Lancet Launches Re-Visioning Process for Psychiatry


Kings College London psychiatrist and World Psychiatric Association President Dinesh Bhugra has announced in The Lancet Psychiatry that the journal is launching a commission of inquiry into the future of psychiatry. Bhugra recently co-authored a Lancet commentary that attacked Peter Gotzsche and the Council for Evidence-based Psychiatry, describing their criticisms of antidepressants as “extreme” and “irrational.” In a new, freely-available commentary, Bhugra observes that a “major division exists between social psychiatrists and biological psychiatrists” that is threatening the credibility and stability of the entire profession. “Psychiatry is in transition and divided: with no clear sense of direction, we risk walking towards the edge of a cliff,” Bhugra writes.

In his commentary, Bhugra concedes that, “First among the internal threats to psychiatry is the often scandalous history of the profession, including appalling human rights abuses in asylums and the profession’s inability at times to challenge these.” He also describes the profession today as “embattled and divided,” and notes that, “Psychiatry’s history of diagnostic confusion, including the medicalisation and inappropriate treatment of individuals with normal human emotions and experiences, remains a topic of debate and a matter of concern.”

“What is the role of the medically trained professional in modern mental health care? What does the medical approach add, and what are its disadvantages?” asks Bhugra. To respond to these questions and the many challenges facing psychiatry, Bhugra writes that, “The Lancet Psychiatry is starting an independent Commission, Psychiatrists of the Future. It will consult with professionals, trainees, and service users. Readers of The Lancet Psychiatry will be kept updated on the process as we collect information and move towards publication.” There is no indication in the commentary about how to participate.

Alienated alienists: a new hope? (Bugra, Dinesh. The Lancet Psychiatry, Early Online Publication. August 13, 2014 doi:10.1016/S2215-0366(14)70283-4)


  1. Well Mr Bhugra, NHS psychiatry had my son for three and a half years, and demonstrated its very clear sense of direction – ignore the wishes of the patient and his family and coerce into useless, damaging, debilitating neuroleptics. The view from the cliff is also very clear – the kind of psychiatry we have experienced should break into a trot and run right off.

  2. “Independent”? They declared their hand in their very public and vicious attack of the Council for Evidence Based Psychiatry.

    Now…just confess a few problems of the past, hold up a couple of examples of overprescribing doctors and say, “Look, we had the inquiry, and found the current system works really well, with the exception of a few minor problems, which we have fixed” and proceed with business as usual, forever referring back to the “independent inquiry” to justify continued abuse and malpractice.

    The technique of using biased studies and concealing/ignoring/discounting adverse reports works for the drug companies, so why not use it to justify psychiatry itself?

    I agree with the above comments…

  3. “First among the internal threats to psychiatry is the often scandalous history of the profession, including appalling human rights abuses in asylums and the profession’s inability at times to challenge these.”

    That’s quite a subtle half truth. It suggests that these professionals were passive about these human rights abuses. Take a little closer look Bhugra, the majority were actively perpetrating and enabling them. And your attack on Peter Gotzsche and the Council for Evidence-based Psychiatry for “challenging” the profession is precisely HOW these abuses were enabled.

    “Psychiatry is in transition and divided: with no clear sense of direction, we risk walking towards the edge of a cliff,”

    That be the same cliff you have been pushing vulnerable people over for so long now? I’m sure the corpses will soften the landing. I know an active volcano with a bit of space available. Let me show you the way.

  4. People,

    This is an opportunity. The Lancet’s article has Dinesh’s email on it: [email protected] .

    So I wrote him the email below. We should all do the same!

    Subject: Your commentary at The Lancet

    Dear Dinesh,

    First, I apologize for this anonymous note. As a survivor of psychiatric abuse, protecting my privacy is paramount.

    I am referring to this,

    It is very ironic that you wrote that after you co-signed a vicious and warrantless attack to Peter Gøtzsche here,

    If that means you are coming to terms with the facts denounced by Peter Gøtzsche, that’s a welcome development.

    The only thing that psychiatry can do to correct its past abuses is to dissolve itself and to ask the public for forgiveness for the abuses it has perpetrated and it continues to perpetrate everyday.

    Take somebody like you, a gay man. 40 years ago, the APA would have considered you “mentally ill”. Up until around 20 years ago, the WHO did the same thing. Why do the rest of us have to put up with being labeled with diseases that are no less invented than “homosexuality”?

    Millions of children are drugged each day to “treat” invented ADHD and pediatric bipolar disorder -the latter invented by Joseph Biederman while on the payroll of Johnson and Johnson. The rate of suicide has increased with the massive prescription of antidepressants. People’s civil liberties are abused to force them into the “behavioral orthodoxy” invented by psychiatrists. In the UK, even Tom Burns has called for the abolition of CTOs after his own study showed that the only thing they manage to do is to abuse people’s civil liberties gratuitously.

    In your position as a gay man leading the World Psychiatry Association, your defense of psychiatry sounds as ridiculous as if a black man presiding a hypothetical World Racist Association would claim that racism against black people is wrong but racism against all other races, including whites, is fine.

    Do the right thing and put an end to the murderous psychiatric profession.


  5. Sounds to me like Bhugra is confessing the psychiatric industry is going through a mentally and ethically confusing period. When I went through a mentally confusing period, and was trying to overcome my denial that my child had been sexually abused at the age of three, a psychologist and her psychiatrist partners mandated a neuroleptic. When that resulted in a medically confessed “Foul up,” a bunch of toxic psychotropic drug cocktails were mandated.

    So apparently, since the psychiatric industry is currently in a state of confusion and uncertainty. According to their own beliefs, the psychiatric industry should all likely be put on neuroleptics to “help” them with their confused state. And if they do not react well to the neuroleptics, then they should all be put on drug cocktails with a minimum of six major drug interaction warnings a piece.

    That’s how they treated me when I was trying to overcome my denial, so it seems clear, that’s how they should all want to be treated. Right?