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Prevention Manual

Preventing Pychological Poblems And Advancing Mental Health

(in Dutch)
2004

by
Jaap van der Stel

Book review by Mira de Vries


There are three kinds of people: loonies, near-loonies, and MHS workers. This manual is intended as a textbook for the last group, so is stated in the introduction.

The author claims that there is a great demand for prevention in the MHS, yet “governments, financiers, and institutional managers … are often insufficiently persuaded of the utility and necessity” of preventive programs. So who is demanding it? Actually, the MHS workers themselves, because they all need jobs. Besides, working in institutions, with their irregular work schedules, low wages, and difficult inmates who only become worse from the treatment, is simply a lot less fun (the author implies).

With dry descriptions, graphs, and tables, the author hums a love song to psychiatric imperialism. He claims all sorts of social phenomena for its legitimate domain: homelessness, drug use, crime, unemployability, truancy, child abuse, and more. Without presenting any evidence whatsoever, he alleges that “prevention” is scientific and effective. Or, anyway, very promising, he hedgingly adds. So it isn’t after all, which is why he calls for lots of research. Of course. Every colonization begins with explorers. No need to fight about dividing the MHS cake. Traditional rivalry between psychiatrists and psychologists is settled by assigning each a role.

The author does not neglect ethics, though this subject occupies scarcely 5% of the book. To this end he takes Friedrich Nietzsche (late 19th century) and Immanuel Kant (yet a century earlier) off the shelf, together with fancy newspeak like “categorical imperative” and “universality approach”. Of course in his view nowadays the MHS does exclusively excellent work, contrary to former times, before physicians had access to so many narcot- I mean, medications. He writes: “Before the advanced psychopharmaceuticals that serve us today, treatment specialists found themselves compelled to apply (physical) forced treatments.” Is a shot of haldol in your buttock while you’re handcuffed, or held down by five nurses, not physical forced treatment? this reviewer wonders. Abuse of power could occur, the author ponders, but that would be unintentional. Thomas Szasz, also called the conscience of psychiatry, who has written more than thirty books and 500 articles on this subject, and who can’t be overlooked by even his most ardent opponents, is mentioned nowhere in the book, including the chapter on ethics. Nor is any other critic of psychiatry mentioned.

It’s little wonder that it took the author a year to fill all those 340 pages with small print even though extensive portions are adaptations of his earlier publications. Never has so little been said about psychiatry in so many and such long words. The reason that the book is aimed only at people who are or aspire to be employed by the MHS is obvious. What it is really about is the expansion of employment opportunities in the MHS at the expense of the taxpayer’s wallet and your and my privacy and self-determination.

Finally, at the publisher’s request, I inform you of the price: €29,50.

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