have decreased the need for long-term hospitalization, thereby lowering the cost of mental health care. The recidivism or rehospitalization of the mentally ill is at a high rate in many countries, and the reasons for the relapses are under research.
The Rosenhan experiment or Thud experiment was an experiment conducted to determine the validity of psychiatric diagnosis. Participants submitted themselves for evaluation at various psychiatric institutions and feigned hallucinations in order to be accepted, but acted normally from then onward. Each was diagnosed with psychiatric disorders and were given antipsychotic medication. The study was conducted by psychologist David Rosenhan, a Stanford University professor, and published by the journal Science in 1973 under the title "On Being Sane in Insane Places". It is considered an important and influential criticism of psychiatric diagnosis, and broached the topic of wrongful involuntary commitment. Rosenhan along with eight other people entered 12 hospitals across five states along the west coast of the US. Three of the participants were admitted for only a short period of time, and in order to obtain sufficient documented experiences, they re-applied to additional institutions.
MindFreedom International is an international coalition of over one hundred grassroots groups and thousands of individual members from fourteen nations. Based in the United States, it was founded in 1990 to advocate against forced medication, medical restraints, and involuntary electroconvulsive therapy. Its stated mission is to protect the rights of people who have been labeled with psychiatric disorders. Membership is open to anyone who supports human rights, including mental health professionals, advocates, activists, and family members. MindFreedom has been recognized by the United Nations Economic and Social Council as a human rights NGO with Consultative Roster Status.
Bruce E. Levine is an American clinical psychologist, often at odds with the mainstream of his profession, in private practice in Cincinnati, Ohio. He has been in practice for more than three decades. Levine writes and speaks widely on how society, culture, politics and psychology intersect.
Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill is a 2002 book by medical journalist Robert Whitaker, in which the author examines and questions the efficacy, safety, and ethics of past and present psychiatric interventions for severe mental illnesses, particularly antipsychotics. The book is organized as a historical timeline of treatment development in the United States.
The Soteria model is a milieu-therapeutic approach developed to treat acute schizophrenia, usually implemented in Soteria houses.
James Barry "Jim" Gottstein is a mostly retired Alaska based lawyer who practiced business law and public land law, and is well known as an attorney advocate for people diagnosed with serious mental illness. Gottstein has sought to check the growth in the administration of psychotropics, particularly to children.
Loren Richard Mosher was an American psychiatrist, clinical professor of psychiatry, expert on schizophrenia and the chief of the Center for Studies of Schizophrenia in the National Institute of Mental Health (1968–1980). Mosher spent his professional career advocating for humane and effective treatment for people diagnosed as having schizophrenia and was instrumental in developing an innovative, residential, home-like, non-hospital, non-drug treatment model for newly identified acutely psychotic persons.
Jeffrey Alan Lieberman is an American psychiatrist who specializes in schizophrenia and related psychoses and their associated neuroscience (biology) and pharmacological treatment. He was principal investigator for CATIE, the largest and longest independent study ever funded by the United States National Institute of Mental Health to examine existing pharmacotherapies for schizophrenia. He was president of the American Psychiatric Association from May 2013 to May 2014.
Rufus May is a British clinical psychologist best known for using his own experiences of being a psychiatric patient to promote alternative recovery approaches for those experiencing psychotic symptoms. After formally qualifying as a clinical psychologist, he then disclosed that he had been previously detained in hospital with a diagnosis of schizophrenia.
Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America is a book by Robert Whitaker published in 2010 by Crown. Whitaker asks why the number of Americans who receive government disability for mental illness approximately doubled since 1987.
Peter Lehmann, D. Phil. h.c., is an author, social scientist, publisher, and an independent freelance activist in humanistic anti-psychiatry, living in Berlin, Germany.
David William Oaks is a civil rights activist and co-founder and former executive director of Eugene, Oregon-based MindFreedom International.
Doctoring the Mind: Why psychiatric treatments fail is a 2009 book by Richard Bentall, his thesis is critical of contemporary Western psychiatry. Bentall, a professor of clinical psychology, argues that recent scientific research shows that the medical approach to mental illness is fatally flawed. According to Bentall, it seems there is no "evidence that psychiatry has made a positive impact on human welfare" and "patients are doing no better today than they did a hundred years ago".
Psychiatry is, and has historically been, viewed as controversial by those under its care, as well as sociologists and psychiatrists themselves. There are a variety of reasons cited for this controversy, including the subjectivity of diagnosis, the use of diagnosis and treatment for social and political control including detaining citizens and treating them without consent, the side effects of treatments such as electroconvulsive therapy, antipsychotics and historical procedures like the lobotomy and other forms of psychosurgery or insulin shock therapy, and the history of racism within the profession in the United States.
Dopamine supersensitivity psychosis is a hypothesis that attempts to explain the phenomenon in which psychosis occurs despite treatment with escalating doses of antipsychotics. Dopamine supersensitivity may be caused by the dopamine receptor D2 antagonizing effect of antipsychotics, causing a compensatory increase in D2 receptors within the brain that sensitizes neurons to endogenous release of the neurotransmitter dopamine. Because psychosis is thought to be mediated—at least in part—by the activity of dopamine at D2 receptors, the activity of dopamine in the presence of supersensitivity may paradoxically give rise to worsening psychotic symptoms despite antipsychotic treatment at a given dose. This phenomenon may co-occur with tardive dyskinesia, a rare movement disorder that may also be due to dopamine supersensitivity.
Giovanni Andrea Fava is an Italian psychiatrist and professor of clinical psychology at the University of Bologna. He is also a clinical professor of psychiatry at the University at Buffalo School of Medicine and Biomedical Sciences.
Mad in America is a webzine dedicated to critical perspectives on modern psychiatry. It was founded in 2012 by Robert Whitaker, who also publishes the site. Whitaker founded the Mad in America website in response to the positive reactions to his books Mad in America and Anatomy of an Epidemic. Its mission statement originally stated,
Mad in America’s mission is to serve as a catalyst for rethinking psychiatric care in the United States. We believe that the current drug-based paradigm of care has failed our society, and that scientific research, as well as the lived experience of those who have been diagnosed with a psychiatric disorder, calls for profound change.
