THE PSYCHOLOGIST DECEMBER 2013 - Sick children or sick society? – LISTEN to the Maudsley Debate

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Sick children or sick society?  – 
the Maudsley Debate

Diagnosis rates for childhood mental illness have increased at pace in recent years. So too have the prescription rates for psychotropic drugs, such as Ritalin used to treat ADHD. Are these changes a sign of sick children or of a sick society? This was the question addressed at the 49th Maudsley Debate held  at the Institute of Psychiatry in October.
On the panel in front of a packed house were Claire Fox, BPS Fellow Simon Baron-Cohen, Stephen Scott, Ken McLaughlin and Chartered Psychologist Barbara Sahakian. Held as a satellite event of the Battle of Ideas, the Maudsley’s usual formal debating format was replaced by
a round-table discussion chaired by David Bowden of the Institute of Ideas.

Professor Baron-Cohen from Cambridge University defended the importance of mental health diagnoses for children. Many children have had years of bad experience before they arrive in the clinic, he said, and for them it’s a relief to hear that there’s a name for their problems. A positive development in recent years, he argued, is the idea of neurodiversity – recognising that some children have special needs and may not thrive in conventional environments.

Stephen Scott, Professor of Child Health and Behaviour at the Institute of Psychiatry, also supported the importance of diagnosis. While acknowledging the risk of over-pathologising, he argued that increased recognition of conditions like autism brings greater humanity. In a similar vein, Barbara Sahakian, Professor of Clinical Neuropsychology at the University of Cambridge, drew attention to the importance of early detection of mental disorder. Seventy-five per cent of mental health problems start before the age of 24, she said, and the longer a person goes without help, the worse their outcomes tend to be.

Claire Fox, director and founder of the Institute of Ideas, was more sceptical. She lamented the way that to have your behaviour legitimised today, you have to have it pathologised. Fox also argued that encouraging children to dwell on their feelings and to seek medical help for their problems was undermining their natural resilience. ‘Everyone is queuing up for a diagnosis,’ she said, ‘and it’s trivialising serious mental health.’

Scott retorted sarcastically: ‘I like your neo-Darwinian approach. Toughen up, get resilient. It’s very British. But the kids I see haven’t managed to toughen up.’ Fox was unabashed. ‘My advice to psychiatrists if you want us to be more resilient,’ she said to muted applause, ‘is to butt out of our lives. We’ll be much better off without you.’

Also arguing that it’s our society that is sick was Dr Ken McLaughlin, a lecturer in mental health at Manchester Metropolitan University. ‘The moral question over how we live our lives and what we consider acceptable behaviour is being recast as a psychiatric one,’ he said. cj

Watch the entire debate, including contributions from the audience, at kcl.ac.uk/iop/news/debates/index.aspxHTTP://WWW.kcl.ac.uk/iop/news/debates/index.aspx