A critical history of ‘mental health care’ in the United States

Authored by: Tomi Gomory , Daniel J. Dunleavy

Routledge International Handbook of Critical Mental Health

Print publication date:  September  2017
Online publication date:  September  2017

Print ISBN: 9781138225473
eBook ISBN: 9781315399584
Adobe ISBN:


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The late medical historian Roy Porter defined madness as the ‘generic name for the whole range of people thought to be in some way, more or less, abnormal in ideas or behaviour’ (1987: 6, emphasis added). He notes that, ‘even today we possess no… consensus upon the nature of mental illness… Short of the discovery tomorrow of the schizophrenia gene, these controversial issues will not be quickly settled’ (Porter 1987: 8–9). Despite decades of research, no genes or biomarkers have been discovered for any ‘mental’ disorder (Andreasen 1997, 2007; Boyle 2002). Though there are numerous theories about the nature of madness (Read et al. 2004), none have been scientifically validated. Despite these scientific uncertainties, one of these theories has persisted – namely, madness as medical disease. This presumption has devastated our understanding of it. Science generally advances through trial and error examination of testable hypotheses: those which explain previously unexplainable observations and can make novel predictions temporarily triumph (e.g. Carnap 1974: 6–16). Madness as medical disease fails to do this and marginalises alternative views.

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