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More and More is Less and Less

The Myth of Massive Psychiatric Need

Published online by Cambridge University Press:  29 January 2018

Alex Richman
Affiliation:
Departments of Psychiatry and Community Health & Epidemiology, Dalhousie University, 5849 University Avenue, Halifax, Nova Scotia, B3H 4H7 Canada
Arthur Barry
Affiliation:
Departments of Psychiatry and Community Health & Epidemiology, Dalhousie University, 5849 University Avenue, Halifax, Nova Scotia, B3H 4H7 Canada

Summary

The idea of massive unmet need for mental health services is a myth, generated and perpetuated by processes within the system which provides psychiatric care and within society. Diffusion of the traditional boundaries of mental health care, lack of norms and standards, medicalisation and ‘healthism’, specialoid practice and patient selection, diversion of resources from the longterm mentally ill and their absorption by better-functioning patients, substitution and development of new mental health service providers, and changes in the threshold for help-seeking all affect our assumptions of need. Needs are less massive, if the boundaries of psychiatry are defined so as to include only those disorders which the profession is best able to treat.

Type
Research Article
Copyright
Copyright © 1985 The Royal College of Psychiatrists 

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