In defence of complainants

It is interesting that the complaints involved within the study by Lester et al (2004) were not subject to independent legal scrutiny. The reader therefore has no idea of their merits.

Anyone who has experienced the difficulties of authorities and courts will realise that bureaucracy and confusion pervade each institution. Anyone who has attended one of our supreme courts will know that the service is slow, correspondence often goes missing, checks are required to ensure that the correct folders and paperwork are presented, and often uncomfortable questions are ignored. These are characteristics of the average day of a normal and rational human being attempting to protect his or her civil liberties. These are practical problems faced by the average person.

With the advent of the Human Rights Act 1998 civil liberties have come to the forefront. It is an Act that cannot be ignored. Indeed, with increasing litigation, authorities have by nature become defensive. Part of the method of making life impossible for complainants is to increase the bureaucracy.

The number of letters, phone calls, etc. reported by Lester et al (2004) may be part of ‘normal’ human behaviour and reaction to bureaucracy. In a democratic country, we all have a right to protect our civil liberties. Often litigants lack knowledge, have no idea of procedures, and are misled by authorities who have a vested interest in protecting themselves. To label this behaviour as an ‘abnormality’ or something that requires psychiatric intervention is ludicrous. Indeed, I note the Royal College of Psychiatrists runs a very successful antistigma campaign to stamp out discrimination against those with mental illness. The diagnosis of querulous paranoia runs the risk of misuse by those who wish to use psychiatry as a manner of silencing criticism. The behaviour exhibited in the study is indeed a normal reaction to the circumstances faced. ‘Normal’ of course depends on many variables such as response time of the complaint officers, failure to address questions, replies to phone calls, etc. These factors have not been addressed.

It stands to reason that psychiatrists are not judges. Indeed, the merits of the complaint will be subjectively assessed by each psychiatrist based on his or her prejudices. This is hardly independent.

Querulous paranoia is a diagnosis best left within the darkened past of psychiatry - perhaps pre-war Russia where Stalin often used ‘madness’ to silence his critics. Genetically, we are all ‘different’ by nature and react in various ways to injustices. It is essential to maintain the civil right to seek a remedy without interference from psychiatry. Interference from psychiatry will only increase the stigma associated with it for so many years.

It is often the case that different personas, atypical to the perceived norm, are subjected to psychiatric analysis. There is a minority of serial complainants but the difference is to ascertain whether their complaints have merits or not. A psychiatrist cannot assess this fairly. Without an independent legal assessment, any person who attempts to fight or campaign for their civil liberties runs the risk of being labelled with a psychiatric illness. Their credibility will often be substantially affected. This, indeed, may be a rather convenient way of silencing uncomfortable critics of negligent authorities. This was not what psychiatry was meant for and neither should it risk going down that route, given the good work done by the College's anti-stigma campaign on raising awareness of discrimination in mental health.