If there is one downside to the field of mental health, declares an editorial in The Lancet Psychiatry, “it is the failure of pleasant, intelligent, and thoughtful individuals to find any common ground in debate, and the subsequent descent of such discussions into bitter, and frequently personal, acrimony.” The editorial cites a comment thread in The Conversation that included Michael O’Donovan, a co-author of the recent high-profile schizophrenia-gene study, the University of Liverpool’s David Pilgrim, and MIA Foreign Correspondent Joanna Moncrieff.
“[T]oo often in mental health, one sees not the engagement of minds, but the performance of immutable opinions. Views are not so much diametrically opposed as existing in different dimensions,” says the Lancet editorial. “To take one example, the recent Nature paper ‘Biological insights from 108 schizophrenia-associated genetic loci’ was accompanied by a blog in which Prof Michael O’Donovan, one of the authors, set out the basic principles of the study and what he saw as the benefits… The discussion that followed publication of this blog was less about the finer points of Prof O’Donovan’s research, and more about whether he and his colleagues should have bothered in the first place.”
The editorial writer complains that Pilgrim made inflammatory links between psychiatry, gene studies, eugenics and Nazism. The writer calls such remarks from Pilgrim “below-the-line comments.”
In the original comment thread Pilgrim wrote, “Science is not politically neutral but always reveals a history of economic and ideological interests (in this case including the professional interests of psychiatry as a fragile and fragmenting medical specialty). Playing the open minded disinterested scientist role fools some of the people all of the time but not all of us all of the time. Being frank about vested interests in relation to biological studies of ‘schizophrenia’ takes us inevitably back to 19th century eugenics, a respectable movement across the political spectrum until Nazism gave it a bad name. (In 1988 the British Eugenics Society euphemised its facade by adopting the name of the Galton Society). This is not a slur — just history.”
The Lancet editorial does not comment on any of those points. However, the editorial writer makes various suggestions for improving community dialogue in the mental health field. “The first is to assume the best of one’s opponent: that their argument proceeds not from self-interest, financial interest, or wilful ignorance, but from genuine curiosity and a desire to improve the lives of people with mental health problems.”
The editorial writer acknowledges that, “There is always potential in the discussion of mental health issues to trigger distress, as everyone, patient or professional, has an unseen personal history and sensitivity.” The writer therefore calls for “space” for being heard to be given not to just psychiatrists and psychologists, but also to nurses, social workers and patients “in all their diversity.”
Duel diagnosis (The Lancet Psychiatry, Volume 1, Issue 4, Page 245, September 2014. doi:10.1016/S2215-0366(14)70363-3)
For the original comment thread, see:
Hundreds of genes and link to immune system found in largest genetic schizophrenia study (The Conversation, July 22, 2014)
