Psychiatrists are the least effective of mental health professionals, says consultant psychologist

Psychiatrists are the least effective of all mental health professionals, a consultant clinical psychologist has claimed.

In a stinging criticism of the psychiatric profession, Dr Henck van Bilsen said there was “no evidence” that psychiatrists, who usually hold most responsibility for patients, were clinically effective.

“For every psychiatrist not employed, we could employ between three and six other mental health professionals,” said Dr van Bilsen, director of Cognitive Behavioural Therapy programmes at Canterbury Christ Church University.

Dr van Bilsen’s comments, posted on his blog, were in response to a statement by Professor Dinesh Bhugra, the outgoing president of the Royal College of Psychiatrists, who said the “massive problem” that consultant psychiatrist posts were not being filled was contributing to failures in inpatient care for people with mental health problems.

A survey by the royal college has found 544 consultants’ posts in the UK – 14% of the total – are either unfilled or filled by a locum.

In addition, 209 consultants intend to retire or resign soon, a situation exacerbated by the government’s cap on immigration from outside the EU.

Dr van Bilsen wrote: “The psychiatrists are at it again. The shortage of psychiatrists is only a shortage in a mental health system that has made itself dependent on the most expensive (and least effective) professional in the field of mental health.

“With all their fancy perks, most psychiatrists earn many times the amount of well-qualified nurses, social workers and occupational therapists.

“Most psychiatrists rely on the system whereby they review the patient every so often and see the patient for 15 minutes.

“I missed the research that indicates that this is an evidence based intervention. No, I did not miss the evidence, the evidence is not there!

“Most mental health problems are better understood from a psychological perspective.”

Dr Van Bilsen, who used to work in Holland, also claimed the extra responsibility for patients that psychiatrists have could be carried out by other professionals, such as clinical psychologists and nurses.

He said: “In the Netherlands I had the pleasure of reducing the input of the psychiatry discipline in mental health services I managed.

“Instead of two full-time psychiatrists, the teams made do with 0.2 psychiatrists for medication review and we employed four nurses and two clinical psychologists instead. We never missed them for a minute.”

Since 1990 Dr van Bilsen has worked privately with the Cognitive Behaviour Therapy Partnership. Previously he was academic director of the Auckland Institute for Cognitive Behaviour Therapy in New Zealand and was deputy director of the ‘Pedologisch Instituut Rotterdam’ in Holland.

In a bid to recruit more UK psychiatrists, Prof Dinesh Bhugra once said psychiatry was the most exciting and fun speciality in medicine.

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