Credibility: The Problem with Psychiatry’s Return to Medicine

Abstract

Amidst the current tumult and shouting there is frequently heard the rallying cry that psychiatry’s course must be steered back to medicine. Hackett (1977) carefully delineated the saga of psychiatry’s progressive estrangement from general medicine. He offered guidelines for psychiatry’s survival and re-entry from the “banks of medicine” into the “mainstream”. Likewise, Hall, Faillace, and Perl (1979) enumerated specific remedies for psychiatry’s present plight; these included special emphasis on the re-establishment of ties with organized medicine. But can a unilaterally desired reconciliation involving psychiatry’s proposed return to the medical model be readily achieved? Or has the medicine-psychiatry dyad been irrevocably altered by the protracted separation? Like Odysseus, what can psychiatry expect as it returns from years of wandering, fighting the “Cyclops” of community mental health, the Sirens of many causes, and other assorted trials? (For example, Is medicine as constant as Penelope?)

Moreover, tell me this truly, that I may surely know, who are thou and whence of the sons of men? Where is thy city and where are they that begat thee? Where now is thy swift ship moored, that brought thee thither with thy godlike company? Hast thou come as a passenger on another’s ship, while they set thee ashore and went away?

— The Odyssey, Homer