Do you still need your psychiatric diagnosis? Or should we be asking not: “What is wrong with you?” but rather: “What has happened to you?”

Mental distress is very real. But what we are very rarely told is that the dominant explanations for these experiences – such as that they are ‘symptoms’ of an ‘illness’ caused by a ‘chemical imbalance’ which psychiatric drugs will rectify – has never had any evidence to support it.

This may come as a surprise, since what is referred to as the ‘biomedical model’ of distress has taken such a hold in public consciousness. At the same time, levels of distress seem to be increasing along with a rise in prescriptions.

Something has gone badly wrong.

We now have a range of alternatives to the diagnostic approach. They can be summarised as various ways of listening to people’s stories – stories that often, though not always, involve trauma, abuse, loss, neglect, poverty and discrimination.

The Power Threat Meaning Framework is a recent project developed in partnership with users of mental health services. By drawing on and expanding these ideas, it has the potential to move us beyond the failed diagnostic paradigm once and for all. Please click here for resources, videos and guided discussion on The Power Threat Meaning Framework.

Dr Lucy Johnstone, CPsychol, is a UK clinical psychologist, trainer, speaker and writer, and a long-standing critic of biomedical model psychiatry. She has worked in adult mental health settings for many years, alternating with academic posts. She is the former Programme Director of the Bristol Clinical Psychology Doctorate, a highly regarded course which was based on a critical, politically-aware and service-user informed philosophy, along with an emphasis on personal development.

Lucy has authored a number of books, articles and chapters on topics such as psychiatric diagnosis, formulation, the psychological effects of ECT, and the role of trauma in breakdown. She was a contributor to the Division of Clinical Psychology ‘Position Statement on Classification’ 2013.

Lucy has spent over five years working alongside a team of the UK’s leading psychologists to develop ‘The Power Threat Meaning Framework’, which offers an alternative to more traditional models of psychiatric diagnoses, and a new perspective on why people experience mental distress.

Her latest book: A Straight Talking Introduction to Psychiatric Diagnosis was published in 2014. You can follow Lucy on twitter @ClinpsychLucy

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