The Alleged “Psychiatry is Dead” Movement

No, psychiatry is not dead. I am called by folks who want to see a psychiatrist.

Not only does insurance pay for it but it pays my rent.

It is definitely a bloody wreck. The anti-psychiatry movement has never been stronger. This does not mean that psychiatry is dead. People take psychotropic drugs and sometimes even benefit significantly from them.

There is apparently a course/symposium/I’m-not-sure-what-that started the author of this article.

The idea is a good one, if a ubiquitous one. Technological advances are certainly changing things in medicine, and they are certain to change even more.

The problem is that authority is there for the taking for anybody who wants to take it. The problem with this as well as a series of arguments that flow from the above piece, is that everybody is a specialist and nobody is a generalist.

Hardly a day goes by without me saying I didn’t expect to be practicing general medicine at this point in my life. But time after time things fall between the cracks of specialties,

I find physical illness missed by primary physicians that accounts for the symptoms of psychiatric illness.

New technology that is supposed to work on humans sometimes simply doesn’t. Humans, most especially brains, just have too many parts. The effectiveness of antidepressants, which most psychiatrists consider “evidence based medicine,” really can’t be, because they just don’t work on everybody. More like 1/3 to 2/3 depending on who you believe.  The most recent example here is the failure of genetic testing to work 100% on predicting response to drugs.

A psychiatrist may still be the one who can best put the pieces together for the treatment of humans.

That is true if and only if the technology can be explained in a way that a psychiatrist can understand.

The technological advances may demand a change of the theoretical framework of how we practice, based on external descriptors palatable to insurance and government.

We all stay tuned.