Allen Frances

In the recent dispute over whether a selfie can belong to a monkey, the monkey lost. The U.S. Copyright Office decided that the selfies a group of Indonesian macaques snapped belong to no one. Food for thought, but what seems to have been lost in this episode is another, larger issue -- how intelligent these and other creatures are.
The history of psychiatry is a history of fad diagnoses that come out of nowhere to capture much more attention than they deserve. Current fads are distinguished only by the billions of dollars spent by powerful commercial forces to create and push them.
Preventing psychosis would be a great idea if we could really do it; but there is no reason to think we can. And reaching beyond our grasp is likely to harm those we hoped to help.
I am always skeptical of suggested new 'paradigm shifts' and worry that ambitiously striving for them will wind up causing more harm than good.
When I started my training in psychiatry 45 years ago, the prevailing model for understanding mental disorders was broadly bio/psycho/social in the grand tradition of Pinel. When psychiatry is practiced well, it integrates insights from all the different ways of understanding human nature.
Prisons are clearly not an appropriate or safe place for psychiatric patients -- but almost a million are behind bars for crimes that could have been avoided had they received proper community treatment.
Some would shout a resounding,impassioned, all inclusive, Never! No psychiatric coercion, not ever, not even under the most seemingly urgent of circumstances.
I have known hundreds of patients who were not helped or were directly harmed by psychiatry. But I have also known many thousands of patients who have benefited greatly. The overall results in psychiatry are quite good and compare favorably to other medical specialties.
Yes, meds are important. For instance, those that change the chemistry of the brain through use of serotonin can help one to feel better. But turning to this drug exclusively without talk therapy does not address what in an individual life may very likely be causing the depression.
Our forty year war against the illegal drugs promoted by drug cartels has been a proven failure. If we devoted just a tenth of the effort to controlling the equally dangerous misuse of legal prescription drugs, we would most certainly succeed.