The Remedicalization of Mental Illness

Despite the efforts of MCOs to limit psychiatric diagnoses and treatment, recent years have seen a new remedicalization of mental illness. Psychiatrists have continued to develop new treatments as well as new the- ories of mental illness that downplay any social causes and instead stress biochemi- cal, neurological, or genetic abnormalities. Meanwhile, the mass media along with the medical and pharmaceutical establishments have “sold” the medicalization of mental illness to the public; the majority of the public now believe that mental illness is a biological problem.

Yet the data for the “biological revolution” in mental health is weak. Despite decades of research, scientists have failed to find evidence demonstrating any brain abnormalities that might explain mental illness . Moreover, to the extent that brains of those labeled mentally ill differ from those of other people, the differences appear to be caused either by the drugs used to treat mental illness or by other factors such as poor nutrition.

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Despite these weaknesses in the biological model of mental illness, most psy- chiatrists have adopted it. As a result, psychiatrists now present more united front in their struggles for control against other mental health occupations such as psychology and social work. In addition, they have increased their political power relative to these other occupations because, having declared mental illness a biological problem, they now can argue that only persons trained in medicine can properly diagnose and treat it.

Reflecting this medical model, both psychiatrists and psychologists now of- ten rely on psychoactive drugs to both diagnose and treat mental illness. For example, doctors now commonly diagnose patients with clinical depression whenever patients respond favorably to antidepressant drugs such as Prozac, even if the patients don’t meet standard criteria for that diagnosis. Yet most people feel better whenever they take a mood-enhancing drug, whether it is Prozac or cocaine. And many people feel better even if they are given only a placebo.

Most of the drugs now used to treat persons with mental illness fall into one of three main categories: antipsychotics, mood stabilizers, or antidepressants. The use of antidepressants has grown particularly rapidly, especially among women.