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Mental health professionals frequently make predictions about the risks of harm posed by patients to themselves and others, and attempt to reduce these, often by enforcing treatment and admission to hospital.  

The concept of risk has gained increasing prominence from high profile failures of care, with publicity in the media further highlighting harms caused by those with mental illness.  More broadly, in all areas of medicine and indeed society, individuals and institutions are increasingly being held accountable for adverse outcomes, further driving the risk agenda.

Reducing harm is an intuitive and desirable goal.  Is a focus on risk an effective way of achieving this goal?  Are we able to predict risks with any degree of accuracy? And do our attempts to reduce risk cause harm in themselves, and distract from other aspects of care? 

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SPEAKERS

Chair: Dr Gwen Adshead, Broadmoor Hospital

For: Dr Matthew Large, University of New South Wales, Sydney

Professor George Szmukler, Institute of Psychiatry, King's

Against: Professor John Morgan, Royal College of Psychiatrists

Professor Tom Fahy, Institute of Psychiatry, King's

On November 15th the Institute of Ideas and the Institute of Psychiatry collaborated for the first time to create a Debate on the challenges associated with legal highs, novel psychoactive substances and less mainstream drugs.

The police, the parliamentarians, the addictions psychiatrists, the general practitioners, the voluntary sector and the family members of those harmed by these drugs were all represented.

A radical departure from the house style meant that there were five speakers, no polarised speeches and no vote. Despite the absence of a democratic voice the audience took part with gusto.

In the preceding weeks the ban of more synthetic cannabinoids and methoxetamine were announced, along with increased detection of deaths from mephedrone and the appearance of 57 new drugs within 11 months.

Did the panel and audience find solutions to this fast changing situation?

Listen for yourself, but I would argue that this constructive discourse fleshed out some promising ideas involving education, novel treatment services and adaptation of regulatory mechanisms.

One thing was clear from all present. The continuation of the status quo cannot cope with the growing challenges of what one young journalism student in the audience dubbed a 'drug revolution'.

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SPEAKERS

Dr Owen Bowden-Jones, consultant psychiatrist and chair, Faculty of Addictions, Royal College of Psychiatrists

Dr Michael Fitzpatrick, GP; author, The Tyranny of Health: doctors and the regulation of lifestyle and Defeating Austism: a damaging delusion

Tim Hollis, chief constable, Humberside Police; chair, ACPO Drugs Committee

Molly Meacher, chair, All Party Parliamentary Group on Drug Policy Reform; former Chair, East London NHS Foundation Trust

Chair: David Bowden, coordinator, UK Battle Satellites; poetry editor, Culture Wars; TV columnist, spiked

The 45th Maudsley Debate took place on 19 July 2012 and was entitled "Insane? Cases such as that of Anders Breivik demonstrate that fanaticism is a form of madness."

Speakers for the motion:

Dr Raj Persaud, Consultant Psychiatrist and Emeritus Visiting Gresham Professor for Public Understanding of Psychiatry

Prof Max Taylor, Centre for the Study of Terrorism and Political Violence, St Andrews University

Against:

Prof Simon Wessely, Director, King's Centre for Military Health Research, Institute of Psychiatry, King's College London

Maajid Nawaz, Chairman of the counter-extremism think-tank, Quilliam

Chair: Prof. Tom Fahy, Professor of Forensic Mental Health Science, Institute of Psychiatry, Kings College London

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March 2012

This house believes that psychoanalysis has a valuable place in modern mental health service. Chaired by Prof Sir Robin Murray. For the motion were Prof Peter Fonagy and Prof Alessandrea Lemma. Against the motion were Prof Lewis Wolpert and Prof Paul  Salkovskis.  

