Medication Revolution and Emerging Discontents

Abstract

The centres of research and progress in psychiatric theory and practice from the 1950s onwards were in the US-UK axis, particularly the USA. As the asylums were phased out, the great medication revolution—no less significant than the ‘great confinement [of lunatics in asylums]’ (Foucault, 1967, p. 38) described in Chapter 3—gradually took hold. The end result was that standard psychiatric practice became basically a matter of matching therapy, usually medication, to diagnoses based on nosology agreed in Europe and the USA after the end of the Second World War (WWII)—ICD-6 Classification of Mental and Behavioural Disorders (ICD-6) (WHO, 1948) or Mental Disorders: Diagnostic and Statistical Manual (DSM-I) (APA, 1952). As a psychiatrist in the British National Health Service (NHS) from the early 1960s onwards, I was part of a changing system, working, at first, in asylums, then at a teaching hospital in central London and then in a psychiatric unit in a general hospital and in the adjoining community.