To the Editor: I am writing in regard to the Open Forum essay, "Evolution of the Antipsychiatry Movement Into Mental Health Consumerism." From a historical perspective the essay was interesting and provocative. However, I was left with a hollow feeling. I wondered about patients and psychiatrists who work hard every day and toward greater understanding of mental illness and recovery. I especially wondered about the hesitancy a patient may have to take the first step for help, either in a self-help program or a psychiatrist's office.
The authors' conclusion was profoundly concerning in that it maintains acrude and cold separation between patient and doctor that does not further the relationship on which so many depend. In fact, it could easily drive help-seeking consumers from the development of a therapeutic relationship. This relationship must be seen as key to consumers who wish to delve further into analysis or clinical interventions that are required for many of us to maintain lives rooted in recovery values.
At a time when consumers are most vulnerable, we must foster the clinical dialogue, not drive a wedge that creates a problem to which there is really no solution. The authors' message, while academically controversial, merely emphasizes this schism. Yes, some psychiatrists and consumers may be at war over ideology, but it is the struggle and eventual healing that can result in ultimate recovery. In this most fundamental instance, psychiatrists and consumers can make a new history that is based on mutual understanding and compassion.
Ms. Van Tosh, who is an editorial consultant for Psychiatric Services, is director of consumer affairs at Western State Hospital, Tacoma, Washington.