Please read the second comment contribution to this blog - it's both hilarious and spot on. Consequently, being ever reflexive and responsive but with little time, we are going to copy out a brief draft for discussion below to indicate that we have a serious side, it pains us to do it but we're aware we have to do. We're in editorial conflict here as the jamie of us is in earnest and the james is in spats.
So What is wrong with Mental Health Service Provision?
For a start off, Psychiatry is at the apex of the power structure of mental health law, classification, explanation, identification, restraint orders and treatments.
It has the legal status of an 'expert' 'science', it has the political and social status and power of a fully competent and coherent medical science and it has the consequent public funding to train new 'experts' and to lead and supervise the provision of mental health services, including legal powers to arrest citizens identified under Sections of the 1983, now revised 2007? Mental Health Act to isolate them from society for extended periods of time; to recommend they lose employment and to force unwanted drug treatment upon them on the grounds that such measures are in the interests of their own and/or others safety and 'well being'.
However: Among those who have received psychiatric 'care and treatment' a number have complained that their needs are not being met by psychiatric provision, that the provision is at best incomplete, at worst inappropriate and brutalising.
Therefore one thing that is wrong with Mental Health Service provision is that Psychiatry has too much power, status and share of funding for provision.
A Proposed Change
That Mental Health Service Provision should be jointly and equally developed, funded and led by and interdisciplinery team composed of psychologists, bio-chemists, social workers, service users and additional complementary therapy representatives.
PROBLEM
This will not come about until the following proposition, or something like it, is accepted - in law - to be the 'truth' vis a vis knowledge and expertise a bout mental illness and dysfuntion:-
"Relatively little is yet properly understood about the aetiology of moderate to severe mental health problems. Causation appears to involve multiple factors of interaction. Available medications can be observed to mask symptoms and calm behaviours but not to heal underlying syndromes, especially in the case of severely psychotic illnesses. Strong and empathic social support can be shown to impact significantly and positively on a wide range, if not all, sufferers of mental health problems. Ditto social inclusion in the social infrastructure, such as employment.
Functional psychiatry has yet to develop a testable, that is, falsifiable, theory of mental illnesses. The most successful psychotropic medications have been 'lucky accidents' rather than anything else.
Psychiatry does not have a sufficient cluster of relevant and fully reliable instruments for diagnosis or follow up treatment evaluations to constitute a medical science, or indeed a science, as such at all of any respectable variety.
Psychiatry as a paradigm of knowledge is in crisis. For the keenest minds this is an exciting time to be joining the profession - it is time to go back to the beginning and ask ourselves:-If we see Kraepelin as analogously pre-Galilean in his conceptions of mind and of mental illness then how can we acquire the equivalent of a Galilean take on Mental Ilness?
The first question we need to address, going back to the drawing board, is 'What is the relationship between the mind and the body, and between the body and its environment?
Cf Karl Popper, Enemies of the Open Society; Thomas Kuhn, Structures of Scientific Revolution (1962 I think but don't quote me)
This is only one angle on stuff but it's a bit of seriousness to be going on with.
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The Communications Department of the 18th International Committee has just alerted me to your second posting on the Mission Miraculous Blog and, although I have not had the chance to consider it in detail I thought I should swiftly let you know that I am reassured to see a little of your serious side, and consider what you say to also be spot on. I congratulate you on having the courage to quickly to put forward views in a draft form. I hope that this will elicit constructive criticism from sympathetic sources and that the philosophy underpinning your work can develop in the best dialectical fashion. I will, myself, be asking the relevant committee of the 18th International Committee to do all they can to contribute to the debate. If, as I fear, there isn’t one, rest assured that I will ensure that one is set up so that finest living minds in what is left of the 18th International Committee (As I am sure you are aware we have been facing difficult and demoralising times for so many years now) are at your disposal.
ReplyDeleteI have not managed to do much reading since my death and have to rely heavily on the Reading Committee of the 18th International. From what they have told me in the past I do believe your reference to Karl Popper needs some comment. In fact members of the Committee in your area had already informed me of your references to Karl Popper and I blame myself for not ensuring that I have not got this message to you earlier. I understand that it’s his “Conjectures and Refutations” and “The Logic of Scientific Discovery’ that are his key works on philosophy of science. His work entitled “The Open Society and Its Enemies” was a rather unfortunate excursion into political philosophy attacking Plato, Hegel, and a certain Karl Marx. Members and supporters of the predecessor to the 18th International Committee spent some considerable time refuting the spurious arguments in Popper’s political philosophy and I know that they still get very agitated when his name is mentioned in their presence! However I believe you are quite right to refer to his philosophy of science because it provides a yardstick by which Psychiatry measures its own efficacy, and, as you point out, it woefully fails its own test for good science. I certainly do think you will need to look elsewhere for a philosophical basis for your own work. I do, of course, believe my own writing are still highly relevant, but I did not write on mental health and you will clearly need to look elsewhere as well. This will take time and clearly you have to follow your instincts in pressing on with your work in the meantime.
