Toward a new psychiatry

In this paper I explore the limitations of the medical model approach to mental health problems that dominate psychiatry. Examining issues of diagnosis, treatment, stigma and the impact of globalising Western thinking on mental health, I hope to demonstrate that the scientific/empirical basis of dominant models is insufficient and that globalising what essentially are ideological positions is potentially damaging. Instead of continuing to globalise current mainstream models, readers are encouraged to join other psychiatrists who are in the process of developing alternative models that are more culturally sensitive.Modern Western psychiatry has secured many important advances in the care of people with mental distress. We have a variety of pharmacotherapies that can help manage distressing symptoms alongside an even greater variety of psychotherapeutic approaches that help people in distress make sense of their experiences and find new ways to deal with them. The old asylums have been emptied and community care has developed a rich variety of services from early intervention to crisis management. The academic community, studying mental distress from a variety of angles have grown in numbers and sophistication with many journals and thousands of articles being published each year. These are worthy achievements and this progress has no doubt helped thousands and maybe millions of people across the world. Yet the desired story of a continuous growth of knowledge leading to better understanding and treatments is at best incomplete, at worst misleading. In this article I will explain the problems with remaining wedded to the current dominant paradigm used in psychiatry (the medical model) and outline one way in which the global community of practitioners can come together to develop ideas and practices that can take them beyond these limitations.