What does the next 100 years bring for mental health and treatment?

It is cold out here in the park. It is a good place to write though. The sound of cars could be the waves. I'm surrounded by organic things. I sit on an overturned log and write on my smartphone. Its not a mad or bad life but its not much of a life either. Sometimes though the simplicity of this moment and this place...it is a privilege few have.

Anyway, future telling is a mugs game which is also played by psychiatrists. I thought I would have a go myself at the impossible.

There have been many trends over the last century. The main one is the increasing pathologisation of ever more of humanity. Modern diagnostic books are bigger than those a generation before and a generation before then. Psychiatric pseudoscience has also advanced considerably. New genetic and brain imaging techniques are pushing the boundaries. There has also been a general trend towards more ethical treatments which risk less harm to the mentally ill.

As the science has progressed there are more and more high quality reviews which show established treatments don't actually work. Antidepressants and electroconvlusive therapy are two victims of high quality trials. Diagnosis has also changed in small areas to depathologise mental illnesses, homosexuality being the obvious one.

Perhaps the biggest change is the acceptance of the social model, mainly in the form of the biomedical model in the psychiatry mainstream but it still exists with greater purity at the fringes of progress. Seeing the problem beyond the individual is a significant advance but the mindset has not taken hold.

The social model is an abstract concept and rarely steps from interesting observation to clinical practice and policy. Work has been done but no direction in treatment tries to change the problems explained by the social model. Or very little.

I'm not their biggest fan but Mind have lead the way in putting the social model into practice. They and Rethink and a few others got together to start Time to Change.

I believe it is the harbinger of change for the mentally ill. It is attacking one small aspect but attempting to solve a giant challenge: mental health stigma and discrimination.

In a sense it sums up the ethos of the next hundred years: change people, cultures and society to help the mentally ill regain their equal place in life.

Small moves to large goals. It is possible though. We only need look back at the history of social and technological treatments for mobility disability. There were crutches then wheelchairs. There are now wheelchairs which can go up stairs. Social change reduced the disability even further when legislation demanded public buildings and workplaces had lifts and ramps to further reduce the burden of mobility disability to the individual.

It requires healthcare to change the world but it has already started in a small way in the UK with Time to Change.

Sent from my smartphone