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This house believes that the closure of psychiatric beds has gone too far.A Maudsley Debate to mark the 50th anniversary of Enoch Powell’s ‘water tower’ speech, which marked the beginning of the process of deinstitutionalisationChaired by Professor Simon Wessely – Head, Department of Psychological Medicine.For the motion were Professor Peter Tyrer, author John O’Donoghue and Dr Trevor Turner.Against the motion were Dr Rachel Perkins, Professor Julian Leff and Professor Sonia Johnson

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June 2011

This house believes that child protection has become a form of madness. Proposing the motion were consultant psychiatrist Dr Alain Greggoire and children's lawyer and novelist Simonetta Agnello Hornby who argued that child protection policies fail to detect 90% of the cruelty children suffer and let down high risk groups. For effective treatment to be possible we must cease our dependency on child protection and move from child to family focused policies, investing in early (pre-birth) interventions that target the most vulnerable families. Opposing the motion, associate professor of clinical psychiatry Dr Margaret Spinelli and author and performing arts director Remi Kapo argued that child protection is an evidence-based rational response which must be developed and refined to curtail the incidence and prevalence of child abuse. The debate was chaired by Professor Louis Appleby. 

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February 2011

41st Maudsley Debate: Love is a Drug

This house believes that female sexual arousal disorder is a fabrication

A work of fiction dreamt up by ‘Big Pharma’ or an under-recognised and under-treated condition that has been side-lined by clinicians for too long? The controversy around the definition, prevalence, treatment and even existence of female sexual arousal disorder has proved inflammatory since the term first emerged in the late 1990s. Debate around the condition has not abated; it has become a flashpoint for arguments relating to ‘medicalisation’, inappropriate prescribing and the trustworthiness of published medical evidence & the research methodologies used. It has also been the subject of argument within feminist literature and its place within the wider history of sexual health & functioning has been a source of argument.

So, a ‘drug marketing merging with medical science in a fascinating and frightening way ’ or is there a ‘need for the assessment and treatment of women along the lines of men being assessed and treated for erectile dysfunction’ . With psychiatrists, physicians, journalists, academics and feminist writers on either side of the argument it is a source of fascinating debate.

Assembled for the 41st Maudsley debate were four highly eminent speakers and Chair who put forth the arguments for and against.

Chair – Prof Dinesh Bhugra

For – Dr Petra Boynton, Dr Ben Goldacre

Against – Dr Sandy Goldbeck-Wood, Dr John Dean

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February 2011

This House Believes That The NHS Mental Health Services Should Not Fear The Private Sector

Chair – Professor Sir David Goldberg

Speaking For the motion:Prof Elaine Murphy, Prof Philip Sugarman

Speaking Against the motion: Prof Allyson Pollock, Dr Laurence Buckma

One hundred and sixty eight voted in this 40th Maudsley Debate. Taking place during the so called age of austerity, this was a politically hot debate with Andrew Lansley’s freshly published ‘Equity & Excellence: Liberating the NHS’ White Paper appearing to encourage increased participation of the private sector and competition for funding in the provision of health care

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April 2010

This house believes doctors should be allowed to assist some people with suicide.

Chair: Professor Simon Wessely

Speaking for the motion:  Baroness Mary Warnock, Professor Raymond Tallis

Speaking Against the motion: Professor Rachel Jenkins, Baroness Ilora Finlay

The movement to increase patient choice has been growing dramatically for years. The Telegraph reports that in January 2010, 80% of 2,053 adults felt that when patients with terminal illness choose suicide, those who assist them should not be prosecuted.However if doctors assist patients with suicide, they can potentially be convicted and imprisoned.

At this 39th Maudsley Debate this house proposes that doctors should be allowed to assist some people with suicide. However, are we so certain that choosing death is not an uncontrolled symptom of mental disorders that we should be treating?

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June 2009

Speaking for the motion: Professor Gordon Claridge, Emeritus Professor of Abnormal Psychology in Oxford University and Emeritus Fellow of Magdalen College

Jonathan Naess, Director of Stand To Reason, RADAR Person of the Year 2008

Speaking against the motion: Dr Liz Miller, General Practitioner, Occupational Health Physician and Psychological Health Specialist, MIND Champion of 2008

Professor Michael Trimble, Emeritus Professor of Behavioural Neurology and Consultant Physician, National Hospital Queen Square

Chair: Dr James MacCabe, Senior Lecturer in Psychiatry at the IoP and Honorary Consultant Psychiatrist at the National Psychosis Unit.

