We are pleased that our article has stimulated debate. This was our intention. We are disappointed that some correspondents dismiss our argument by attacking a stereotype of who they think we are or a caricature of what they think we might have said, rather than addressing what we actually did say. Such correspondents have missed, or ignored, the point of the article – namely, to ask whether the de-medicalisation that has taken place over recent years in British psychiatry is bad for the health of patients and the specialty. We believe this is a question that is worth taking seriously. It is clear from the substantial correspondence and other feedback that many psychiatrists share our concerns and wish for constructive debate.
This primary concern with the decline in medical standards of care and the deliberate politicisation of debates about service delivery does not imply that we cannot (a) embrace the importance of the full range of biological, psychological and social interventions for psychiatric illness and (b) value our non-psychiatric fellow professionals and their integral contributions to mental healthcare. We also believe to be self-evident that services should be informed by the experiences of patients, their relatives and carers, and that multidisciplinary teamwork is crucial for optimal management of psychiatric illness. We are not terribly interested in what is past. We are much more interested to look ahead.
Of the wide range of views expressed by respondents, we believe the voice of trainees and those contemplating a career in psychiatry should carry particular weight and we should like to hear more from them. They are the future of British psychiatry.