A consensus standpoint within contemporary critical psychology and psychiatry is that the medicalisation of human misery, represented by psychiatric diagnoses, thrives because of its connections to other structures of power (see Bentall 2009; Rapley et al. 2011; Johnstone 2014). These include the global pharmaceutical industry, socio-political, criminal justice, popular cultural, economic, and mental health professional, policy and research interests. Although subject to robust critique for lacking scientific credibility (Bentall 2009; Cromby et al. 2013; Johnstone 2014), diagnostic portrayals of human distress maintain a high level of international cultural hegemony. Reified in contemporary global media, celebrity culture and UK party politics, these portrayals connect public with mental health professional, research and policy discourses. Hornstein (2013) conveys the strength of such hegemonic acceptance in her assertion that diagnostic understandings of human misery are sedimented in public and professional consciousness to the extent that, collectively, they constitute an authoritative meta-narrative to guide human life and experience.
However a paradigm shift is underway, discussed in the above contemporary de-medicalisation literature, from diagnostic to narrative-based understandings of human distress (see Grant in press; Hornstein 2013; Thomas and Longden 2013; Johnstone 2014). As a stakeholder in this shift, Dr Alec Grant has for several years written critically with colleagues about our involvement in the institutional psychiatric system, with implications for healthcare education. They have done so in relational autoethnographic work, in increasingly existential ways, on the basis of our hybrid identities: as mental health academic-professionals-survivors of the institutional psychiatric system (see Short et al 2007; Grant 2013; Grant and Leigh-Phippard 2014; Grant et al. 2015). Such re-storying of our life narratives has enabled them to construct and develop viable identities, independent of the institutional psychiatric system, and free from the disabling and disempowering biographies that were once imposed on them as a result of their inscription within this system.
This presentation was mainly based on the Demedicalising Misery paper (Grant in press). After describing the rationale for the paradigm shift, its contextual bases and main features, Grant presented key reasons for moving from technological to human understandings of what are normally described as ‘functional mental health problems’. This paved the way for a discussion of emerging human paradigm principles for changing health and social care education and practice.