The master's thesis deals with the current psychiatric paradigm from the perspective of contemporary critical psychiatry, more specifically that of some prominent members of the Critical Psychiatry Network (CPN). The selected critiques focus on the problematic nature of psychiatric »diagnoses« from a scientific and biomedical perspective, the logic of psychiatric »diagnostics«, and the effects it has at the clinical (individual) and community levels. The issues surrounding the understanding, testing, and use of psychotropic drugs are also identified. Among the alternatives highlighted by critical psychiatrists of CPN, particular emphasis is placed on a different view of psychiatric drugs (i.e. the drug centered model), non-specific factors of recovery (e.g., a supportive and trusting relationship, expansion of narratives and reframing users' experiences, recognizing injustices, strengthening personal agency), the importance of collaboration with users and their organizations, and expansion of educational content for psychiatrists and other mental health professionals to include social sciences and humanities. A special chapter of the thesis also touches on broader critical psychiatric perspectives, namely the medicalization of society (i.e. the predominance of medical explanations in understanding individual and social problems) and the biopsychosocial model of (mental) health. According to CPN psychiatrists, both reflect the predominance of biomedical reductionism present in the current psychiatric paradigm and supported by various social and political-economic processes.
The thesis aims to present current critical psychiatric perspectives that remain insufficiently understood in Slovenia, including within the field of social work. To better contextualize the critiques and proposed alternatives, they are framed by a brief overview of the history of psychiatry and the emergence of the current psychiatric paradigm in the 1980s with the adoption of the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). This overview brings to the fore two tensions inherent to psychiatry, namely psychiatry's relationship to the rest of medicine and two views on the etiology of mental »diseases« within it: the psychogenesis and organogenesis. Proponents of the former emphasize the decisive role of psychological and social factors in the genesis of mental issues, while proponents of the latter focus on possible organic causes. The latter view coincides with the trends within psychiatry to bring it closer to the rest of medicine.
Understanding of both tensions, as well as of the critiques of contemporary critical psychiatry, can contribute to social work in Slovenia in several ways, as presented in the discussion. Possible contributions include strengthening existing social work efforts as well as upgrading and enriching them in practice (e.g., in community work and work with users) and in theory; better insight into the environment in which social workers in the field of mental health operate, and the difficulties and challenges they face (e.g., underestimation of social work in healthcare settings, team discord, spread of institutional culture into the community). All of the above primarily enables the empowerment of social workers. The master’s thesis also highlights the importance of stronger articulation of the psychological dimension of human beings within community social work, which further influences the understanding of the community as such. It also attempts to open up space for strengthening cooperation between various experts (by profession and experience) in the field of mental health in Slovenia.
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