May 2007, p 40

Review of Critical voices in child and adolescent mental health

Timimi and Maitra have collected an erudite selection of writings that together present a trenchant critique of child psychiatry as it is currently practised.

The book situates mental health in a western way of life that is fixated on consumption and individualism, and contemptuous of diversity. Child psychiatry, as critiqued here, is dominated by a biomedical framework (reflected in the rising numbers of children diagnosed with psychiatric illness), and led by a small number of powerful academics who persist in ignoring the cultural, social and political context in which their young clients live.

There are some highly informative chapters exposing the murky relationship between the pharmaceutical industry and psychiatry. Sami Timimi questions the validity of the diagnosis ‘childhood depression’, when children show so few of the accepted symptoms of depression. Charles Whitfield points out that many children diagnosed with ADHD may have a history of abuse or trauma that has been overlooked. Begum Maitra eloquently argues for a more encultured approach to developing expertise on children’s health.

Timimi announces that it has been years since he last needed to prescribe an antidepressant, engaging instead with the ‘interpersonal realities’ of his young patients. Yet so many child psychiatrists still refuse to recognise the validity of non-medical accounts of mental distress. This surely speaks volumes about the terminal condition of child psychiatry.