Shared Decision Making In Medication

Some of the great and good in the field of mental health and well-being will gather this week in West London to discuss the issue of medication.

Is the right medication being prescribed, are there alternatives, is there enough choice in the matter?

The event is billed as a “Question Time Style Debate” and hosted by Lord Nigel Crisp.

The impressive list of speakers includes Eleanor Longden who movingly delivered this TED talk on her own struggle and eventual (resounding) success in finding the help she needed.

Eleanor’s story illustrates how the medicalising of a problem can sometimes be the very opposite of what a person needs. Although getting the attention of her GP began when she started talking about hearing voices, the subsequent diagnosis and treatment may have complicated and lengthened the road she had to travel to well being.

The question therefore is that if alternatives are needed in treating health issues, are these alternatives available and are they effective?

Searching for alternative treatments that have efficacy is a thorny issue. Vested interests are present within the drug manufacturers and ‘alternative therapists’ alike. Everyone is pushing their own product albeit with the best of intentions. In the search for evidence based medicine the bar is high at the moment, and rightly so. However some approved treatments also attract skepticism.

A renowned researcher in the area of psychology and proponent of Hypnotherapy, Irving Kirsch, has long questioned the use of anti-depressants. and produced studies that indicate that placebo (suggestion) is equally effective as anti-depressants.

Kirsch goes on to suggest that Hypnotherapy is the only ‘ non deceptive placebo’: where suggestion is applied knowingly and to good effect. Some may argue that many other ‘alternative’ treatments are placebo but wrapped up in what Ben Goldacre would call Bad Science.

I googled the host, Lord Crisp (what a name) and found he read Philosophy at Cambridge which prompts me to suggest how this conference reflects two of Philosophy’s big names and ideas.

Aristotle would be pleased that dialectic, the process of discussion (not top-down edicts), is being used at this conference, it is a co-production between providers and users, an unusual combination. Maybe answers can be found between people through the process of discussion and dialogue.

Emmanual Kant would be pleased that the synthesis of Science and the Mind is being promoted here by reaching out to ‘users’ and resisting the temptation for the establishment to impose ‘scientific fact’ on to people who seek, and are possibly able, to create their own solutions. The individual’s mind has its own structure, set of beliefs and stories which can work with a medical model. In short, a partnership.