“Psychiatric Power: A Personal View” by Pat Bracken


Psychiatrist Pat Bracken, “a friend of Mad Pride Ireland,” writes about the current state of psychiatry in the Irish Journal of Psychological Medicine. As a review of the 2001 Irish Mental Health Act approaches, Dr. Bracken states that “the decision-making powers that are currently given to psychiatry cannot be justified on either scientific or moral grounds. I will go on to argue that shedding these powers (and subsequent responsibilities) would be a positive move for our profession.”

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. A remarkable challenge to the status quo. Ireland would be very progressive to heed this paper.

    From the paper: “….It seems that while we are comfortable working with individuals and organisations who accept the medical framing of mental problems, we are less willing to contemplate working with critical service users. These are people who reject the medical model because they feel harmed by a system that describes their problems using the language of psychopathology. If we are serious about having an inclusive debate on mental health we will have to overcome this impasse. We need to entertain the idea that people who reject the medical framing of their problems are nevertheless legitimate stakeholders. It is time that we learned how to talk to them and to listen to their ideas. The user movement, with its substantial critical component, is not going to go away….”

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