By Hugh Middleton.

During the pre-Covid years, the Critical Psychiatry Network ran a series of successful one-day conferences at the University of Nottingham each April. A move to London was planned for 2020 but the coronavirus pandemic intervened, and it was rearranged as an online conference, which was held in April 2021.

The Nottingham conferences give a flavour of the Critical Psychiatry Network’s activities and concerns, and some of the interest it has been able to attract. Each was attended by some forty to fifty delegates. Many stayed overnight and were able to enjoy informal time together and an evening meal. In 2017 we arranged to watch David Tennant’s portrayal of R.D. Laing in Mad to be Normal at Nottingham’s Broadway Cinema together.

The 2013 conference followed shortly after publication of Psychiatry Beyond the Current Paradigm in the British Journal of Psychiatry, in December 2012. It was intended to build upon the widespread interest that publication generated, and flesh out its message. The conference went under the name of ‘Beyond the Current Paradigm’ and was billed as an opportunity for practicing UK psychiatrists to discuss and reflect upon the implications of uncertainties in the evidence base for current practices, and growing respect for the value of service users’ contributions to an understanding of mental health difficulties. Speakers included Peter Tyrer, Joanna Moncrieff, Rex Haigh, Sami Timimi, Phil Thomas and Bob Johnson.

In 2014 the April CPN conference went under the name of ‘Emerging Perspectives in Psychiatry’. Speakers included Brian Martindalewho considered Psychodynamic Perspectives of Psychosis, Pat Bracken on questions of Global Mental Health, Rex Haigh who discussed Greencare, Phil Thomas on the difficulties of withdrawing from neuroleptic medication, and Bradley Lewis who shared his experiences of articulating critical psychiatry in the United States.

The 2015 conference attempted to address the question, ‘What is the future of UK psychiatry?’. The conference heard from Peter Kinderman who had recently published A Prescription for Psychiatry: Why We Need a Whole New Approach to Mental Health and Wellbeing, from Nick Manning who had recently retired after several years setting up Nottingham’s Institute for Mental Health, from Sir Simon Wessely who had recently been elected President of the Royal College of Psychiatrists, and from Russell Razzaque and colleagues who provided an introduction to Open Dialogue.

In 2016 attention was directed towards issues of race and discriminatory practices under the title of ‘Critical Thinking about ‘Race’ and Culture in the Psy Disciplines – Psychiatry, Psychology and Psychotherapy’. Vieda Skultans provided an ethnographic perspective, Suman Fernando spoke about the implications of terminology and the consequences these have for unintended, but nevertheless experienced, institutional racism within psychiatry, Jayasree Kalathil addressed the question, ‘What do critical psychiatry and emerging ‘alternatives’ mean to survivors from racialised groups?’, Begum Maitra also addressed the power of words, considering the effects of styles of practice upon derived meanings from the perspective of a child psychiatrist, and Derek Summerfield outlined some of the particular difficulties experienced by African women with HIV referred to a London mental health service. 

The 2017 conference was held against the background of austerity politics and a rise in the popularity of ‘recovery’ as way of understanding the resolution of mental health difficulties. The conference went under the title of ‘Recovery in a Time of Austerity’. It seemed appropriate to ask ‘Against a background of fiscal tightening, has the recovery agenda has been hijacked to save money?’, and to consider the tension between this and the fact that that ideal practice should include closer attention to clients’ individual needs and vulnerabilities if they are to resume or acquire independence and autonomy. Mike Slade, who had recently been appointed Professor of Mental Health Recovery and Social Inclusion at Nottingham spoke to the title, Recovery – commandeered but rescuable?, Geoff Shepherd set contemporary understandings of ‘recovery’ in an historical context, and Dave Harper gave a memorable account of the associations between material hardship and mental ill-health.

This led on to the theme for 2018; ‘Neoliberal Ideology and Mental Health’. Phil Thomas offered an interpretation of neoliberal ideologies, and why they are relevant to an understanding of mental well-being. Dr Neil Armstrong, a Lecturer in Anthropology at Oxford gave insights from his studies of healthcare management, and how it influences practices and expectations, John Cromby provided a philosophical perspective of how and why neoliberal policies that undermine public services also undermine health and wellbeing, Helen Spandler reflected upon the tensions between neoliberalism and an approach to healthcare that might be truly accountable to ‘service users’, and James Davies gave a vivid account of the unholy alliance between the pharmaceutical and financial industries, which can be seen as contributing to the ‘pharmaceuticalisation’ of mental health services.

The 2019 conference focused upon what critical ideas in psychiatry, psychology and psychopharmacology might mean for everyday clinical practice, under the title of ‘Putting Critical Ideas into Clinical Practice’. Magnus Hald gave an account of running a drug-free treatment unit for people with psychotic disorders in the Norwegian health service, Ben Sessa (re-) introduced delegates to the use of psychedelic substances, in particular MDMA, in the treatment of consequences arising from child abuse and trauma, Sami Timimi described how it is possible and indeed productive to work outside of a diagnostic framework, and Lucy Johnstone introduced the Power, Threat, Meaning framework, and described some the challenges faced by those attempting to put it into practice.

Many of those, particularly regular attenders, who have made it to the CPN conferences have valued the annual get-together, and it is to be hoped that coronavirus restrictions will be lifted sufficiently to allow that to happen again before too long. In the meantime, CPN continues the series online, until we are able to gather in person again.