Despite the tube strike on June 10th 2009 two hundred and thirty people attended the Wolfson Lecture Theatre of the Institute of Psychiatry to partake in the 38th and arguably the most creative Maudsley Debate. The motion was ‘this house believes that mental disorder is the price we pay for exceptional creativity’.

Before any speaker had taken to the podium a majority of 118 had voiced their opposition to the motion, whilst a significant minority of 73 voted for and 33 opted out by abstaining.

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February 2009

Can you trust researchers with your confidential data?
This house believes that clinical research has too few safeguards for consent and confidentiality.

Speaking against the motion: Sir Mark Walport - Wellcome Trust, Professor Charles Warlow - Edinburgh University

Chair: Professor Simon Wessely - Institute of Psychiatry

Set against a background of rising public concern about surveillance and data collection, is medical research now viewed with suspicion? Are there enough safeguards for privacy in NHS research? Are the goalposts for safeguards shifting as centralized health databases allow for unprecedented data access?

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June 2008

This House Believes Antidepressants are no Better than Placebo.

Speaking for the motion: 

Irving Kirsch, Professor of Psychology, University of Hull and lead author of the now notorious meta-analysis suggesting that selective serotonin reuptake inhibitors were little better than placebo (Kirsch I et al. (2008) Initial Severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Medicine). He is a Fellow of the American Psychological Association and Past-President of the American Psychological Association’s Hypnosis Division.

Dr Joanna Moncrief, Senior Lecturer Social and Community Psychiatry, UCL. And Co-Chair of Critical Psychiatry Network. She is author of The Myth of the Chemical Cure: a Critique of Psychiatric Drug Treatment (2007) published by Palgrav

Speaking against the motion:

Prof Wolpert is Professor Emeritus in Biology as Applied to Medicine, University College London. A distinguished scientist, he is as famous for revelation that he suffered from severe depressive illness requiring antidepressant therapy. This was the basis for his book 'Malignant Sadness: the Anatomy of Depression' and a BBC television series on the subject. He is also the author of 'The Unnatural Nature of Science' and his most recent book is 'Six Impossible Things Before Breakfast' (2007). He is a Fellow of both the Royal Society and the Royal Society of Literature.

Prof Goodwin is W.A. Handley Professor of Psychiatry at the University of Oxford where he heads the Department of Psychiatry. He is an international expert in the psychopharmacology of depression and bipolar disorder, and was formerly President of the British Association for Psychopharmacology. He is a Fellow of the Academy of Medical Sciences.

Chair: Tom Fahy, Professor of Forensic Mental Health, Institute of Psychiatry

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March 2008

Is happiness overrated? How to define happiness? Is depression its polar opposite? And just who gains from re-translating and individualising collective, public issues?

Speaking for the motion: 

Mr Paul Ormerod, an economist and Fellow of the British Academy of Social Sciences, writes on a range of topics to include a recent pamphlet on Happiness, Economics & Public Policy.

Dr Rachel Perkins, clinical psychologist, Director of Quality Assurance & User/Carer Experience at an NHS Trust, user of mental health services, and Vice Chair of Rethink.

Professor Lord Richard Layard, Emeritus Professor of Economics at the London School of Economics, where he is Head of the Programme on Well-Being, and author of Happiness – Lessons from a New Science.

Dr Carmine Pariante, consultant psychiatrist, Head of the “Stress, Psychiatry and Immunology Lab” at the Institute of Psychiatry, and expert on stress hormones in mental health.

Chair: Professor Robin Murray from the Institute of Psychiatry

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November 2007

This house believes that psychiatrists are unable to resist the seductive messages on the pharmaceutical industry.

