A critical look at professional education in the mental health field.

Abstract

A CENTRAL ISSUE IN THE MENTAL HEALTH FIELD IS THE QUESTION OF THE RELEVANCE OF MEDICAL EDUCATION TO PROFESSIONAL FUNCTIONING IN THE FIELD. INTERPROFESSIONAL RIVALRIES HAVE HAMPERED DISCUSSION OF THIS PROBLEM, WHICH INVOLVES PSYCHIATRISTS, PSYCHOLOGISTS, SOCIAL WORKERS, AND LAY ANALYSTS. ONLY 3 PROFESSIONAL ACTIVITIES IN THE FIELD ARE FIRMLY OPERATIONALLY CONNECTED WITH MEDICAL TRAINING: PERFORMING PHYSICAL EXAMINATIONS, PRESCRIBING DRUGS, AND GIVING ELECTROSHOCK TREATMENT; OF THESE, ONLY THE PRESCRIBING OF DRUGS IS COMMONLY DONE BY LARGE NUMBERS OF PSYCHIATRISTS. THE CONNECTION BETWEEN MEDICAL EDUCATION AND MENTAL HEALTH PRACTICE IS THUS ALMOST ENTIRELY AN INSTITUTIONAL CONNECTION, NOT AN OPERATIONAL ONE. THE MENTAL HEALTH PRACTITIONER, WHETHER HE BE PSYCHIATRIST, PSYCHOLOGIST, PSYCHIATRIC SOCIAL WORKER, OR LAY ANALYST, IS BASICALLY PRACTICING APPLIED PSYCHOLOGY. A TRULY RELEVANT CURRICULUM LEADING TO A DOCTORATE IN MENTAL HEALTH MUST BE DEVELOPED FROM THE CURRICULUM IN CLINICAL PSYCHOLOGY, NOT THE MEDICAL CURRICULUM. (24 REF.)

Psychology and community mental health: The medical muddle.

“…One can recall Kubie's (1957) proposals in the past for developing new training models. More recently Allen S. Mariner (1967) writing in the American Psychologist, suggested lhat there be developed a curriculum for a school of mental health based on existing curricula in clinical psychology with appropriate additions from other fields such as medicine, sociology, and social work. Mariner, a psychiatrist, concludes a lengthy discussion of professional education in the mental health field by saying, "The mental health professional, then, is really working in the field of applied psychology in the best sense of that muchmisused .…”

Profile: Professor Philippa Garety

“…A truly relevant curriculum leading to a doctorate in mental health must be developed from the curriculum in clinical psychology, not the medical curriculum’. 1 Neuropsychiatry and liaison psychiatry aside, does Dr Mariner have a point? But Professor Garety is too tactful to make any superior claims for psychology (in spite of the better research training we do agree that psychology trainees receive).…”

“…A truly relevant curriculum leading to a doctorate in mental health must be developed from the curriculum in clinical psychology, not the medical curriculum’. 1 …”

Prescribing psychologists and patients' medical needs: Lessons from clinical psychiatry.

“…An argument could even be made that an individual without medical training who has been taught to look out for certain conditions, lacking the false sense of security provided by largely forgotten medical training, might be more likely [italics added] to investigate the possibility of relevant physical factors affecting his patient, (p. 71) Recognizing the limited use and subsequent atrophy of their medical skills, other psychiatrists decades ago also expressed doubt about the relevance of much of their medical school training to their daily practice (Brady. 1978: Mariner, 1967 or prescribing activities (Platman, Dorgan, & Gerhard, 1976). Undoubtedly, some of the knowledge and skills acquired from medical school remains relevant to the competent practice of psychiatry; however, the facts suggest that a large part of medical school training is unused and may be superfluous.…”