Psychiatry for the future
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Why does Dr Joe Raleigh think psychiatry needs a revolution?
This is an ABC podcast.
Hi, it's All in the Mind on RN. I'm Lynn Malcolm. Today, the future of psychiatry. Does it need a revolution? Dr Joe Raleigh is a medical doctor from the UK with experience in mental health. He's now working in Australia and he feels that the field of psychiatry is seriously struggling to understand mental health problems and to provide satisfying ways to treat them. In this program, Joe speaks with people who are imagining a future golden age of mental health about what it will take to get us there. First, here's Helen Christensen, Director of the Black Dog Institute.
What I would like to see is that somebody who has a mental health problem walks into an environment where they're treated with respect. and offered a range of opportunities to undertake uh different sorts of therapies or activities that they choose and which have an evidence base.
We've got stuck, I believe, in the idea. that the future is just about science, that the future is about genetic research or biochemical research or various kinds of scans of the brain or whatever it is. All of those things might be important, but they're not the future of mental health.
For me the advances are actually gonna come with the way that patients interact with the psychiatrists themselves. It's not just a matter of, okay, here's a theory that's gonna solve all of our problems. It's a matter of for me how patients are increasingly becoming a part of that system.
My own vision is that Eventually, I can't say when, the mental health system will not exist. The happy ending is where there's no need for it.
Helen Christensen, Pat Bracken, Ivan Crozier, and Kathy Picconi. Two psychiatrists, a historian and a service user, all imagining different revolutions for psychiatry. And a revolution may be exactly what psychiatry needs, because our problems with mental health are not going away.
We recognise now that the prevalence of mental health disorders is probably one of the biggest burdens, disease burdens, and that its relative contribution to overall health in the world is estimated to be the leading cause of disease burden by twenty thirty.
Helen Christensen is Professor of Mental Health at the University of New South Wales, and she's the director of the Black Dog Institute, which is only one of two medical research institutes in Australia which focuses specifically on mental health. Along with leading psychiatrists around the world, Helen sees progress in psychiatry as facing many difficult challenges.
I think the science of psychiatry has become slowed. We do have a lot of uh new areas to investigate, but I think that people recognise that the genomics revolution hasn't really delivered us in understanding, say, for example, better uh indicators of who might respond to a particular treatment and who might not. I think in terms of medications and our understanding of the brain mechanisms that these medications target require more work. And I think it's highly complex to understand the causes and risk factors and the biological mechanisms and the neuroscience of mental illness. Yes, we're we're really struggling with that. However, we have to realise that much of what psychiatry does is effective compared to fifty years ago where light years ahead.
Helen is co-author on a recent commission on the future of psychiatry. This was produced by the World Psychiatry Association and the Lancet Psychiatry. It aims to plot the future course of psychiatry and to identify ways that the specialty might reach its full potential.
I think the digital space is really one of the most exciting areas.
How does Helen Christensen envision respectful, choice‑driven mental‑health care?
I mean we've known for twenty years that you can actually deliver psychotherapy through apps and online programs and that in some circumstances it is as effective as face to face therapy.
Helen Christensen sees one use of digital technology in particular as having great potential. This is the area of digital phenotyping.
Essentially, this is the idea that we carry around mobile phones with us all the time. And these mobile phones allow us to pick up signals.
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Chapters
8 chapters
1
Why does Dr Joe Raleigh think psychiatry needs a revolution?
0:02–4:44
2
How does Helen Christensen envision respectful, choice‑driven mental‑health care?
4:44–10:04
3
What role could digital phenotyping play in future psychiatric treatment?
10:04–12:39
4
Why do Pat Bracken and the Critical Psychiatry Network call for a new doctor‑patient relationship?
12:39–15:29
5
How does Kathy Picconi describe the lived experience of the mental‑health system?
15:29–18:46
6
What historical shifts does Ivan Crozier say are essential for psychiatry’s future?
18:46–21:46
7
How might empowering patients change the way psychiatry works?
21:46–24:55
8
What vision does the episode present for a society without a traditional mental‑health system?
24:55–29:04