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Wake-up call for British psychiatry

Department of Psychological Medicine, Medical School, Cardiff University, UK

Danny Antebi, FRCPsych

Gwent Healthcare NHS Trust, Newport, UK

Mary-Jane Attenburrow, MRCPsych and Anthony Bailey, MRCPsych

University of Oxford, Department of Psychiatry, The Warneford Hospital, UK

Alan Carson, FRCPsych

Royal Edinburgh Hospital, Edinburgh, UK

Phil Cowen, FRCPsych

University of Oxford, Department of Psychiatry, The Warneford Hospital, UK

Bridget Craddock, FRCPsych

ABM University NHS Trust, Bridgend, UK

John Eagles, FRCPsych

Royal Cornhill Hospital, Aberdeen, UK

Klaus Ebmeier, FRCPsych

University of Oxford, Department of Psychiatry, The Warneford Hospital, UK

Anne Farmer, FRCPsych

Institute of Psychiatry, London, UK

Seena Fazel, MRCPsych

University of Oxford, Department of Psychiatry, The Warneford Hospital, UK

Nicol Ferrier, FRCPsych

Institute of Neuroscience (Psychiatry), Newcastle University, Royal Victoria Infirmary, UK

John Geddes, FRCPsych, Guy Goodwin, FRCPsych, Paul Harrison, FRCPsych and Keith Hawton, FRCPsych

University of Oxford, Department of Psychiatry, The Warneford Hospital, UK

Stephen Hunter, FRCPsych

Gwent Healthcare NHS Trust, Cwmbran, Torfaen, UK

Robin Jacoby, FRCPsych

University of Oxford, Department of Psychiatry, The Warneford Hospital, UK

Ian Jones, MRCPsych, Paul Keedwell, MRCPsych and Mike Kerr, MRCPsych

Department of Psychological Medicine, Medical School, Cardiff University, UK

Paul Mackin, MRCPsych

Institute of Neuroscience (Psychiatry), Newcastle University, Royal Victoria Infirmary, UK

Peter McGuffin, FRCPsych

Institute of Psychiatry, London, UK

Donald J. MacIntyre, MRCPsych, Pauline McConville, MRCPsych and Deborah Mountain, MRCPsych

Royal Edinburgh Hospital, Edinburgh, UK

Michael C. O’Donovan, FRCPsych and Michael J. Owen, FRCPsych

Department of Psychological Medicine, Medical School, Cardiff University, UK

Femi Oyebode, FRCPsych

Department of Psychiatry, University of Birmingham, Queen Elizabeth Psychiatric Hospital, UK

Mary Phillips, MRCPsych

Department of Psychological Medicine, Medical School, Cardiff University, UK, and Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

Jonathan Price, MRCPsych

University of Oxford, Department of Psychiatry, The Warneford Hospital, UK

Prem Shah, MRCPsych

Royal Edinburgh Hospital, Edinburgh, UK

Danny J. Smith, MRCPsych and James Walters, MRCPsych

Department of Psychological Medicine, Medical School, Cardiff University, UK

Peter Woodruff, FRCPsych

Department of Academic Clinical Psychiatry, Sheffield University, UK

Allan Young, FRCPsych

Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada

Stan Zammit, MRCPsych

Department of Psychological Medicine, Medical School, Cardiff University, UK

Correspondence: Nick Craddock, Department of Psychological Medicine, Medical School, Cardiff University, Heath Park, Cardiff CF14 4XN, UK; Email: craddockn{at}cardiff.ac.uk

Declaration of interest

All authors are members or fellows of the Royal College of Psychiatrists and currently work within, or have recently worked within, the UK National Health Service. We hope that both of these organisations will be influenced by this paper.

The recent drive within the UK National Health Service to improve psychosocial care for people with mental illness is both understandable and welcome: evidence-based psychological and social interventions are extremely important in managing psychiatric illness. Nevertheless, the accompanying downgrading of medical aspects of care has resulted in services that often are better suited to offering non-specific psychosocial support, rather than thorough, broad-based diagnostic assessment leading to specific treatments to optimise well-being and functioning. In part, these changes have been politically driven, but they could not have occurred without the collusion, or at least the acquiescence, of psychiatrists. This creeping devaluation of medicine disadvantages patients and is very damaging to both the standing and the understanding of psychiatry in the minds of the public, fellow professionals and the medical students who will be responsible for the specialty’s future. On the 200th birthday of psychiatry, it is fitting to reconsider the specialty’s core values and renew efforts to use psychiatric skills for the maximum benefit of patients.

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