World Social Psychiatry

INVITED COMMENTARY
Year
: 2019  |  Volume : 1  |  Issue : 1  |  Page : 22-

Medicine is medicine through its disciplines


Norman Sartorius 
 Past President, World Psychiatric Association, President, Association for the Improvement of Mental Health Programmes (AMH), Geneva, Switzerland

Correspondence Address:
Prof. Norman Sartorius
Past President, World Psychiatric Association, President, Association for the Improvement of Mental Health Programmes (AMH), Geneva
Switzerland




How to cite this article:
Sartorius N. Medicine is medicine through its disciplines.World Soc Psychiatry 2019;1:22-22


How to cite this URL:
Sartorius N. Medicine is medicine through its disciplines. World Soc Psychiatry [serial online] 2019 [cited 2021 Apr 19 ];1:22-22
Available from: https://www.worldsocpsychiatry.org/text.asp?2019/1/1/22/267962


Full Text



The erudite and sparkling article by Di Nicola[1] touches on a large array of issues that make social psychiatry an essential part of psychiatry, of medicine, and of social sciences. Among them are those which explain the origin of social psychiatry; those describing ways in which social psychiatry can serve as a counterweight to the tendency to restrict psychiatry (and medicine) to its biological determinants; those that make social psychiatry vulnerable because they render its goals vague; those that can make its methods badly used or misused; and many others, too numerous to list.

The origin of social psychiatry can be traced into the two or three decades that followed the Second World War. Some of the building blocks of social psychiatry were created earlier by sociologists, psychologists, and psychiatrists, but they did not gel into a discipline. Those were the years of acceptance that the epidemiology of mental disorders can provide information which will help build programs to help the mentally ill; the years of antipsychiatry which brought its shortcomings into a sharp focus; and the years of defining mental disorders and attempting to shape the treatment to fit the individuals who were receiving it. There were also the years of de-institutionalization and of attempts to make people with mental illness long separated from their peers re-enter their families, communities, and time.

The creation of social psychiatry was a reaction to the neglect of social factors, of the environment in which people with mental illness become ill and have to live, and of the powerful role which social factors may play in the course of illness and in its outcome. Di Nicola is proposing a social psychiatry manifesto for our century: I think that he is right to do so because the many dangers through which psychiatry passed in the past are re-emerging. The silicon age improves the exchange of information in unprecedented quantity and manner: yet perhaps, paradoxically, it also reduces social skills and the capacity and wish to be with others, to live in the society, and to help make it a better place to live. The simple politics of the second half of the past century are replaced by a general distrust of government, by awareness of corruption at all levels, by fears about the consequences of the unbelievably fast and dangerous accumulation of capital into an ever smaller number of hands – all of which contribute to a mental atmosphere likely to be an additional risk factor for mental illness and a source of difficulty in all efforts to improve mental health.

The re-emergence of the mid-20th century calls to approach health and mental health globally is encouraging, and it is to be hoped that a synthesis of efforts of all psychiatric disciplines involving all stakeholders of mental health in all countries will be possible. The obstacles to the success of the reborn idea of global health are different from those in the 1970s, and Richard Horton's summary of steps that would have to be taken to promote global (mental) health makes it clear that it will be difficult to move into a global mode of health care in a foreseeable future.[2]

All of the above considerations make action by social psychiatry more important and more desirable. The paper which Vincenzo Di Nicola produced summarizes what social psychiatry could do: more importantly, however, it also urges all of us to not only list functions and praise powers of social psychiatry but also to ensure that it makes its contribution to psychiatry and to medicine as a whole. Medicine is defined by its disciplines: the values and skills which social psychiatry contains can contribute to medicine (and the promotion of health) and are essential for its success.

References

1Di Nicola V. A person is a person through other persons: A social psychiatry manifesto for the 21st century. World Soc Psychiatry 2019;1:8-21.
2Horton R. Offline: Has global health lost it? Lancet 2019;393:972.