The article reviewed here is a 1988 article by Glin Bennet in the British Medical Journal – ‘What Should Psychiatrists Be Doing in the 1990’s’ and freely available here. Firstly this article is 21 years old. However the issues discussed here are as relevant today as when they were written over two decades ago. Indeed the issues are particularly relevant to contemporary debates in psychiatry. Bennet weaves an historical perspective in with changing roles of psychiatrists and health professionals:-
‘The health professionals do not have a medical training, and so tend not to conceive the problems of living in terms of illness. These professional people are primarily interested in health, and variations on ordinary functioning are seen as far as possible in social terms‘
There are profound differences between working health and illness models although it would seem sensible to unify such models. Such a unification would I believe necessitate a number of hermeneutical considerations and the transformation of the resulting theoretical structure into a pragmatic clinical language which can be translated into individual and organisational behaviours. This may already be happening. In some senses it is tempting to consider the integration of psychiatrists into teams where the health model predominates as the testing bed for a rather subtle but pervasive Hegelian dialectical between health and illness models perhaps leading inexorably to a new understanding. This new understanding may be a ‘working’ unified model which is yet to be formalised. Such a dialectical crystallises out from time-to-time in simplified psychosocial versus medical debates.
Bennet then considers the future role of psychiatrists within teams and relates this to historical roles showing that in some ways similar relationships will occur with different professionals taking the lead in different areas. In the final section on the 1990’s, Bennet suggests that psychiatrists will need to develop new skills both in liaison and community settings as well as being aware of their own traits as well as embracing general medical training. Bennet’s article is thought provoking as it touches on many fundamental issues that face psychiatry in the early 21st century and offers a number of perspectives on these issues for further reflection.
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