Speaking for the motion: David Healy, Professor of Psychological Medicine at the University of Cardiff. Prof Healy is arguably the most vocal critic of the influence of the pharmaceutical industry on the academic freedom of psychiatrists. A psychiatrist and former GP, Dr Peter Aitken (Director of Research and Development, Devon Partnership NHS Trust) has experience of working in the pharmaceutical industry and will second the motion.

Speaking against the motion: Prof. David Taylor is chief pharmacist in the South London and Maudsley NHS foundation Trust, and is the lead author of the Maudsley Prescribing Guidelines, which has become the de facto standard reference for clinical psychopharmacology in the UK. The second opponent will be Prof Tony Hale, Professor of Adult Mental Health at the University of Kent, a psychiatrist with experience working in the drug industry.

Chair: Robin Murray (Professor of Psychiatry, Institute of Psychiatry)

Prior to the debate, a significant majority of the audience supported the motion.

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February 2007

This House believes that the Mental Health Bill 2006 will improve mental health care in England and Wales

After 8 years of fraught controversy, Parliament is now debating the Mental Health Bill 2006 to amend the Mental Health Act of 1983. Strongly backed by government as introducing overdue updates to the law and necessary measures for public protection, the Bill is as fiercely opposed by the united forces of the Mental Health Alliance, a coalition of 78 organisations from across the mental health spectrum campaigning to secure better mental health legislation for England and Wales.

The debate takes place at an absolutely critical point. The Bill has passed its first, second and committee stage readings in the House of Lords in January, and is expected to come to the House of Commons before Easter. Time is short for all sides to enter the debate and make their views known.

Speaking for the motion are two distinguished Forensic Consultant Psychiatrists: Professor Tony Maden, Professor of Forensic Psychiatry at ImperialCollegeLondon Professor Tom Fahy, Professor of Forensic Mental Health, Institute of Psychiatry, King’s College London

Speaking against the motion are: Dr. Rowena Daw, Vice-Chair, Mental Health Alliance Baroness Elaine Murphy, an Old Age Psychiatrist, is an independent crossbench peer, and is Chairman of Council, St George’s, University of London.

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December 2006

This house believes that charges of institutional racism in psychiatry damage patient care.

This highly controversial subject has received a great deal of attention recently, in large part stimulated by a commentary published in the British Medical Journal by Professors Swaran Singh and Tom Burns*. This commentary argues that current approaches to addressing ethnic inequalities in mental health and mental health care are not based on the best available evidence. Instead, the authors argue, unsubstantiated charges of racism in psychiatry drive current initiatives to reduce ethnic inequalities, the result being that other causes are ignored and patient care suffers. The implications of this analysis for mental health services and policy are far-reaching. *Singh, S & Burns, T (2006) Race and mental health: there is more to race than racism. BMJ, 333, 648-651

Speaking for the motion: Professor Swaran Singh, from the University of Warwick, and Professor Robin Murray, from the Institute of Psychiatry,

Speaking against the motion: Professor Kwame McKenzie, from University College London and the University of Central Lancaster, and Mr Lee Jasper, Senior Adviser on Equalities for the Mayor of London

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September 2006

In the last few years the identification of the first susceptibility genes for schizophrenia has offered the prospect of a better understanding of the condition and better prediction of the outcome of those who develop it.

While most psychiatrists and their patients recognise the role of environmental risk factors in the aetiology of psychiatric disorder, many are distrustful of psychiatric genetics which still pays the price of an ancient stigma.

This debate asks whether we should continue to regard psychiatric geneticists as closet fascists or whether it is time to rehabilitate the reputation of psychiatric genetics.

The debate will be chaired by Simon Wessely, Professor of Epidemiological and Liaison Psychiatry the Institute of Psychiatry and Director of King’s Centre for Military Health.

Speaking for the motion: Prof. David Collier, Professor of Neuropsychiatric Genetics, Institute of Psychiatry; Prof. Robin M Murray, Professor of Psychiatry, Head of Division of Psychological Medicine, and Psychiatry, Institute of Psychiatry.

