ABSTRACT

Since the Second World War there have been many developments in the theory and practice of mental health care. These include the emergence of various critiques of mainstream psychiatry, the proliferation of different schools of psychotherapy and a succession of challenges to psychiatric and psychotherapeutic orthodoxy. Additionally, in the British context, a succession of scandals in psychiatric hospitals during the 1970s (Martin, 1984) plunged the mental health services even deeper into a crisis of legitimacy which had begun to unfold with the publication of Russell Barton’s Institutional Neurosis in 1959. Nevertheless, there has been no sustained effort to develop an integrated critical analysis of the theory and practice of mental health care which takes account of all these developments. Books by Lucy Johnstone (1989) and Parker et al. (1995) have gone some way towards developing such an analysis, while literature such as Phil Thomas’s (1997) book about schizophrenia provides in-depth critical analysis of competing discourses of certain specific forms of mental distress. In this chapter we draw on the methodology of critical criminology in an attempt to take some tentative steps towards the development of an all-encompassing critical model of mental health, mental distress and psychotherapeutics. As there are already many competing perspectives on mental health it would be naïve to pretend that we are able to offer a definitive critical model of mental distress. Rather, we attempt to show how overlaps and tensions between various Western conceptions of mental health, mental distress and psychotherapeutic intervention might be subjected to systematic critical analysis.