How has psychiatric diagnosis both failed and survived?

This chapter provides opportunity to demonstrate three linked key resources from critical realism: immanent critique; explanatory critique; and omissive critique. Functional psychiatric diagnoses have failed humanity. Most of the functional psychiatric diagnoses could be subjected to a very similar damning immanent critique. ‘Schizophrenia’ is illustrative of the weakness of psychiatric diagnosis in general but it is not uniquely inadequate. The description of ‘schizophrenia’ affords clinicians poor concept and predictive validity, does not guide specific treatment decisions and often is not experienced as helpful by the identified patient. An implication of assuming that mental illnesses reflect defective brain functions or structures is that physical methods of treatment are the default position of psychiatric routines. The actual biopsychosocial complexity of mental health problems could be ignored as a result of the collusive relationship between bio-reductionist psychiatry and ‘Big Pharma’.