Neuroscience and the future for mental health?

Psychiatry is in one of its regular crises. It is a crisis of its diagnostic systems despite - perhaps because - of the recurrent claims about the extent of diagnosable 'brain disorders'. It is a crisis of its explanatory systems despite - perhaps because - of its current wager on the brain as the ultimate locus for explanations of mental disorders. It is a crisis of its therapeutic capacities despite - perhaps because - more and more people are making use of its primary mode of intervention focussed on the brain - psychiatric drugs. In this editorial, I will suggest that this triple crisis of diagnosis, explanation and therapeutics arises from the dominant reductionist approaches to the role of neurobiology in psychiatry that priorities the analysis of brain mechanisms, at the expense of an understanding of the whole living organism in its milieu, and the processes which social experience shapes neurobiology from the moment of conception if not before. I shall suggest a different approach that starts from the experience of persons coping with adversity in their forms of life. This approach does not require giving up on our search for plausible explanations of mental health problems that engage neurobiological mechanisms, but it begins from a commitment to understanding, and hence intervening in, the ways in which social adversity shapes and blights the lives of so many of our fellow citizens.