Recovery from Schizophrenia: Psychiatry and Political Economy

Recovery from Schizophrenia: Psychiatry and Political Economy

Recovery from Schizophrenia: Psychiatry and Political Economy

Recovery from Schizophrenia: Psychiatry and Political Economy

Synopsis

The first edition of Recovery of Schizophrenia was acclaimed on publication as a work of major importance. It demonstrated convincingly, but controversially, how political, economic and labour market forces shape social responses to the mentally ill, mould psychiatric treatment philosophy, and influence the onset and course of one of the most common forms of mental illness. In this revised and fully updated edition, Dr Warner examines the changes in approach to schizophrenia since publication of his original book and analyses new research to answer the question: `Are they advances or not?'

Excerpt

Does the way we make our living or the level of economic development of our country affect whether or not we become insane? Do social class or the state of the economy influence whether schizophrenics recover from their illness? Has industrial development affected the number of schizophrenics who become permanently and severely disabled—lost to their families, costly to the community and leading lives of emptiness and degradation? These questions are at the heart of this book.

My original intent was to uncover what the natural course of schizophrenia had been before the antipsychotic drugs were introduced, but this simple goal led to the realization that some current beliefs about the illness, widely accepted in psychiatry, are not accurate. We may well have been too pessimistic about the course of untreated schizophrenia and overconfident about the benefits of modern treatment. The antipsychotic drugs, it emerges, have not appreciably improved the long-term outcome from the illness; these drugs alone did not unlock the doors of our mental institutions and make possible the community treatment of psychotics. Despite a massive annual investment in the treatment of schizophrenia, the outcome from the illness in modern industrial society is no better than in the Third World.

Each change in our treatment approach to schizophrenia, moreover, is not necessarily an advance. A treatment method of demonstrated effectiveness—moral management—was laid to rest in the mid-nineteenth century only to be resurrected in a similar form nearly a hundred years later. Much of what today is called community treatment is, in fact, the antithesis of treatment: people suffering from psychosis are consigned to a sordid, impoverished existence in which even basic needs, such as food and shelter, are not met. To understand how such aberrations and misconceptions have come about, to appreciate what has shaped the course and occurrence of schizophrenia, and to see what has molded psychiatric ideology and the social response to the schizophrenic, we need to step outside psychiatry. We have to venture into the territory of the sociologist, the anthropologist and the historian; we must enter the

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