Open Letter about BBC Coverage of Mental Health

Anne CookePeter KindermanRai Waddingham
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Following Richard Bentall’s inspired Open Letter to Stephen Fry, we – a group of people who have (and still do) use mental health services, who work in mental health, or who work as academics… or fall into more than one of those categories – have decided to write a parallel Open Letter to the BBC and other media organizations about their coverage of mental health issues.

We need as many signatures as possible! If you wish to sign, please email Peter Kinderman at [email protected] with ‘BBC letter’ in the subject heading, and your name, title and organization as you would like to be represented. You can also leave comments below.

 

Open Letter about BBC Coverage of Mental Health
 
We are writing together, as mental health professionals and people who have experienced mental health problems, to complain about the coverage of mental health in the recent BBC In the Mind series. We believe that, despite your obvious good intentions, your coverage may have done more harm than good. 
 
There are ongoing debates among mental health professionals and others, about whether it is meaningful or useful to think of mental health problems as illnesses. There are also debates about whether their origins are necessarily always in the brain, as opposed to being responses  to life events and circumstances. But your coverage – for example The Not So Secret Life of the Manic Depressive: 10 Years OnMy Baby, Psychosis and Me, together with your news item about research on miniature brains – completely ignored all of these debates. Instead of laying out the controversy in the unbiased fashion for which the BBC is known, they took for granted the view that mental health problems are necessarily a manifestation of biological illness.
 
The idea that bipolar affective disorder (manic depression) and schizophrenia are separate, identifiable illnesses with their origins in the brain is highly contested and unsupported by evidence. Even those in favour of the idea acknowledge that there are no blood or other independent tests for either condition, or indeed for any of the other so-called ‘functional’ psychiatric disorders.  Despite 50 years of well-funded and increasingly technologically sophisticated brain research, no ‘biomarkers’ (identifiable biological signs) have been found.  This has led an increasing number of professionals and researchers (including many psychiatrists) to question the simple biomedical theories promoted by your programmes.
Your programmes also appear to suggest that psychiatric medication should be the main, if not the only, treatment for mental health problems. But many believe that this simplistic illness/medication message is harmful, because it potentially leads to hopelessness, despairand (ironically, given that your broadcasts aimed to reduce stigma), prejudice and discrimination. Many are also concerned about the long-term efficacy and safety of these drugs. It is of course crucial that people receive care that meets their individual needs. Given the diversity of these needs, this care might include peer support, information, psychological therapy, or (where the person finds it helpful) medication. So to simply promote medication without also presenting other approaches (such as psychological therapy, as recommended by NICE) is biased and irresponsible.
 
Whilst some people who experience mental health problems think of their problems as an illness and find medication useful, many others do not. For example, many members of the Hearing Voices Network have been given diagnoses of bipolar disorder or schizophrenia but have now found other ways of understanding and living with their experiences. Some of them choose to take medication but others choose to live without it. Their stories could provide inspiration and hope to those who feel overwhelmed by their difficulties, but neither documentary included people who had found non-medical roads to recovery. Your programmes did not present any balance between those are resigned to living with what they see as an ongoing illness, and those who have found other ways of living with difficult experiences (or, indeed, no longer have them).
 
We are equally concerned about the BBC’s failure to acknowledge that the origins of problems, and the things that keep them going, are often not simply in the brain but in the events and circumstances of people’s lives – including povertyurban living, migration, childhood abuse, bullying and other forms of victimisation.  This has been confirmed by a vast volume of research, and the evidence is in fact stronger than for the involvement of biological factors. Educating the public about this would not only increase understanding: research suggests that this kind of approach reduces stigma and, in many cases, is more helpful for those affected. So it would have been more appropriate for your programmes to adopt the kind of approach taken in the recent British Psychological Society public information documents ‘Understanding Bipolar Disorder’ and ‘Understanding Psychosis’: namely, to lay out both sides of the debate and allow people to make up their own minds. Indeed, the just published Mental Health Taskforce Report also recommends this more balanced approach to mental health care.
 
