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Public Rejects Illness Model of Schizophrenia

MEDIA RELEASE October 16, 2006

Public Rejects Illness Model of Schizophrenia

The November edition of a prominent scientific journal, Acta Psychiatrica Scandinavica, includes a review of international studies of how the public understands the causes of schizophrenia. The review, of 37 studies from 17 countries (including Australia, New Zealand and Britain), concludes that:

"Internationally, the public, including patients and carers, have been quite resilient to attempts to promulgate biogenetic causal beliefs, and continue to prefer psychosocial explanations and treatments".

The causes cited most often include stress, poverty, family problems and child abuse and neglect. This contrasts with biological psychiatry's belief that schizophrenia is a brain disease with a strong genetic component.

The other significant finding is that in the rare instances that lay people do adopt a medical model, "Biogenetic causal beliefs and diagnostic labelling by the public are positively related to prejudice, fear and desire for distance".

Currently many destigmatisation programmes, often funded by pharmaceutical companies, try to teach the public to adopt an illness model. The reviewers conclude, however, that:

"An evidence-based approach to reducing discrimination would seek a range of alternatives to the 'mental illness is an illness like any other' approach", adding that "Destigmatisaion programmes may be more effective if they avoid decontextualised biogenetic explanations and terms like 'illness' and 'disease', and increase exposure to the targets of the discrimination and their own various explanations".

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The paper's first author is Dr John Read, editor of the controversial book 'Models of Madness", which argues that schizophrenia is an understandable response to adverse life events and documents the role of the pharmaceutical industry in promulgating a simplistic biological approach. Last year Acta Psychiatrica Scandinavica published his review of the fast growing number of studies showing that child abuse is a cause of schizophrenia.

Dr Read: "What these two papers suggest, taken together, is that the public may have a better grasp of the causes of hallucinations and delusions than some of us mental health experts". "All the social causes cited by the public have recently been substantiated by well designed international studies"

"There are two major implications to be drawn. Firstly, all the efforts to educate the public to adopt a biological ideology about mental health have been at best a waste of money and, more probably, extremely damaging in terms of increasing stigma and prejudice. Secondly, mental health services need to move away from the rigidly biological emphasis on drugs and shock therapy and embrace a more evidence-based, balanced and humane approach to understanding and treating human distress".

Dr Read will present the findings of the review at mental health conferences in Auckland and Los Angeles in November.

"Prejudice and schizophrenia: A review of the 'mental illness is an illness like any other' approach". Acta Psychiatrica Scandinavica, 2006, 114, 303-318. John Read. (Department of Psychology, The University of Auckland) Nick Haslam (Department of Psychology, The University of Melbourne) Liz Sayce (Disability Rights Commission, London) Emma Davies (Institute of Public Policy, Auckland University of Technology)


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