“Brief History of Psychiatry” or “The Origin of a Nonsense”

APRIL 25th, 2014

Psychiatry has a legal origin, and until the early twentieth century was a branch of Legal Medicine: its main purpose was to settle if mentally ill people is responsible for their actions.

In the past 60 years Psychiatry has made significant efforts to reach other medical sciences, carrying out countless genetic studies of mental disorders, of neuroimaging, of brain neurotransmission, etc.. However, the results are very poor and we still know almost nothing about the causes and the anatomopathological bases of mental illness. There have been only a modest advance in the understanding of the role they can play  different brain neurotransmitters, which has improved a bit the medications used for anxiety, for depression and for productive psychosis.

Its legal nature remains the source of all evils because it allows forced hospitalizations and treatments. During an involuntary admission, the patient is convinced that he has been locked up unfairly in an establishment considered by him worse than a prison. To adequately deal with a person in that state, it is required an unusual sensitivity that very few people possess. The mistreatment of involuntary psychiatric patients is still the norm: they are naked before several people, they are tied to the bed (mechanical attachment), most of the time  without anyone explaining them why. The few times I´ve seen a nurse explaining to the patient the reasons for mechanical attachment, the patient calmed and accepted such preventive measure.

Psychiatric patients commit crimes with the same frequency as the rest of the population. This matter, focus and management of criminal acts made by psychiatric patients, constitutes the origin of all problems and deficiencies of current psychiatric model. With existing legislation in most countries of the world, certain psychiatric diagnoses , such as schizophrenia, bipolar disorder, acute psychosis, chronic delirium, etc., can be used as cause of insanity defense .

This is the reason that the current psychiatric model inevitably generates tremendous frustration. The problem does not lie in the fact that psychiatry is a medical discipline, neither in the consequent use of drugs, as antipsychiatrists maintain again and again, the crux of the whole question is the primary legal character of Psychiatry.

We said above that Psychiatry is derived from the Legal Medicine, and was essentially intended to determine whether a criminal act has been committed by a sane person or insane. "Insanity" is still the term used in the legal jargon for saying that a person accused of a crime has a psychiatric disorder.

Thus, at the beginning of psychiatry as a discipline the most important was that medical expertises would allow to judges to decide if people suffered "insanity" or not.

Now, what to do with a person declared irresponsible because of his "insanity" after having committed a crime? He could not be convicted and sent to jail because of his insania, but neither seemed prudent to leave him free on the street. It was necessary to establish the appropriate measures in order that this "crazy people" does not commit new crimes. Solution: the creation of "asylum", that is, a centre where insane people would be locked up. This is the origin of asylums in Europe and the United States in the early nineteenth century.

Here is the core of all evils in the current psychiatric model: Its legal nature and the consequent possibility of forced hospital incomes. Indeed, this legal conception of mental illness opens the possibility of declaring crazy a great number of people, since all the professionals related to insanity (psychiatrists, forensic, judges, etc.), when they have the minimum doubt that a psychiatric patient may commit a crime, determine his income and forced psychiatric treatment.

This is the reason that at the mid-twentieth century Mental Hospitals was home of some millions of people, the vast majority of them locked up there against their will.

What to do now with all these miserable people locked up, often for life, in asylums?

Thus arises, in a second instance, the need to offer any help or treatment for detainees in these hospitals. Throughout the nineteenth century the therapy used was the "
moral therapy" advocated by Pinel, a rudiment of current psycho-educational therapies. A mid-twentieth century pharmaceutical laboratories synthesize diazepam, imipramine and haloperidol, useful drugs to relieve symptoms of anxiety, depression and psychosis respectively. Thus began a frantic research career that has put on the market hundreds and hundreds of psychoactive drugs, with which, surprisingly, has not improved the effectiveness of those first three drugs, although they have declined somewhat its uncomfortable side effects.

Psychiatry, the little branch of Legal Medicine, has become a medical discipline that seems limitless and now affecting almost 50% of the population in developed countries. What initially began as a legal problem for specific situations has become a medical specialty that grows without bounds and looks ready to devour everything around it. No one, except perhaps the pharmaceutical industry, understands how it can be that half of the U.S. population is taking any psychotropic drug.

Is there any solution to stop this nonsense?

Anti-psychiatry has proposed again and again its solution: to suppress Psychiatry since it is a fundamentally pernicious activity. This interpretation does not seem adequate. Indeed, what about all the people who want a psychiatrist to help them overcome depression or generalized anxiety, either with medication or with other treatment types? The antipsychiatric proposal should be rejected as not operative.

Facing the drastic and ineffective answer of antipsychiatrists, Newpsychiatry proposes a complete and effective solution: the suppression of legal connotations of mental illness. That is, insanity can not be used in any way as an argument for the non-liability of a crime. Whatever the diagnosis of that person, his counsel for the defense has strictly prohibited the appeal to psychiatric history as cause of non-liability for the crime committed.

The only cause which may claim counsel is the existence of am impairment of 
consciousness at the time that the defendant committed the crime. And conscious alterations are not disorders psychiatric, but neurological conditions.

With this simple measure would have put an immediate end to 100% of income and/or forced psychiatric treatment, which are the cause of all the ills of the current Psychiatry. With that simple rule only persons who voluntarily request would attend to the psychiatrist. Treatments with psychotropic drugs against the patient´s will and forced internments would have suddenly disappeared.

Psychiatry then ceased to be a legal discipline in the service of public safety, to become a medical discipline in the service of individuals. For those who think that this solution proposed by Newpsychiatry is too novel and/or daring daring, we remind them that 
insanity defense is already banned in some Western states, including Kansas, Montana, Idaho, and Utah.