I worked as an NHS psychiatrist for quarter of a century and when I prescribed medications I tried to do so as carefully and appropriately as I could. In doing so I did my best to share all that was known and unknown about psychotropic medications, including the strengths and limitations of the supporting evidence. I also gave the necessary context that any intervention, not just medication, has the potential for benefit, harm, and a range of effects in between. Finally, I made clear that consideration needed to be given to the fact that most of the evidence supporting psychotropic medication is based on short term studies.
In my time as a doctor I never experienced anyone being mocked for deciding that medication was their best course of action.
Following the publication and media reporting in February 2018 of a Lancet meta-analysis the term “pill shaming” came to the fore, not for the first time, and was frequently used by senior representatives of the Royal College of Psychiatrists.
It was an anonymous but highly influential blogger who developed this BINGO card:
“Here, go amuse yourself with the #pillshaming buzzword bingo card, which was created years ago in response to the endless, endless repetition of extreme scaremongering tropes that have been repeatedly debunked but nevertheless keep being revived. Now go away.”
Professor Wendy Burn, as President of the Royal College of Psychiatrists said this of the pillshaming bingo card: “Love the card!” It is interesting to reflect that two consecutive Presidents of the Royal College of Psychiatrists have chosen to promote the pillshaming hashtag.
My view is that all experience of prescribed medications (and indeed any medical intervention) cannot be fairly represented by a hashtag. My concern is that a hashtag or a bingo card reduce complex issues and decontextualise a whole range of necessary considerations for realistic prescribing and informed consent. It can also fuel polarisation and antagonism which may get in the way of better understanding of complex issues.