I wonder if I could get Big Pharma to fund a research trial or two?

Perhaps their reps may be easier to persuade than the dogmatic psychiatrists who overlook these important research questions, chosing instead to inject people with cannabis constituents.

Let wisdom guide. Let the pharmaceutical companies come together to do this. The prize for them is the treatment which patients want, the treatment patients will ask their GPs and psychiatrists for. The one which genuinely reduces the delusions and hallucinations antipsychotics are suppose to treat.

It wouldn't cost that much. The important thing is the full systematic review of measures of effect on delusions and hallucinations only in all modern high quality trials is good enough to be published in a peer reviewed journal so it can influence commissioning.

I think I might see if I can sell the idea to them for the funding to do a second, more important piece of research. A census of people with psychotic illnesses to see what they want and expect from their treatment.

Anyone is welcome to use the market data from the second idea.

For everyone involved in treatment patients this second piece of research is the first step to a leap in mental healthcare: an evidence base to give people what they want and expect, rather than have to tolerate.

There's money in that. Loadsamoney. However my only hope is it is the sort of progress mental health science really needs. It is just the start and an example of an idea of what might be in forty or fifty years time: the evidence base to understand and assist people's needs, not what psychiatrists think they need or what society wants to do using the word illness.

I hope they'd be more willing to listen to this simple idea. Use the old data to answer patient expectations. The hegemony has to be willing to give up power.

This is the sort of principles which make democracy a good idea applied, poorly perhaps, to the problem of psychiatric practice and the tyranny of power which psychiatrists have empowered by a lack of evidence or attempt to seek evidence based on patient expectation of treatment.

The unwitting tyranny is incompetence or lack of wisdom, not malice. But a sequitor to hanlon's razor is what to do in the face of psychiatric incompetence?

Ask any psychiatrist to name of the top of their head the study of patient expectations of treatment they remember from their psychiatric education? Ask them to find the study which looks at the effect of antipsychotics purely on delusions and hallucinations? Ask they questions which, in my opinion, they will have no answer to and you will start to feel an ire.

At least if you are a person blessed or cursed with a psychotic disorder. As a teacher it is always a blessing.