Anomie and Egoism in Relation to Contemporary Psychiatry

With increasing numbers of people in western society engaging in deliberate self-harm behaviours, psychiatric practitioners should reconsider some of the implications. 1. Psychiatry as a branch of medicine has a medical bias in assessing people who have engaged in deliberate self-harm behaviours and tends to view these behaviours as symptoms of psychiatric illness rather than sociological disorder. 2. The increasing number of these distressed people is causing an increasing psychiatric workload to the disadvantage of other patients, research activity and teaching. 3. The psychiatric profession should focus its attention on patients with formal psychiatric illness and encourage the involvement and participation of professionals from other agencies and services who are now trained and willing to become involved. Psychiatry cannot replace the enfeebled phenomena of collective sentiment or the regulatory function of a simpler, more cohesive society (as described by Durkheim) but many of the established self-help groups can help and links could be established with these agencies. To do this will require changes to established professional role boundaries and the loosening of medico-legal constraints which currently prevent relinquishing of responsibility when there is an obvious absence of psychiatric illness.