As a matter of urgency, then, we ask you to commission a similarly high-profile programme featuring professionals and service users who adopt the approach outlined here.  We would be very happy to help, and can put you in contact with many suitable individuals.
Yours Sincerely
 
Peter Kinderman, Professor of Clinical Psychology, University of Liverpool & President-Elect, British Psychological Society
Jill Anderson, Co-ordinator, Mental Health In Higher Education Project, University of Lancaster
Richard Bentall, Professor of Clinical Psychology, University of Liverpool
Anne Cooke, Consultant Clinical Psychologist & Clinical Director, Doctoral Programme in Clinical Psychology, Canterbury Christ Church University
John Cromby, Reader in Psychology, University of Leicester
Angela Gilchrist, Clinical & Academic Tutor, Doctoral Programme in Clinical Psychology, Canterbury Christ Church University
Nicky Hayward, Mental Health Campaigner, Survivor, Blogger and Activist
Sue Holttum, Senior Lecturer, Doctoral Programme in Clinical Psychology, Canterbury Christ Church University
Steven Jones, Professor of Clinical Psychology, University of Lancaster
Lucy Johnstone, Consultant Clinical Psychologist
Laura Lea, Coordinator of Service User and Carer Involvement, Doctoral Programme in Clinical Psychology, Canterbury Christ Church University
John McGowan, Academic Director, Doctoral Programme in Clinical Psychology, Canterbury Christ Church University
Joanna Moncrieff, Senior Lecturer in Psychiatry, University College London
David Pilgrim, Professor of Health and Social Policy, University of Liverpool
Mark Radcliffe, Lecturer in Mental Health Nursing, Kings College London
Rai Waddingham, Hearing Voices Network and International Society for Psychological and Social Approaches to Psychosis
Jay Watts, Clinical Psychologist and Psychotherapist, Queen Mary, University of London
Paul Wilson, Head of Mental Health Services for Sirona

34 COMMENTS

  1. So far removed from the BBC’s usual excellent and balanced approach to broadcasting.
    Little evidence of impartiality.
    These programs were in fact very powerful pharmaceutical marketing propaganda for medications which may suppress symptoms, albeit on occasion with appalling adverse effects. They are not specific “treatments” as portrayed, as for example by the term “anti-mania”.
    The reality is that some of these drugs are actually the cause of non-existent “mental health disorders.”
    Those injured by psychopharmacology have no NHS recognition of the true cause of their immense suffering, as with – for example, akathisia.
    The toxicity of akathisia was apparently well illustrated by the film crews??? – but was evidence of akathisia ignored by these “mainstream” psychiatrists????
    Worse still, those “patients” whose physical, psychological, emotional health; and social, economic, employment and relationship aspirations are destroyed by unrecognised (or denied) cumulative medication toxicities, have no appropriate rehabilitation services in which to recuperate.

  2. There is a test for urinary pyrolles that crosses DMS diagnostic groups that appears in 5% of a (so-called) normal population, but is relatively high in psychiatric populations with perceptual disturbances. No matter what their DSM diagnostic groups, these individuals respond to treatment with vit. B6 and zinc.

  3. It is inconsistent with the research to not include the significance of social-psychological (socio-developmental) factors in the onset, course and outcomes of the heterogeneous group of people we diagnose with bipolar disorder. Expressed emotion, lack of social support, the presence of negative life events, personality factors,forms of interpretation of events, etc., all play a significant role in relapse and course of the disorder. There is a cohort effect not seen in all cultures since the mid-19th century. Even at the level of neurobiological alterations, one could make a reasonable case that hypercortisolemia (increased cortisol which can be neurotoxic) and other stress-related processes play a significant role. As in schizophrenia research, the atrophy of certain neural regions in bipolar disorder, e.g., the prefrontal cortex, insula, cerebellar vermis, corpus callosum, etc., are also observed in developmental traumatology research studies (exposure to traumatic and chronic stress from various events, sources, etc.). Gray and white matter (the information highway of the CNS) are affected. The hyperintensities seen in bipolar disorder are also observed in major depressive disorder. In fact as a stress researcher, I was the first to point out the significant overlap in the neuroscience of schizophrenia and bipolar disorder and the neuroscience of profound and chronic stress, formally at the ISPS London conference in 1997 and prior to that at meetings in the NYC , the states, and to Wayne Fenton, a colleague who was a deputy director at NIMH prior to his tragic death.

    Some of the new biological research in bipolar disorder is centering on mitochondrial dysfunction and the role of oxidative stress in causing it. Again, severe life stress (SLS) invariably induces oxidative stress and thereby can play a significant role in the mitochodrial dysfunction. SLS can induce genomic and epigenomic alterations which may play important roles in the pathophysiology of schizophrenia, bipolar disorder and major depressive disorder. There is so much to say about the new research showing the relevant linkage. SLS shortens telomere length,alters neuronal morphology and gene expression through various epigenetic channels, reduces neurogenesis and synaptogesis, is associated with synaptic pathology, is also associated with the new findings in complementary C4 proteins recently identified in the New York Times as “scientists homing in on the genetic cause of schizophrenia’!

