ABSTRACT
In the mental health field we face a number of overlapping and competing professions that rest on conflicting epistemologies. Psychiatry, for example, is a medically-oriented statutory profession with strong legal powers over individuals, while much counselling and psychotherapy is antagonistic towards the biomedical model and has no legal power over individuals. The mental health professions in the UK include psychiatry, mental health nursing, psychoanalysis, clinical and counselling psychology, psychotherapy and counselling, and it is not immediately clear where coaching and related complementary therapies fall. These psychological therapies are delivered by statutory professionals but also by therapists in the educational, corporate, voluntary and private practice sectors. Different but also similar professional pluralism operates in other countries, often causing confusion for referral pathways and consumer choices. This degree of professional complexity results not from necessity but simply from historical forces; and some faltering attention is given to integration in the field but with little success. We also need to factor into the mental health debate the variety of so-called psychiatric disorders or psychological problems, amounting to over 300 (up from an original 106), according to the famous American psychiatric Bible, the DSM (APA, 2013). Even acknowledging ongoing critiques of the DSM and psychodiagnosis generally, we may concede that myriad problematic conditions exist, which are themselves refracted via culture and personality.