Speaking against the motion: Prof. Richard Bentall, Professor of Clinical Psychology, University of Manchester; Prof. Peter Beresford, Professor of Social Policy at Brunel University  

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June 2006

This house believes child abuse is a cause of schizophrenia.

The 30th Maudsley Debates is on the topic of child abuse and schizophrenia, a controversial topic that has been given a lot of recent attention as a result of a review published recently by Dr. John Read and colleagues in the journal, Acta Psychiatrica Scandinavica*.

* Read, J., van Os, J., Morrison, A.P., & Ross , C.A. (2005) Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatrica Scandinavica, 112, 330-350

Speaking for the motion: Dr. John Read (University of Auckland), Mr. Paul Hammersley (University of Manchester)

Speaking against the motion: Professor Peter McGuffin (Institute of Psychiatry), Terry Hammond (RETHINK)

CHAIR: Professor Til Wykes (Institute of Psychiatry)

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This house believes that the legacy of RD Laing was detrimental for patient care.

Supporting the motion will be: Adrianne Revely, Consultant Psychiatrist and Mike Launer, Consultant Psychiatrist at the Lamont Clinic, Burnley.

Opposing the motion will be: Adrian Laing, Solicitor in London and Tony David, Consultant Psychiatrist in SLAM and Professor of Cognitive Neuropsychiatry at the IOP

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April 2005

The speakers for the motion are Dr. Harvey Gordon and Dr. Frank Tallis. Dr. Gordon is a Consultant Forensic Psychiatrist at the Littlemore Mental Health Centre in Oxford. Dr. Frank Tallis is a writer and a Clinical Psychologist. In addition to his numerous academic publications he is the author of several novels including “Killing Time” and the recent bestseller “Lovesick”.

Speaking against the motion are Dr. Glenn Wilson and Ms. Cherry Potter. Dr. Wilson is a Reader in Personality at the Institute of Psychiatry. He is a pioneer in the field of evolutionary theories of sex differences, attraction and love and he is ranked within the 10 most cited British psychologists. Ms. Cherry Potter is a Journalist and Psychotherapist. She was head of screenwriting at the National Film and Television School and is well known for her articles in the Guardian and The Times as well as her latest novel “I Love you but... Seven decades of romantic comedy”.

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January 2005

This house believes that modern science has demonstrated the implausibility of an afterlife.

Speakers for the motion are Professor Lewis Wolpert and Professor Peter Atkins. Lewis Wolpert is professor of biology at University College London and is recognised as one of the pioneering thinkers of embryology. He is a former chairman of the Committee for the Public Understanding of Science and has presented science in books, on radio and on TV. He also writes a column for The Independent. Peter Atkins is professor of physical chemistry at Lincoln College, Oxford, and is an honorary associate of the National Secular Society. His research interests are in the field of theoretical chemistry, particularly magnetic resonance and the electromagnetic properties of molecules. He is the author of several world-famous chemistry textbooks and now spends virtually all his time writing, including books for more general audiences.

Speakers against the motion are the Rev Dr John Polkinghorne and Dr Sean Spence. John Polkinghorne is a mathematical physicist and Anglican priest. He resigned as professor of mathematical physics at the University of Cambridge in 1979 to pursue theological studies, becoming a priest in 1982. Since then, his writings and lectures have applied scientific habits to Christianity, resulting in a ‘modern, new exploration of the faith.’ Sean Spence is reader in adult psychiatry at the University of Sheffield and honorary consultant psychiatrist to the homeless at Sheffield Care Trust. His research interests include the investigation of the cognitive neurobiology of higher executive function in humans in health and disease.

The debate will be chaired by the IoP’s Professor Robin Murray.

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May 2004

This House believes London's mental health services are in a state of permanent crisis.