  4. What this open letter does not consider is why we are in this situation. The obvious answer is that there is a lot of money riding on the so called “fact” that medication is the only answer. Pharmaceutical companies will go far to defend that psychiatric medication should be the main, if not the only, treatment for mental health problems. Unfortunately they have a lot of resources to sell that idea to us.

  5. I think it is important to make a clear separation between the psychological precursors and the psychological interventions proposed for bipolar disorder and schizophrenia. Leaving aside psychological precursors, it is worth looking at the psychological interventions that you mention in your letter.
    You say “Given the diversity of these needs, this care might include peer support, information, psychological therapy, or (where the person finds it helpful) medication. So to simply promote medication without also presenting other approaches (such as psychological therapy, as recommended by NICE) is biased and irresponsible”
    If we turn first to the empirical evidence on peer support for bipolar disorder and schizophrenia, it is not positive. A recent meta-analysis found no evidence that peer support has a positive impact on hospitalisation, employment, or self-reported outcomes such as symptoms of mental health problems, quality of life, recovery, hope, empowerment or satisfaction with services http://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-14-39 Although peer support is of course desirable, empirical evidence suggests it has little or no impact in the areas that we might hope and expect.
    If we turn to your reference of the NICE guide advocating CBT for schizophrenia and psychosis. This NICE guidance is now unacceptably outdated – their review and current recommendations cover studies published only up until 2008 – clearly in this instance, NICE are not meeting their own commitment to keeping guidelines current and evidence-based.
    In the case of the NICE guideline advocating psychological interventions for bipolar disorder, the evidence is very low quality and as with the NICE guidance on schizophrenia, has very recently been questioned https://theconversation.com/are-treatment-guidelines-on-schizophrenia-and-bipolar-disorder-just-plain-wrong-54369

    • Interesting that you find the evidence for peer support for bipolar and schizophrenia to have no positive effects. I’m wondering if you are familiar with the emerging research demonstrating that long-term treatment with medication appears to have a detrimental effect on those outcomes you mention?

      • The evidence on peer support making little or no difference in both bipolar disorder and schizophrenia is not my research, but comes from a meta analysis of all published studies. Interestingly it was conducted by the chief meta-analyst who is also responsible for the NICE guidance on bipolar disorder alluded to above.

        I am not aware of research showing that medication (in these disorders) has a ‘detrimental’ effect on the outcomes I mentioned (i.e. hospitalisation, employment, or self-reported outcomes such as symptoms of mental health problems, quality of life, recovery, hope, empowerment or satisfaction with services) but would be very interested to look if you can provide references

        • Hi Keith,

          What about this one:

          http://programme.exordo.com/nursingmidwifery2013/delegates/presentation/100/

          I attended these groups many years ago in Ireland. I didn’t follow any program (exactly) but I did get the necessary peer support. The group were also able to point me in useful directions where I did get more of the ‘approach’ I was looking for. But the whole thing was inclusive and the peer support definitely worked.

          The author Mike Watts was around at the time I was around and he is a very honest (English) man. When he writes about full non drug recovery from ‘schizophrenia and manic depression’ he is telling the truth.

          • Hi Fiachra, Thanks – its an interesting Powerpoint presentation. If they haven’t written it up for publication , then they should.
            I cant tell too much from the slides, but it looks like it would fall foul of the kinds of methodological rigour required in a controlled trial (i.e. a control group, random assignment, blind assessment of outcomes). The paper I referenced above is an analysis of RCTs. I understand that not everybody is enamoured with RCTs but health bodies (NHS, NICE in UK) are when considering investing in interventions.
            On the other hand, as I said above, peer support is often desirable (for anyone in any distress) and I am surprised that the evidence is so universally negative on outcomes in peer-support trials (for people with schizophrenia and bipolar diagnoses) – it looks like it should be an effective and easy-to-administer source of help

          • Keith,

            I think the presentation is from a Phd thesis (from Mike Watts) and it’s about free and voluntary peer support.

            I’m not that well up on RCTs, but what about the Hearing Voices Network (in terms of peer support group). This organisation is rated as having a very successful track record?

        • I would suggest you start by reading Anatomy of an Epidemic, by Robert Whitaker, who does an excellent job of summarizing this research over many years.

