Book Review:  Tales From The Madhouse, by Gary Sidley


Earlier this year the British publisher PCCS Books published Tales From The Madhouse: An insider critique of psychiatric services, by Gary Sidley.  Gary worked for thirty-three years in the British NHS mental health service.  He has held positions as a psychiatric nurse, a manager, and a clinical psychologist.  He is currently a freelance writer and trainer.  His present focus is the promotion of alternatives to biological psychiatry in the alleviation of human suffering.

Here are some quotes from the book.

“Psychiatry is a fundamentally flawed discipline routinely delivering a form of institutionalized discrimination that detrimentally impacts on the lives of many people already blighted by distress and misery.  The engine room for its deleterious practices is psychiatry’s stubborn, fallacious and self-serving insistence that the range of human suffering construed as ‘mental illness’ primarily represents the manifestation of some form of biological aberration.  The pervasiveness of this government-sponsored malpractice across the Western world, maintained by the powerful vested interests of professional psychiatry and the pharmaceutical industry, amounts to a modern-day scandal.” (p xi)

“So Mark had spent 20 years of his life believing himself to be the carrier of a brain deficit, a biological incendiary device in his head that would be detonated by a powerful emotional experience.  Little wonder that he constantly felt on the cusp of something disastrous, and thereby lived a restricted, mundane existence.” (p 38)

“In practice, the person struggling with unusual experiences is forced to choose between either accepting the dominant psychiatric view that they have a biochemical imbalance in their brains, or rejecting this conclusion and risking the subsequent coercion into treatment or loss of support.  Inevitably, feeling overwhelmed and vulnerable, many service users will passively accept the explanations being offered by psychiatric experts.” (p 67)

“Two prerequisites for success in therapy, therefore, are a belief that one can influence one’s own future wellbeing and a readiness to put effort into doing so.  If a person has already been sold the idea that mental health problems are primarily caused by defects in brain biochemistry it is improbable that either of these imperatives will be evident.” (p 87)

“The unholy alliance of drug companies and biological psychiatrists has spawned malpractices of a more blatant kind that range from the highly selective and self-serving sharing of information, to bribery and stark criminality.” (p 149)

“Clearly, vested interests inherent to biological psychiatry are not about to willingly capitulate their privileged positions.” (p 191)

“As part of their desperate mission to promote psychiatry as a legitimate medical speciality, the psychiatric profession persists with their fallacious claims that their drug treatments achieve disease-centred effects, restoring harmony to the brain’s biochemistry.” (p 201)

“The views expressed in this book are the product of my experiences associated with 33 years of continuous employment within psychiatric services.  A lifetime of working as part of a system whose remit is to help people suffering misery and distress has led me (and many others) to the stark conclusion that Western psychiatric services are not fit for purpose.” (p 207)

Gary’s criticisms of psychiatry are cogent and convincing. But in addition he has drawn on his extensive experience working in the system to describe in close detail psychiatry’s devastating effects in the lives and hopes of real people.  Through Gary’s sensitively written anecdotes, psychiatry’s “treatments” are exposed as the disempowering, hope-destroying tactics that they are.  In Gary’s stories, the individuals come “alive,” and the descriptions of the “treatments” and manipulations to which they are subjected are credible, compelling, and at times heart-rending.

Gary also addresses the far-reaching issues of psychiatric coercion, hegemony and arrogance, and the barriers that they pose to real progress.  In a readable style, Gary outlines for us the tactics used by psychiatrists to maintain their control, and to pressurize clients and non-psychiatric staff to conform.  Several examples are provided of psychiatry’s failure to address the issues that are raised on this side of the debate, or indeed to take any steps away from a medically-dominated model.

While Tales From The Madhouse is based on Gary Sidley’s experiences within the British system, the material will have strong resonance for readers from other countries.  Pharma-psychiatry is a multinational behemoth whose tentacles span the globe.

Tales From The Madhouse is readable and outspoken.  Its 211 pages constitute an unrefutable critique of psychiatry, and an insistence that fundamental change is long overdue.

I strongly recommend this book.  Please read it and tell others about it.

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Disclosure:  I have no financial links to this book or to any books/materials that I endorse on this website


  1. But how can we be sure that Sidley is not suffering from a mental disorder which prevents him from embracing psychiatric hegemony? Could it be anosognosia, or lack of insight, that is causing him to write such scathing critiques in such lucid prose? I recommend that he visit a psychiatric nurse, a manager, and a clinical psychologist, or in other words, himself.

    Great stuff as always Dr. Hickey. Keep up the good work.

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