Jim van Os, Professor of Psychiatric Epidemiology and Public Mental Health and Chair Division Neuroscience at UMC Utrecht, studied, taught and 'did' psychiatry in various countries, including France, England, Indonesia and Casablanca. Van Os pleads for a more patient oriented approach and works on a low-threshold public mental health care, focused on connection, self-management, the importance of language and concepts, and personal recovery
Until recently, positivist optimism was the norm in academic psychology and psychiatry. The diagnosis/evidence-based-practice/symptom-reduction/routine-outcome-monitoring model of mental suffering seemed to offer a successful premise for a wide spectrum of research concerned with things like the technical active ingredients of specialised psychotherapy, the neuroimaging correlates of experience, the development of new ‘antidepressants’ and the genetics of ‘schizophrenia’.
"...waiting to no avail if the problem was a tangle of paranoia, cognitive disability and addiction"
A marriage between the projected perfectibility and measurability of the diagnosis/evidence-based-practice/symptom-reduction/routine-outcome-monitoring model and market forces gave rise in the Netherlands to a mental healthcare landscape in which one could receive immediate psychotherapeutic treatment, but might also spend years waiting to no avail if the problem was a tangle of paranoia, cognitive disability and addiction.
Developing in parallel to these specialist and technical neuroscientific pyrotechnics over the past 40 years, albeit largely off the press and public radar, was a growing body of ‘science’ founded on the experiential knowledge of individuals with lived experience of mental suffering. Unlike positivist neuroscience, empirical knowledge operates mainly in the domain of existential and relationist analysis. Non-linearity and unpredictability (‘turning points’) are key values, with a focus on personal meaning, hope and connection.
In somatic medicine, the past ten years have seen a surging interest in bridging user and professional knowledge. There is a call for professionals who have learned to attune their technical practice to the existential dimension of users. How do academic psychology and psychiatry stack up? How wide is the divide between professional and user knowledge, and what might a synthesis of the two look like? And what would be the implications for training and practice?
Van Os, J., Guloksuz, S., Vijn, T. W., Hafkenscheid, A., & Delespaul, P. (2019). 'The diagnosis-evidence-based group-level symptom-reduction model as the organizing principle for mental health care: time for change?' World Psychiatry, 18(1), 88-96. doi:10.1002/wps.20609