          Key research: the two WHO studies in the 1990s showing that people diagnosed with psychotic disorders in developing countries like Columbia and Nigeria have much better FUNCTIONAL outcomes (relating to employment, relationships, community involvement, etc.) than those in Western countries where medication use is much more common.

          https://schizophreniabulletin.oxfordjournals.org/content/34/2/253.long

          The Harrow Study, showing that even those with a better prognosis in the beginning did worse on medication over the long term than those who had a worse prognosis but did not use medication over the long term.

          http://www.ncbi.nlm.nih.gov/pubmed/22340278

          The Wunderlink Study, showing again that those taking less medication at lower doses for shorter periods of time did better in the long run:

          http://www.ncbi.nlm.nih.gov/pubmed/23824214

          Thanks for being interested. I hope those help get you started. It’s all very counterintuitive from the short-term symptom management viewpoint, but I find the research compelling and replicable at this point, and I see no credible replicated research that contradicts it.

          — Steve

          • Thanks Steve. The balance regarding how medication ‘helps’ and ‘harms’ has been quite well explored as has the interaction with duration of treatment. Certainly more investigated than whether psychological alternatives (such as CBT) are harmful or indeed, helpful. Interestingly, some evidence now suggests that longer durations of psychological therapy (esp CBT) may also be counter-productive for people with psychosis http://bjp.rcpsych.org/content/207/3/269.1.long

          • It would not surprise me if longer durations of therapy are also harmful.

            Your comments appear to skirt the question of whether you’re familiar with Wunderlink and so on and how you think that affects the decision to use drug treatment in the long run. There is a new but increasing trend toward delaying initial drug treatment in favor of psychosocial options, and then adding medication temporarily and in as low a dose as possible, based on these findings. I’m interested to hear your take on this new thinking, which I personally find is much more consistent with the literature findings than the classic, “You need to take these for the rest of your life” model.

            — Steve

          • Not sure why you think I am skirting any issue. As a psychologist, my research interest is in the role of psychological therapies in psychosis and not in medication.
            But to answer your question, yes, I do know the Wunderink study and it seems sensible to me. The evidence suggests that psychological interventions might be potentially helpful at the earliest point (e.g. preventing transition to psychosis), but less apparently successful after that point (at least in terms of the outcomes that CBT researchers use in their RCTs)

          • Steve, most evidence for long-term psychotherapy – on people with any diagnosis, not just “schizophrenics” who of course are just humans too – contradicts your notion that long-term therapy may be harmful. You might check out The Heart and Soul of Change by Barry Duncan in which much research on shorter and longer-term psychotherapy is summarized. Another book by his group is The Great Psychotherapy Debate by Wampold et al.

            Also ,you can find studies online and in print by Paul Knekt (Helsinki Psychotherapy Study), William Gottdiener (The Benefits of Individual Psychotherapy for People Diagnosed with Schizophrenia), Gaetano Benedetti (Individual Psychotherapy for Schizophrenia, in his book Psychotherapy of Schizophrenia), Roberta Siani (self-psychology therapy for psychosis, summarized in the book Effective Psychological Approaches to Psychosis by Martindale), Falk Leichsenring (several meta-analyses comparing long-term, greater than 1 year length therapy, to short therapy of a few months).

            If you search on Google and Amazon used books you can find links to these. Sorry I am too lazy to find them all right now.

            Some of these studies concern psychotic people only and others troubled people more generally. But the large majority that I’ve read generally point to the position that more help for longer tends to be better. It doesn’t mean that for some people staying dependent on a therapist too long could not be a bad thing. There is much variation among individuals of course.

    • Here is a major study to look at, Keith Laws. This meta-analysis would also be relevant to people labeled bipolar, since as Van Os has argued bipolar and schizophrenia are not truly distinct conditions but rather continuums that fade into each other.

      http://psychrights.org/Research/Digest/Effective/BGSchizophreniaMeta-Analysis.htm

      This is a meta analysis comparing effects of psychodynamic, CBT ,and supportive therapies on over 2,600 people labeled schizophrenic – taken from over 37 different studies, 19 randomized and 18 not randomized. Therapy length on average was 20 months, 1.5 times a week. The results strongly support psychotherapy of all kinds for psychosis. This information needs to get out more.

