Is the practice of psychiatry really crumbling and in crisis, as stories of over- and under-diagnosis show? Psychoanalyst Matthew Tiffany on an important new book that shows just how complicated the issues and challenges are in the field.

Set aside an afternoon to go online and search for how psychiatry is failing. You’ll discover a cottage industry—a slew of books, editorials, essays, and news features covering the crumbling mental health services in America. Coast to coast, from The Los Angeles Review of Books to The New York Review of Books, there are essays on over-diagnosis, misdiagnosis, under-diagnosis; there’s a Greek chorus singing the zealotry of how doctors are all-too-frequently throwing medications at mental illness, while the pharmaceutical industry pulls the strings, like a malevolent Oz. We have a culture that favors fast, quantifiable results through measurable, evidence-based treatments—in schools, in the workplace, and in medical care. Get in, put a bandage over the problem, submit your bill to the insurance company, and get out. Problems that develop over years, decades—even over generations, as the patterns of one pass on to the children—are increasingly expected to be set right in a few sessions.
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