Introduction

Abstract

This book has been written because there is a desperate need for it. Public service psychiatry is a fulfilling and challenging occupation but it is wrought with controversy and contradictions. Quite often what was taught during exhaustive training and acquired through reading and research does not prepare practitioners for the job. The task they face and the skills and training they bring to it often fail to add up. Many of those who encounter mental health services as a ‘consumer’, or as someone associated with one, frequently find themselves confronted by unclear treatment options or difficulties of access. Medical students encountering psychiatry for the first time and probationary doctors testing out longer-term options sense these tensions. For years this has resulted in problems of recruitment and morale, and psychiatry’s poor standing within the family of medical specialties. Whether considered in the context of the UK National Health Service (NHS) or in other jurisdictions this raises difficult questions, and those who have chosen a career in psychiatry deal with them in different ways. Some struggle with why they are there and what they are being asked to do. Some buckle down and get on with the job they are paid to do without asking too many questions. Some use the situation as an entrepreneurial opportunity to develop a prestigious career.