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Mad in America: Rethinking Mental Health

The Mad in America podcast, hosted by James Moore, examines mental health with a critical eye by speaking with psychologists, psychiatrists and people with lived experience.

When you hear such conversations, you realise that much of what is believed to be settled in mental health is actually up for debate. Is mental health a matter of faulty biology or is there more to it? Are the treatments used in psychiatry helpful or harmful in the long term? Are psychiatric diagnoses reliable? With the help of our guests, we examine these questions and so much more. 

This podcast is part of Mad in America’s mission to serve as a catalyst for rethinking psychiatric care and mental health. We believe that the current drug-based paradigm of care has failed our society and that scientific research, as well as the lived experience of those who have been diagnosed with a psychiatric disorder, calls for profound change. 

On the podcast over the coming weeks, we will have interviews with experts and those with lived experience of the psychiatric system. Thank you for joining us as we discuss the many issues around rethinking mental health around the world.

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Jul 3, 2019

Last year, Lucy Johnstone and her colleagues in the UK launched the Power Threat Meaning Framework (PTMF), a set of ideas that represented a sharp departure from the biomedical conceptions that animate the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM). This framework shifts the notion of “what is wrong with you” in the DSM to “what has happened to you,” and by doing so turns away from a medical process bent on diagnosing broken brains and toward a narrative response that tells of contexts, power dynamics, and systems.

At a time when the Movement for Global Mental Health is intent on exporting the Western biomedical approaches around the world, Johnstone and her PTMF team, which has included numerous individuals who identify as service users/survivors, are seeking to promote a radically different way of understanding distress. Responses to the PTMF have ranged the gamut from criticism to gratitude.

Johnstone, a consulting clinical psychologist who has experience working in adult mental health settings for many years, believes that the current mental health system has failed, and we are now in the process of witnessing its inevitable downfall. She questions whether a mental health system is needed at all. However, as Thomas Kuhn wrote in his work on scientific revolutions, a system cannot be fully abandoned until there exists a conceptual alternative for the system to move towards. The PTMF, Johnstone believes, offers that conceptual alternative that is necessary for a revolution.

In this interview, she reflects on the reaction to the PTMF, and the possibility that it will help stir up a revolution in the field. How is the framework to be used? Does it stand a chance of becoming adopted? She also tells of how her own life experiences and the influences on her work.

Relevant Links

Dr. Johnstone took part in an earlier interview after the PTMF was launched. You may view
this interview here:

More about the PTMF:
Lucy Johnstone discussing the primary features of PTMF:
A British Psychological Society report (with full document link to the framework included):

© Mad in America 2019