Wake-up call for British psychiatry: responses

I would like to provide a medical student's perspective on the paper by Craddock et al. ¹ I am about to enter my 4th year of medicine (having just completed an intercalated BSc in psychology and medicine) and will soon have my first real exposure to clinical psychiatry. Although I am keen on psychiatry, the majority of my fellow students are happy to express disdain at the thought of a psychiatric career. It is obviously difficult to say why this might be the case but something is clearly amiss in the way that psychiatry is being presented to tomorrow's doctors.

During my BSc, it was interesting to gain insight into the opinion that psychologists have of psychiatry, which unfortunately was one of ‘over-medicalisation’ and neglect of psychosocial factors. For me, this reiterated the importance of early positive interaction between the two professions and a need for better understanding of each others' strengths. Perhaps this interaction is best initiated during undergraduate training?

More importantly, and from the angle of a card-carrying wannabe psychiatrist, this paper has confirmed that clinical psychiatry is attractive to me not because it is excessively reductionist but because it deals with the complex interplay between psychiatric (and non-psychiatric) illness and countless important psychosocial factors. Furthermore – and this may be the blind optimism of youth talking – I hope to become an excellent physician who is trusted and respected by her patients. Because of this, I am not discouraged by those who fail to consider psychiatrists as ‘proper doctors’, although it is clear to me that this negative view by other doctors acts as a deterrent for some of my colleagues who might have been interested in a psychiatric career.

Finally, on a more anecdotal note, I have the perspective of someone who has lost a relative because of failure in psychiatric and non-psychiatric care and social support. Had an appropriate (and properly functioning) multidisciplinary team been in place, both in assessment and management, I believe that the outcome would have been very different. So in response to the question ‘if a member of your family were a patient, is a distributed responsibility model the one for which you would opt?’ my answer would be an uncertain ‘ummm, I think so’, so long as this included the appropriate level of assessment and involvement of a senior psychiatrist alongside other professionals.