Ten things every psychiatrist should (hopefully) know . . .

This is one of the educational seminars to be held at the RCPsych International Congress in Edinburgh, in June of this year:

I worked as an NHS psychiatrist for over 25 years. I retired in 2020. I would like to suggest the following ‘Ten things every psychiatrist should (hopefully) know‘:

1.  Physiological dependence on psychiatric drugs is commonplace. Withdrawal effects can be most severe and prolonged.  It is vital not to confuse such with ‘relapse’ or ‘treatment resistance’.
2. ‘The chemical imbalance theory’ has never been proven. When it comes to wellbeing neurotransmitters are not the whole story and never can be.
3. Psychiatry is near the top of the list of which specialties have received the largest proportion of the billions of dollars paid by industry in the USA.
4. The Royal College of Psychiatrists has actively chosen not to support the introduction of Sunshine legislation in the UK. Currently there is no way of establishing the extent of any payments made to UK psychiatrists. Several of the above panelists are career-long paid opinion leaders.
5. The Royal College of Psychiatrists has actively chosen not to comment on any of the patient safety recommendations of the Cumberlege Review.
6.  PSSD, Akathisia and suicidality can result from psychiatric medications.
7. Psychiatry has failed to prioritise how to avoid ‘too much medicine’ [a longstanding BMJ campaign] and how to limit iatrogenic harm from inappropriate medical interventions. In Scotland this approach was termed ‘Realistic Psychiatry’.
8. The so-called “subjective-objective divide” is a fallacy and should be abandoned.
9.  When it comes to screening for mental illness it is essential that the Wilson and Jungner [WHO criteria] are followed.
10.  As a charity the RCPsych is not a public body. This status exempts the college from the regulation or outside scrutiny that would apply to a public body.