A non-drug therapy used by a clinical psychologist when working with a voice-hearing client has provoked a storm of mixed reactions.
A Channel 4 docudrama last month centred on the work of Bradford NHS psychologist Rufus May as he attempted to help a real-life junior doctor who was suspended from her job after hearing voices telling her to kill herself.
Outside his NHS work, May used psychological and physical techniques to help the woman, “Ruth”, who had been diagnosed with bipolar disorder, to cope with sleep problems, voice-hearing and her moods. Ruth, now back working as a doctor, did not take any psychiatric medication.
But some psychiatrists have reacted furiously, calling May’s approach “dangerous” and “damaging”.
One leading psychiatrist as well as other mental health professionals have, however, strongly defended May’s intervention, arguing it is based on more than 20 years of research.
Mental health charity Mind has also nominated May for its “Champion of the Year Award” for his efforts to “improve public understanding of mental health issues”
May, who works with Bradford District Care Trust’s assertive outreach team, was himself diagnosed with schizophrenia at the age of 18. Against his doctor’s advice he came off all his medication and later trained as a clinical psychologist.
In the film, entitled The Doctor Who Hears Voices, he was shown speaking directly to Ruth’s voices, a technique backed by the UK charity, the Hearing Voices Network.
But, reflecting deep and long-running divisions in mental health practice, May’s approach angered some professionals.
“The biggest concern for me was his [May’s] assumption that … schizophrenia doesn’t exist, based on his own experiences of his treatment at 18 for a psychotic episode,” wrote consultant psychiatrist Catherine Wainhouse on the bulletin board of doctors.net.uk, a site for doctors registered with the General Medical Council..
“This clouded every judgement he made and made him very dangerous. The risks he took with that young woman’s life were appalling.”
Another consultant psychiatrist, Nicholas Bescoby-Chambers, said: “I am alarmed by his approach. He was advising a young, dare I say naïve, doctor to jeopardise her career…
“I suggest he has probably harmed not only his career, but, as a consequence, the young doctor’s, as she should have come under an early intervention approach which works holistically anyway, and encourages compliance with medication as one facet in multidisciplinary treatment.”
The approach used by May was praised by psychiatrist Marius Romme, visiting professor at the Mental Health Policy Centre at the University of Central England in Birmingham.
Romme urged psychiatrists and other professionals to use the approach used by May to help patients understand their experiences. He also denied the therapy was dangerous.
“This programme shows that by simply sitting down and talking to a voice hearer about their experience, validating the reality of what is happening to them and working alongside them to better understand the message the voices bring, then dealing with these issues, a person can start to live their life again,” said Romme.
“This approach is not controversial or dangerous. It is based on over 20 years of research and action and now with initiatives in 19 countries across the world.
“It represents a major challenge to the approach used by psychiatric services.”
However, another consultant psychiatrist, Russell Lutchman, wrote at doctors.net.uk that he feared the programme was unbalanced and risked causing “unquantifiable damage” to patients diagnosed with psychosis.
“The film did not make any reference to the large body of research that points to schizophrenia having much of a biological foundation,” he said.
One of May’s NHS trust colleagues, Richard Nisbet, an assistant ward manager, was also critical, accusing May of “empire-building”
“Mr May’s ignorance and bitterness at his own experiences (with which I empathise) seem to have coloured his judgement to such a degree that I do not understand how anyone can take his mantra of “no drugs good, all drugs bad” remotely seriously,” he told psychminded.
“Empire building and flagrant self promotion to indulge one’s grievances at the expense of others is not an attractive quality,” he said.
Lisa Brownell, a consultant psychiatrist at Queen Elizabeth Psychiatric Hospital in Birmingham, questioned Mind’s decision to nominate May as a “champion”. Mind says May is “revered in his field”.
“Can you imagine someone saying that we should stop treating people with cancer with medication and close down all the cancer centres and then be nominated for an award by a cancer charity?,” she wrote at doctors.net.uk
“Of course we should treat our patients with respect, and dignity, and holistically, and as individuals. Like all docs should treat all patients. Like oncologists treat their patients. But to say that in order to do this we should deny them appropriate medical intervention?”
“Don’t let him anywhere near me if I become mentally ill,” she added.
Mind’s head of media relations Claire Ashby said: “Rufus’ s pioneering approach gets remarkable results and shows that people can recover to lead a full life.”
Other mental health professionals and service users told psychminded they supported May’s work.
“Thank you, Rufus, for acting with the courage of your convictions in this very difficult situation.” said Mary Maddock, from Cork in Ireland, who once was prescribed neuroleptics and antidepressants for depression.
“Medical ‘treatments’ such as psychotropic drugs and electro shock can cause brain damage.
“Since there is no evidence that chemical imbalances in the brain can cause psycho/social difficulties then it does not make sense to uses drugs or electro shock as a solution.
“I hope that [the programme] will help many people to escape the chemical lobotomy I received for almost 20 years.”
Afroza Ali, a support worker with the Beside mental health charity in Tower Hamlets, London, said: “I hope this documentary encourages other mental health care professionals to look at the experience of hearing voices from a humane perspective.”