Psychologists v’s Psychiatrists and Children Law

I have reproduced below an article from the Guardian Website together with a link. There are associated articles including one from the well known Psychologist Oliver James (which was in today’s Observer). Its all well worth a look.

In a nutshell; [the British Psychological Society ] effectively casts doubt on psychiatry’s predominantly biomedical model of mental distress – the idea that people are suffering from illnesses that are treatable by doctors using drugs. The DCP said its decision to speak out “reflects fundamental concerns about the development, personal impact and core assumptions of the (diagnosis) systems”, used by psychiatry.

It’s all high powered stuff, but has implications on the practice of family law and in particular Child Care Proceedings.

Many parents whose children are subject of proceedings have mental health or personality issues, which have affected their capacity to effectively parent their children to a good enough standard.

Once proceedings have started (brought by Social Services) parents have to demonstrate; insight [understanding of where they have gone wrong], engagement [with professionals], and change [improved parenting, getting off drugs, drink] pretty quick, if they are to achieve rehabilitation of their children.

Over the last 12-18 months, there has been a massive sea change to how proceedings are dealt with, both to shorten the length of proceedings [down to 26 weeks from 52 or so] and with a big push for adoption. It needs to be demonstrated that any expert report sought is necessarily. [It is now much harder to get the Court’s permission to instruct an expert than it was 6 months ago]. If you can get an expert, then what expert? Psychologist or Psychiatrist?

often psychological reports will say that a parent needs therapy that will take 12 -24 months.

Psychiatric reports are more the norm for drug/drink cases, but also where a parent has a previously diagnosed mental health condition of some sort.

Generally Psychiatrists offer shorter timescales within which change can be achieved. When acting for a parent, there is often a preference to instruct a psychiatrist.

But even if  the exerts timescale for change for the parent is too long for a particular case; it is important for the next […more children….]. If a parent has another child shortly after one case ends, but has done nothing to seek help recommended in the previous case, the Court in the new case will be reluctant to authorize a new expert report. [what has changed?]

but if the psychiatric model of medication is largely wrong, then are parents just wasting their time if they end up within the psychiatric model?

Is it ever worth getting a psychiatric assessment of a parent?

Or are the psychologists wrong? and there is more effective [and potentially quicker treatment through medication?]

How will this dispute effect the treatment of addiction?  if an addict is better served with psychological therapy [are they?] then what is the point of methadone? or the drugs used to “assist” alcoholics?

so many questions…

I don’t have the answers, but will read the debate with great interest…

Read the Guardian… here is the main article;

Psychiatrists under fire in mental health battle

British Psychological Society to launch attack on rival profession, casting doubt on biomedical model of mental illness

http://www.guardian.co.uk/society/2013/may/12/psychiatrists-under-fire-mental-health

There is no scientific evidence that psychiatric diagnoses such as schizophrenia and bipolar disorder are valid or useful, according to the leading body representing Britain’s clinical psychologists.

In a groundbreaking move that has already prompted a fierce backlash from psychiatrists, the British Psychological Society’s division of clinical psychology (DCP) will on Monday issue a statement declaring that, given the lack of evidence, it is time for a “paradigm shift” in how the issues of mental health are understood. The statement effectively casts doubt on psychiatry’s predominantly biomedical model of mental distress – the idea that people are suffering from illnesses that are treatable by doctors using drugs. The DCP said its decision to speak out “reflects fundamental concerns about the development, personal impact and core assumptions of the (diagnosis) systems”, used by psychiatry.

Dr Lucy Johnstone, a consultant clinical psychologist who helped draw up the DCP’s statement, said it was unhelpful to see mental health issues as illnesses with biological causes.

“On the contrary, there is now overwhelming evidence that people break down as a result of a complex mix of social and psychological circumstances – bereavement and loss, poverty and discrimination, trauma and abuse,” Johnstone said. The provocative statement by the DCP has been timed to come out shortly before the release of DSM-5, the fifth edition of the American Psychiatry Association’s Diagnostic and Statistical Manual of Mental Disorders.

The manual has been attacked for expanding the range of mental health issues that are classified as disorders. For example, the fifth edition of the book, the first for two decades, will classify manifestations of grief, temper tantrums and worrying about physical ill-health as the mental illnesses of major depressive disorder, disruptive mood dysregulation disorder and somatic symptom disorder, respectively.

Some of the manual’s omissions are just as controversial as the manual’s inclusions. The term “Asperger’s disorder” will not appear in the new manual, and instead its symptoms will come under the newly added “autism spectrum disorder”.

The DSM is used in a number of countries to varying degrees. Britain uses an alternative manual, the International Classification of Diseases(ICD) published by the World Health Organisation, but the DSM is still hugely influential – and controversial.

The writer Oliver James, who trained as a clinical psychologist, welcomed the DCP’s decision to speak out against psychiatric diagnosis and stressed the need to move away from a biomedical model of mental distress to one that examined societal and personal factors.

Writing in today’s Observer, James declares: “We need fundamental changes in how our society is organised to give parents the best chance of meeting the needs of children and to prevent the amount of adult adversity.”

But Professor Sir Simon Wessely, a member of the Royal College of Psychiatrists and chair of psychological medicine at King’s College London, said it was wrong to suggest psychiatry was focused only on the biological causes of mental distress. And in an accompanying Observerarticle he defends the need to create classification systems for mental disorder.

“A classification system is like a map,” Wessely explains. “And just as any map is only provisional, ready to be changed as the landscape changes, so does classification.”

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