A plea for re-illusionment

Burns' cri de coeur ¹ about the thoughtless severing of in-patients from community responsibility will strike a chord in colleagues of his demographic. Our generation saw the special contribution of the consultant psychiatrist as encompassing continuity of care across time and space in ways unique to our discipline. We hoped to see our patients holistically through the vicissitudes of illness, recovery, health and relapse, creating, when things went well enough, a deep life-enhancing mutual knowledge. Yes, we were spread thin, the workload was tough at times, and Jacks of all trades (psychotherapy, group and systemic therapy, psychopharmacology) must sometimes give way to master-craftsmen. But has psychiatry traded an easier life for a diminishing and less satisfying role? How long before an impoverished state finds our profession largely redundant? Are we in danger of becoming our own grave-diggers? Or is all this merely nostalgia seasoned with generational grumpiness? Re-illusionment please!