Friday 27 January 2012

Cure Or No Cure

If you haven't seen it already take a look at Hafal Expert Patient Trainer Dave Smith's recent article in the Western Mail concerning finding a cure for mental illness (the on-line version can be read here).

Though it's his own view I for one don't have any quarrel with Dave's opinion on this important subject. But it is a matter which many are reluctant to discuss and I'd like to consider why. I think that there are a set of reasons as follows with my comments appended:

People are reluctant to raise people's hopes too much - yes, that is a fair consideration, but we must surely be brave enough to discuss the possibilities with people who have experience of mental illness and with their families. Apart from anything else the people doing the science need the active cooperation of patients for research purposes.

Mental illness has been around for years and yet nothing you could call a cure in clinical terms has been identified for the key mental illnesses - true, but then nobody expected the recent exponential advances in understanding genetics: as Dave says discovery of decisive genetic treatments is getting more and more credible.

Mental illness isn't just a question of genetics or brain chemistry ("nature") but also of life experiences ("nurture")so "cure" is an inappropriate term
- there are a few hard-line exponents of antipsychiatry who think it's all nurture not nature but most of us are honest enough to acknowledge that we aren't sure but it's probably a mixture, varies a lot between illnesses and individual patients, and frankly we don't yet know enough about this. But it is surely right to look at the biochemistry for cure so long as we also give appropriate weight to the psychodynamic therapies which (and here I'm generalising quite a bit) best address the "life experiences" side of things.

Tricky stuff this both scientifically and politically but let's at least discuss it openly and not hide away in the cop-out which says recovery or cure isn't about real health gain but rather just some woolly ideas about coping and adjustment. Good for you, Dave.