ABSTRACT

From psychiatry’s beginnings around the late 1800s, when medical doctors entered the growing insane asylum enterprise and sought to possess it, the profession proclaimed its roots to be in medicine and its practitioners guided by medical knowledge. Psychiatry’s foundational claim is that various distresses and misbehaviours are a species of bodily disease that it calls ‘mental illness’. The claim has become widely accepted and remains so despite the shortcomings of the main developments psychiatry has led or joined: institutionalisation in insane asylums (1850s–1950s), induced comas, convulsive treatments and lobotomy (1920s–50s), de-institutionalisation from state hospitals into coerced and voluntary community care (1960s–80s) and, since the late 1970s, expanding the range of mental illnesses to cover half of American adults and prescribing psychoactive drugs as first response to anyone distressed or misbehaving.