      • Just a few quick points:
        a) van Os may (like many others) have argued that bipolar and schizophrenia have ‘similarities’, but he also argues that they have ‘differences’ http://bjp.rcpsych.org/content/194/2/101 and http://www.ncbi.nlm.nih.gov/pubmed/15474912
        b) whether they are the same or not is not relevant here though – as interventions need not be the same nor necessarily similarly efficacious in bipolar and schizophrenia. For example, there is no evidence whatsoever that ‘any’ psychological intervention reduces the mania symptoms or indeed, depression symptoms in bipolar disorder (despite being effective in unipolar depression!). Similarities have no bearing on what interventions will be efficacious – more likely, its the differences that are key
        b) The book chapter you link to is very poor on many levels – first, it is 12 years out-of-date and so totally redundant. Second, it finds only a small impact of psychotherapy in trials that used a control group. Third, even where a tiny effect is found, most of the trials are open i.e. assessed by people who knew the group assignment – this was a problem of early trials – so even the small effect (r-.1) would disappear with blind outcome assessment

  6. There are ongoing debates among mental health professionals and others, about whether it is meaningful or useful to think of mental health problems as illnesses.

    This letter is also beside the most important point, which is that “mental illness” is a myth, period. The above statement for example talks about a debate about “mental health problems” being considered “illnesses” but doesn’t consider that “mental health” is as medical model a term as is “mental illness.”

    • So true Oldhead!
      One of the reasons that many people become victims of the medical model in the first place is because we have to much ‘ professionalism ‘! You could say I am a music ‘professional’ but true musicians hear and feel music. Many of our best musicians never had a music lesson!

      We who have survived psychiatry know it does much more harm than good. Many other well meaning ‘mental health!!!’ ‘professionals are the same.

      It is time to speak simply and leave the labels behind. They are clearly doing no good and increasing the discrimination which is rampant already! There is no divide only the one which is created to have us believe that some of us are sound and others are not.
      However the so called remedies (drugs, electroshock etc) are definitely causing serious harm even in some cases death.
      If you are a true professional you will want to support the voice of survivors and let them lead the way. Let us accept ourselves with all our shades of humanity. Let us love ourselves the way we are….. HUMAN.
      http://www.mindfreedomireland.com

      • Hi Mary and Oldhead,

        From my experience with doctors, the UK General Medical Council the UK Ombudsman (and a few more) I think these ‘labels’ are too unreliably formed to stand for anything.

        I believe, I could probably factually demonstrate that the UK GMC performance in ‘mental health’ is poorer than the minimum performance expected of a doctor in General Medicine.

  7. I’m really at a loss to know what the BBC ‘In the Mind’ season was all about. I have just watched a BBC documentary broadcast in October 2015 “Professor Green: Suicide and Me” – programme making at its very best. This is compelling TV, with not a mention of brain chemistry, medication or trips to the doctor. Prof Green is a natural in front of the camera – interesting how he uses the phrase “open dialogue” at around 12mins 30secs. Highly recommended. Here’s the link…

    http://www.bbc.co.uk/iplayer/episode/b06mvx4j/professor-green-suicide-and-me

    • They are tranquillizers, no more, no less. And that’s what we called them, way back when the first group came in. `Anti-psychotics’ was a marketing term when Big Pharma saw $$$. There were always drugs, barbiturates, Chloral Hydrate etc. The only use for them is that they can reduce the extreme agitation and fear people can feel in the grip of a psychotic episode. They are NOT anti-anything except that. The Open Dialogue program in North Finland use them, but also the anxiety reducing benzodiazepines for the very acute stages only, if absolutely necessary. And in most people they are not.

  8. A few years ago on a routine records examination I found my GP Practice had my name on a ‘Mental Health Register’ (SMI). This was without my knowledge or consent, and without a Care Plan.

    I’m a building worker and I have never suffered from Severe Mental Illness in the thirty years that I’ve been in the UK. I recovered in 1984 in Ireland as a result of coming off strong medication and moving to the Talking Treatments.

    The 1984 ‘diagnosis’ had been Severe: but my own problems had been extrapyramidal movement disorder, and suicidal reaction to strong medications (depot).

    (In 1986 I wrote to the ‘Unit’ in Ireland and asked them to send Adverse Drug Reaction Warning to the UK concerning depot medication. The ‘Unit’ sent a negative account of me over to the UK – with ADR Warning deliberately omitted)

    When I made complaints about the ‘Register’ my GP Practice was accommodating at the beginning, but when I persisted they tried to put ‘illness’ on to me.

    I made complaints to the UK Ombudsman and the UK General Medical Council. Both of these organisations blocked my complaints.

    I asked for Funding from the NHS to my see my own specialists to get my Recovery through Psychotherapy accurately recorded, and they told me that I would have to do this privately.

    In 30 years in the UK I have never been mentally disabled, my mental health has cost the UK nothing, and I am also a net UK taxpayer.

