Whither Psychiatry in 2005 and Beyond?
So when Pilate saw that he could do nothing, but rather that a riot was beginning, he took some water and washed his hands before the crowd, saying, "I am innocent of this man’s blood; see to it yourselves." Then the people as a whole answered, "His blood be on us and on our children!" So he released Barabbas for them: and after flogging Jesus, he handed him over to be crucified.
Matthew 27.24 - 27.26
In an article in this morning’s Irish Times "Scandal of our mental health services," Mary Raftery uses the phrase "….the area of psychiatric care, for which, of course, the Minister has ultimate responsibility." Let me point out immediately that I do not want to cast Mary Harney in the role of Pontius Pilate.
No. The point I want to make is that everyone involved including myself (although I keep my mouth strategically shut a lot of the time) bears some responsibility for the way things are. When I was young in school the lesson of the Nuremberg trials was often drilled home. Like Goehring and Goebbels we cannot shuffle off responsibility onto the Hitler at the top of the chain of responsibility.
Even if we cannot open our mouths we can keep our eyes open. A blind man could see a lesson in the human wreckage we are all surrounded by in 2004 and 2005. That wreckage is the product of a half-century of modern psychiatric treatment.
It seems to me that the key interaction in the psychiatric system is between patients and nurses. The quality of that relationship is what determines the quality of life for the patient on a day-to-day basis. That quality can vary and it is, by no means, always bad. However nurses are not insulated from patients as psychiatrists invariably are. So their observations on systematic deficiencies are more likely to be grounded in reality.
I hope that modern advances - like the nurse training school in Dundalk Institute of Technology - will produce nurses who feel an authentic sense of their own responsibility and who are observant and encouraged to think independently and, also, who recognise the humanity of their patients and are apt to look at things from the patient’s point of view.
My biblical research this morning carried me into St Luke’s (the physician) Gospel. He pointed out that in the hour that Herod and Pilate conspired to sentence Jesus to be crucified they both became friends where they had been enemies before.
To my paranoid mind it seems to me that there are a number of alliances which are shoring up the failed system of modern psychiatry. The least of these alliances is not that between the medical and political establishments.