Surely the headline of your editorial in March presents a false dichotomy.1 It led me to reflect on the patients between 16 and 20 years of age who, as a psychiatrist working in a rural area of Scotland, I have seen over the past year. The vast majority of these patients were neither ‘clinically depressed’ or ‘moody’. They did have major emotional problems but these problems were completely understandable in the light of horrendous circumstances that they have been brought up in. One could say that if they didn't feel unhappy there would have been something wrong with them. It is just not true to pretend that there is evidence that medical intervention, whether psychotropic medication or psychological therapy, has been shown to be of major benefit to such folk.
I am proud of what psychiatry can achieve in relieving the chaos of psychosis or the despair of clinical depression, but I think that psychiatry and general practice should reject all efforts made to pretend that they can deal with the understandable sadness of the victims of our horrendous society.
After 30 years as a doctor — in psychiatry and general practice — it is a terrible sadness to see the decline in the quality of life experiences that young people have. I think it is our duty as doctors to point out the facts about the experiences of young people and to endeavour to get society to change its values so that it sees the upbringing of young people as the core function of society. We must not pretend any longer that we can cure the victims of society's failings.
- © British Journal of General Practice, 2009.