You described my previous contribution as hilarious and I am really chuffed about this. (I hope hearing such a phrase from a 19C political economist is not too shocking, but that’s what your blog has done for me. For years some of my more cheeky younger supporters have been saying “lighten up, ……….”, but it has taken Mission Miraculous to achieve that). Today I was feeling quite low after my usual large ‘Sunday dinner, bemoaning the fact that all that food only seems to nourish my beard nowadays, and it made my day to receive such a compliment when I did indeed set out to amuse and make a serious point at the same time.
I notice that there is nothing about hats in your second posting, and I trust that you will not leave them in the cloakroom for too long, or I will start to worry that you have misinterpreted my comradely advice. Keep talking about hats, I say, but the less you have on poos the better. I could say more about the poos. Well actually I don’t really like saying anything about poos – but that’s another story involving young Sigmund, and I don’t think I should detract from the serious and indeed SPOT ON points you make with further personal reminiscence.
I believe you also have an email address and perhaps I should indulge this developing urge to tell you more about my life and after life by email rather than become a distraction in your Blog.
Best wishes
Formart H. Sax
You have taken more time both to entertain and to spur more effort to go into this blog than the editor has spent planning, preparing and publish it! The hats are off and point their tips and other topped shapes in their expression of shame at both slaphappy standards and failure to marry depth of reference, purpose, dialogue and 'Della Theatre d'Absurdo'.. Must do better dance the spats as they move around the umbrella stand taking digital photos of the rainbow forming
ReplyDeletegot the time wrong for last edit comment in fact 18.37 not 10.37 So what it doesn't make any difference, so why is an inaccuracy that bothers me - it must be something to do with poo...
ReplyDeleteAny private or confidential correspondence should be sent to the Editor at missionmiraculous@googlemail.com. I will be organising to ensure that an easier facilty is set up to enable visitors to use an easy link for this purpose. 24/02/09 00.14am
ReplyDeleteI, Formart H. Sax, do thank you for your kind words. Yes I am putting some time into trying to support you in your work, but your work could not be more important to me. My life and, insofar as has been possible, my afterlife has been dedicated to the more general struggle for international socialism and I continue to believe that this is the key to establishing a society where people of all races and cultures can live wherever they wish and achieve their full potential, free from so many of the problems and hardships (including mental distress) that abound in societies today. However I have always (despite the suggestions of some of my detractors) recognised the importance of groups such as yours in focussing and campaigning on particular aspects of our constricted existence in society as it is now – provided that you are truly able to unite around an understanding that those particular aspects or difficulties are linked to the broader nature of capitalist or indeed precapitalist society.
ReplyDeleteOn a less serious note I am glad to hear that the hats are still in use.
Taking a few steps up the ladders of seriousness, your reference to the Theatre of the Absurd is apposite, for, like Estragon and Vladimir, I too have the feeling that I am sitting here waiting for something that is not going to happen. At this very moment I feel your question, “What is that something?” hurtling through the fibre-optic cables that connect us in this 21st Century. The answer, of course, is that I am waiting for a day when your Blog will not contain gratuitous references to poos.
I originally voiced my concerns on this matter in my comment to your first posting. Members of the 18th International Committee in your area observing your work have suggested to me that you may not have fully understood the nature of my concerns at that time and I will take this opportunity to provide clarification. I was not referring to your editor’s first posting, which contained no mention of, or allusion to, poos. I was, of course, referring to the comments of you Contributor, Beohamster who referred to poos and torpedos in the contribution entitled “Bol” and to excessive consumption of alcohol in the other contribution whose title my 19C socialist sensibilities forbid me from quoting.
I know it was I who introduced the subject of poos in my last comment, but this was purely because you had not commented on or acted upon the comments in my first posting. The “Drag……..(sorry the Propaganda Committed have still not lifted their embargo, but have no fear, I am in discussions with them) Into The 21st Century Committee” of the 18 International have subsequently pointed out to me that these comments are not actually in Mission Miraculous’s own Blog. Nevertheless these comments are seen to be closely associated with your cause. Maybe there is some connection with mental health that I am missing, having a limited of knowledge of your country’s sense of humour, but at the moment I remain convinced that their presence is not helping your cause.
