Critical Psychiatry

From the Preface to the second impression: The reissue of this book, 24 years after its first publication, is a very welcome initiative by Free Association Books. When Critical Psychiatry saw the light of day, the debate over psychiatry which had raged in the 1960's and 1970's was well past its peak: sales of the book were modest and the publishers soon allowed it to fall out of print, although well-thumbed copies continued to circulate in limited circles. All of us who worked on the book are therefore delighted to see this old war-horse once more being led from the stables. We hope, of course, that the book will not simply be bought as a collector's item. Inevitably, after a quarter of a century many details have become out of date. However, the book's basic message seems even more relevant now than it did in 1980. Mental health services have gone on changing, and new research has continued to be generated - but the importance of the book's central topic has, if anything, become greater. What is this topic? In a nutshell, it is the discrepancy between the size of the problem of 'mental illness' and the inadequacy of responses to it. As far as the size of the problem is concerned, the figures cited in the original introduction to Critical Psychiatry have become even more alarming. In Holland, for example - a prosperous country rated highly by its inhabitants on 'quality of life'- one in four of all adults now experience a diagnosable mental health problem in the course of a year. Such figures are typical for Western countries. Worldwide, the WHO has estimated that depression will become the second most important cause of disability by 2020 - and in the developed world, the major cause.