16 June 2000
Dear Sir
"Trust me, I'm a doctor". This does not negate the statement, "Trust us, we've tried it and it works for us" as Raj Persaud seems to suggest (First Person 10 June 2000).
Yes, there is a weight of clinical evidence behind pharmaceutical approaches to mental health problems. We accept that. We know many people for whom medication has been a lifeline. But no evidence, however scientific, suggests that any drug works for everybody even if they have the same diagnosis. Some drug side-effects can be severely debilitating to people to the extent that they discontinue treatment. All of this suggests that the individual patient’s ‘evidence’ should be just as important to the clinician as any weight of research evidence.
The reason that there is a weight of evidence for medication is because the research has been extremely well funded by pharmaceutical companies and others. Only a fraction of these total resources have been available to evaluate alternative non-drug-based therapies.
Our own research with mental health service users shows that alternative approaches do work, so surely we need to fund more clinical research in order to build up the evidence-base? Then people with mental health problems, and their psychiatrists, would be better informed in making appropriate decisions.
Getting this full range of research funded should be a priority for Government. But in the meantime, the Mental Health Foundation will continue looking at a variety of approaches to mental health problems, recognising the expertise of all - from service users to psychiatrists.
Yours faithfully
Nigel Duerdoth
Director of Programmes, Mental Health Foundation
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