    The Mental Health System in England costs billions, it’s getting worse and it has no interest in any improvement.

  9. I feel deeply for your anguish.
    A “duty of candour” is allegedly required of all medical practitioners in the UK.
    It is one of the G.M.C. “Duties of a Doctor”.
    Might it be that mainstream psychiatry is absolved from, and / or has opted out of this requirement? Elsewhere in medicine, this duty of candour is taken very seriously.
    When it comes to the fundamental failure of psychiatry – i.e. : – the inability to distinguish initial, and then cumulative psycholeptic drug toxicities from serious mental illness – (leading to undisclosed condemnation for life, via S.M.I registration) – then it appears that “Psychiatry means never having to say you’er sorry”.
    Akathisia following serial change of SSRI’s, and then exacerbated by increasing SSRI dosage, is vulnerable to misdiagnosis as psychotic depression or first episode psychosis.
    This is all that is required for the misfortune to be subsequently SMI – “labelled for life.”
    Surely this is unbelievable arrogance and brutality?
    This is the basis for the “life chances destruction” that I have mentioned in my post above.

  10. Thanks Drtim,

    Akathesia is torture. My former psychiatrist was unable to tell the difference between the side effects of his own medication and genuine mental illness (though he did go on to write several published papers on the efficacy of these medications).

    I was provided in 2012, with a copy of my Irish notes (the present day ‘director’ didn’t fancy getting involved) and my 1986 ADR Warning Request letter was at the very back of these notes.

    I also experienced years of ‘High Anxiety’ or Withdrawal Syndrome after coming off the strong medications. I think I’d have no difficulty explaining what worked for me (psychotherapeutically) in recovery, and why it did.

    Thanks again for your empathy.

  11. I don’t know about the numbers for peer assistance versus meds, but with a 10% plus or minus recovery rate, the antipsychotic meds do worse for patients than the old Moral Treatment used by the earliest real mental institutions in the first half of the 19th Century, the better of which claimed a recovery rate of about 50%. With peers, I’d think the individual peers would make a difference- if the peer knew nutrient therapy, he or she could do a far better job with patients than shrinks using meds alone- I’ve met schizophrenics far more knowledgeable about the subject than most of the psychiatrists I’ve met.

    • As you stated, the Quakers achieved a much higher rate of recovery and healing for the people that they worked with during the ear of Moral Treatment, and they did it by treating people like human beings. Go figure. But of course, none of that is of any importance today when the recovery rate with the toxic drugs is stuck at around 15-16%. But of course we also know who is pushing drugs as the one and the only treatment for emotional and psychological distress. The good old drug companies are making money hand over fist and laughing all the way to the bank as they pull the biggest scam of history on everyone who isn’t willing to question things.

  12. The article on the bias in the BBC assuming “that mental health problems are necessarily a manifestation of biological illness” put me in mind of an analogy that we used to use when I was studying Artificial Intelligence programming alongside Biological models in the 1980s as part of my Bachelor’s Degree in Experimental Psychology.
    Attempting to “fix” mental health problems using medical interventions exclusively is like trying to fix every problem with your computer using a screwdriver. The fact that your computer stops working is much more likely to be a “bug” in the Software (the programs running on the computer, like Windows or Microsoft Office) than a problem in the Hardware (the keyboard, screen, microchips, memory cards, etc).
    Now if you’d just poured a cup of coffee over your keyboard, I might assume a hardware problem, but more likely I’d be looking to see if you’d installed a new program or clicked on an unexpected email and got a computer virus.
    Trying to fix a complex computer system with a screwdriver or even a highly skilled electronic engineer has no chance of success if the problem is in the program – You need a computer programmer. To put it another way, if Windows stops operating, I’d call Microsoft, not Intel.
    To stretch the analogy a bit further ( and get a bit technical), psychopharmacology is like trying to fix a computer with a virus by pouring an electrolyte solution over the chips because somebody thinks there are not enough electrons moving around. Like using an SSRI to “fix” a bereaved person’s “depression” because someone has a theory about Serotonin.
    Limiting the search for relief of mental health problems to biological rather than social interventions which acknowledge the role of life experience is equally unlikely to succeed.

    • You are, to a large degree, echoing the analysis of someone who used to post here as “cannotsay” (whose participation I miss). Anyway, he had a quite sophisticated analogy about psychiatry approaching a software (“mental”) problem as a hardware (neurological) problem. It is completely accurate analysis and I would like to see more people taking this up in their anti-psychiatry talking points, as I think it’s something people could understand and relate to.