Anyway, I was surprised to find that it was your editor who dropped this matter in this time in this evening’s second comment. However, perhaps this was your Editor’s sense of fun again and perhaps your editor was hoping that I would indeed tell the story concerning the young Sigmund, which I alluded to last time. If this is the case, you are not to be disappointed, for I have succumbed to temptation. I say temptation, but it is story for us to learn from, rather than enjoy.
It was some years after my death that I realised that I realised that the young Sigmund was not only a little misguided, but increasingly influential. Members of the 18th International Committee assisted me in writing to him asking for an audience in which I could tell him about the importance of bringing dialectical materialism into his work. Given his line of work, I was confident that he would find a request for an audience from a dead political philosopher very intriguing. However, by that time I was already succumbing to this afterdeath tendency to reveal too much about myself and I also mentioned my problems with constipation in my letter. He clearly thought my problems with constipation were psychological in origin for in his reply he said “……., I will listen to all you have to say about dialectical materialism if you also tell me about your poos.” Unfortunately my abhorrence at talking about my own poos (or at least the absence of them) exceeded my eagerness to lecture him on dialectical materialism. This was a moment of cowardice which I bitterly regret, and to which I alluded in my first posting. I’m sure you will agree that there are important lessons to be learnt from this sad story.
I do hope that we will now be able to push the poos to one side and concentrate on less distracting matter in future dialogue.
I had hoped to finish on a lighter but still serious vein, by returning to passing reference to my fear of looking like Father Christmas in my first comment, if all you had to offer me was red hats. As well has providing you and your readers with some further amusement there are also important points in the story about mental health issues. Unfortunately it is getting late and the candles are going out in my birthplace and final home of………. This will therefore have to wait until another day.
Formart H. Sax
Can I ask of you a little favour? Let me know your thoughts of the relevance and value of my reference to Kuhn's Structures of Scientific Revolution? Your points re Popper were spot on on both counts of course. As to 6 x 7 - the answer, my friend lies that well known Study of future plausibilities, or not, something to do with Hitchhikers, I believe...
ReplyDeleteVery serious news, dear reader(s) - I have attempted to find a way to exert some editorial choice in selecting commentaries to appear on the blog and have in some bizarre way managed to cancel any editor or author for the blog... For the time being, until I can find any assistance with this technical hitch, I must update the journal via commentary form as the blog is now empty of official author or editor, From your ever calamitous editor...
ReplyDeleteYour master or mistress of fun, scourge of psychiatry and editor certainly deserves full marks for ability to confuse old Formart in the last two postings of the 23rd. 6x7, future plausibilities, Hitchhikers? Is this metaphysics after all, or perhaps you are confusing me with some obscure reference to Theatre of the Absurd? And I see that you also have a technical hitch in your Blog. Have your hikers brought it in?
ReplyDeleteYou are lucky not to have me as your only source of assistance on these matters, and I hope that in the near future we will both feel lucky that I can turn to the relevant department of the 18th International Committee. I am not sure which ones are relevant, but rest assured that I will find them and ask them to assist you as quickly as possible.
I am aware of Kuhn’s Structures of Scientific Revolution, but I was very busy travelling around various parts of the world in the turbulent 1960s when this book was published and, as you know I do struggle to read after my death, especially during times when even I have felt demoralised about defeats in the struggles against oppression and inequality. I feel sure that this work is highly relevant to your critique of psychiatry, but the more important question is where do you need to look for a solid basis for your own work. I think I need to take a little time to read and consider this (enthused as I am by your arrival), and I am sure you will be doing the same. Hopefully we can generate a debate on these pages.
As you may recall. I have other points to make and stories to tell, but the “Drag ….. into the 21st Century Department” have advised me to wait for the “thumbs up” (they would not tell me why tell were grinning when they used this phrase) from them regarding your technical hitch before contributing further.
I will of course pass on any advice I am given regarding your hitch.
Formart H. Sax
Consider my thumbs up Mr Formart H Sax, and send in plentifully your thoughts and reflections regardng the optimum development and effectiveness of Amazing Lives, the unofficial work in progress blog of Mission Miraculous
ReplyDeleteThe Editor
I am please to announce that the new IT Department of the 18th International Committee was set up this morning and, just hours later, the horses are saddled, the laptops are primed, and members of the department are ready to gallop to your assistance regarding your hitch problem. The department tell me that you can follow the link under my anonymous photo above or contact me directly via Google (whoever Google is).
ReplyDeleteFormart H. Sax 13.40 GMT Saturday 28.2.09