A comprehensive review of the evidence of psychiatry's shameful deficiencies, illustrated with disturbing anecdotes of how these failings are currently playing out within psychiatric services throughout the UK and beyond.
Clinical psychologist, Gary Sidley, believes that current psychiatric practices are based on pseudo-scientific assumptions that are barely more valid than those of witchcraft and demonic possession that dominated society’s approach to madness in bygone centuries.
Gary’s 33 years of experience working as a mental health professional – psychiatric nurse, clinical psychologist and manager – has enabled him to write a distinctive insider account of the shameful failings of the Western psychiatric system. In his book, published on 4th February 2015, he clearly lays out the scientific evidence against psychiatric practices, going on to illustrate key points with beautifully written, poignant, at times deeply shocking stories from his years of experience. The result is a book that engages head and heart in a very striking way. His stories leave us in no doubt about how medically lead practices impact negatively on those in the care of mental health services. Tales from the Madhouse challenges us to question blind faith in psychiatric services in the UK.
Tales from the Madhouse details the evidence that the ‘illness like any other’ dogma has had a detrimental impact on the lives of psychiatric patients, promoting stigma, low expectations, passivity and gross overprescribing of toxic medication. Each of these themes is brought to life with authentic tales of what actually goes on in the murky world of psychiatric services.
The symbiotic relationship between the state and the medical profession; the simplistic and often fallacious categorisation of the mentally disordered; the loss of human individuality and the de-emphasising of personal meaning; and the arbitrary “diagnosis” of mental illnesses and the valuing of compliance – characteristics that remain rife within current psychiatric provision – can all be recognised within the workings of the old mental asylums.
So once selected for the bowel-care session, the most favourable outcome awaiting a resident of Fullwood Ward in 1981 was to have 200 millilitres of warm fluid squirted into his rectum.
Although genetics clearly influences whether or not someone will develop symptoms that will attract a diagnosis of schizophrenia, the research purporting to demonstrate genetic causation is riddled with biases ranging from flagrant manipulation of data to subtle statistical manouvres.
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.
It is a supreme paradox that the most potent source of stigma for people with mental health problems is the network of established clinical and research practices of psychiatric professionals.
The fact that managers and the majority of clinicians, within a specialist mental health team in the year 2012, were unwilling to sit alongside service users and learn a new skill demonstrates the expanse that psychiatric professionals have yet to travel to free themselves from stigmatising “us and them” attitudes.
Having been rendered symptomatic, vulnerable and powerless by previous adverse experiences, psychiatric experts enter the scene and assign diagnoses to the service users that act both to formalise their impotent position in society and to attribute the source of their difficulties to internal deficits.
… but you have to understand that I am the doctor here and I have a professional responsibility to treat each of my patients in the way I deem fit so as to alleviate the mental illness as quickly as possible.
Foreword by Professor Tony Morrison
The Psychiatric Asylum
Part I: The doctors assume control of the mentally disordered
Part II: Routine and conformity
An Illness Like Any Other
Part I: Where it all went wrong
Part II: The pernicious assumption of underlying deficits
Witches of the Twenty-First Century
Part I: The stigma of being a psychiatric patient
Part II: Discrimination in action
The Witch-Finder Generals
Part I: Psychiatry and the misuse of power
Part II: Who is in charge here?
Let the Doctors and Nurses Treat You
Part I: Passivity and submissiveness
Part II: The debilitated must take it easy and follow instructions
Risk Distortion and Risk Aversion
Part I: Bureaucracy and defensive practice
Part II: Action plans, policies and sharp edges
There is No Hope for the Brain-Diseased
Part I: Pessimism and low expectation
Part II: We shouldn’t expect too much
An Unholy Alliance
Part I: Psychiatry and the pharmaceutical industry
Part II: Currying favour
A Basic Lack of Compassion
Part I: Coldness and spite
Part II: If I don’t think you’re mad, you must be bad
How Can We Improve the Mental Health of the Population?
For me, the power in Sidley’s book comes from the way he combines exploration and critiques with a string of essentially human tales that bring to life the damage caused by the status quo. Reading each tale, my heart is as engaged as my head as Sidley shares the everyday interactions that demonstrate how our good intentions are often tainted by a paradigm that is ultimately flawed. I challenge anyone to read this book and say, without reservation, that there is nothing wrong in the way we understand and support those of us who are most distressed and overwhelmed. Rai Waddingham,
Gary Sidley has written a passionate and gripping critique of mental health services in the UK, informed by his long experience as a psychiatric nurse and then, later, as a clinical psychologist practicing in the NHS. Although he supports his case with clearly reviewed research, it is the accompanying stories of his experiences with vulnerable patients mistreated by the system which are particularly compelling. Sidley vividly describes how power operates within psychiatric teams to the detriment of those who are utterly powerless.
A brave and creative way of presenting "tales from the madhouse" to illustrate some of the ills of psychiatry and mental health services. Both humorous and moving, the switch from the "academic arguments" to the personal narratives / experiences is creative and brings the discussion to life. An easy yet thought provoking read, which challenges some of the damaging, implicit assumptions about mental health "management" and the systems, which are, afterall, meant to be supportive. Perhaps students of nursing, psychiatry and psychology in the uk should be offered this as a core preliminary text to working in mental health?
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.
In the preface to Tales from the Madhouse, Gary Sidley describes his book as 'a damning critique of the system'. Damning indeed, but certainly not through diatribe or bitter polemic - this is a thoughtful, deep and persuasive critique of how and why psychiatric services have failed time and time again on so many levels. Gary Sidley blends powerful examples from his life's work with wide ranging references from academic research to bring to light the failings of the established psychiatric system. The author's clear-headed and warm writing style makes Tales from the Madhouse a compelling read. I recommend it to anyone with an interest in Mental Health services - patients, staff, journalists and academics - but especially psychiatrists.The author expresses optimism that change is a-foot in the way society addresses human suffering, and that transformation of Mental Health services away from biological psychiatry is possible. Maybe so, but such a revolution will need Psychiatry fully on side - that's a big ask.