Supporting the motion: Angela Greatley, Director of Policy, The Sainsbury Centre for Mental Health and co-author of the King's Fund mental health report 2003 & Cliff Prior, Chief Executive, Rethink (formerly the National Schizophrenia Fellowship)

Opposing the motion: Alan Cohen, Chair, London Development Centre for Mental Health & Stuart Bell, Chief Executive SLAM NHS Trust

Chair: Professor Robin Murray, Professor of Psychiatry, IoP

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November 2003

This house believes that there should be a free market for recreational drugs.

Chaired by Dr Michael Farrell, Consultant, Maudsley hospital

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September 2003

Feelings ran high at this debate touching on gender issues within psychiatric services. The audience started the evening strongly behind the motion supporting gender-segregated in-patient services but with a number of voters waiting to be persuaded.

The proposers of the motion centred their arguments on issues of women’s safety and were opposed by a counter-attack emphasising the importance of patient choice. We heard several women service users give heartfelt testimony to their experience of the vulnerability of women within mixed acute wards, in particular to sexual exploitation and violence. Although nobody denied that women had the right to safety as in-patients, it was argued that maybe a better solution lay in improving the general quality of in-patient care and giving careful consideration to ward architecture and staffing levels to allow safety for all. Would sex-segregation not be a move to benefit women and disadvantage men? Lynne Clayton spiritedly attacked this notion on the grounds that it was unreasonable to put women at risk so that they could act as ‘civilising’ influences for men. Interestingly, Dr Eleanor Cole’s overview of the literature showed that research into the proposed benefits of gender-separated services was equivocal. Should we not, therefore, take more time to reflect and research the issue before committing to change? Otherwise we might fail to learn from the past experience of segregated wards that was illustrated by Professor Peter Tyrer

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July 2003

22th Maudsley Debate Supporting the motion: Dr David Healy and Mr Charles Medawar

Opposing the motion: Dr Veronica O'Keane and Professor Lewis Wolpert

Chair: Professor Robin M Murray

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May 2003

War is an expression of the psychopathology of the male brain.

Does maleness predispose an individual to innate, pathological belligerence?
Is the male brain in some cases 'hard-wired' to be warlike?
Would women have a different approach to conflict resolution?

Supporting:
Professor Germaine Greer - Professor of English and Comparative Studies at Warwick University, pioneering feminist and celebrated author
Johanna Burke - Professor of History at Birkbeck College, specialist in social, gender and military history.

Opposing:
Lord Owen - Former Shadow Defence Spokesman, Labour Foreign Secretary and Co-Founder of the SDP
Dr Felicity de Zulueta, Maudsley Hospital

Chair: Professor Simon Wessely, Maudsley Hospital and IOP

March 2003

This house believes that criminals need treatment not punishment

Proposing the motion:Prof. John Gunn, Forensic Psychiatry, IOP and Prof. Christopher Cordess, Forensic Psychiatry, University of Sheffield.

Opposing the motion: BRENDAN O'NEILL - Assistant Editor, SPIKED PHILIP BEAN - Director, Midlands Centre for Criminology and Criminal Justice

February 2003

This house believes that the problems of everyday life are being over-medicalised.

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Supporting the motion that schizophrenia does not exist will be Professor Jim Van Os and Richard Bentall.

Opposing the motion will be Dr. Peter McKenna & Professor Anthony David.

November 2002

This house believes that nurses and psychologists should be allowed to prescribe.

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May 2002

 For

Mr Ben Shephard - Noted historian, journalist and commentator. Author of 'War of Nerves', the much praised history of the effect of war on the mind, and the often ineffective ways in which military psychiatry seeks to prevent this.

Dr Derek Summerfield - Consultant Psychiatrist, SLAM Honorary Senior Lecturer, Institute of Psychiatry. Consultant to OXFAM. Principal Psychiatrist, Medical Foundation for the Victims of Torture. Research Associate, Refugees Study Centre, Oxford University. Leading critique of the medicalisation of distress via the diagnosis of PTSD, and strong critic of western psychiatric aid programmes to those in other cultures exposed to the horrors of disaster or war.

Against

Doctor Chris Freeman - Consultant Psychiatrist and Psychotherapist, Royal Edinburgh Hospital, Edinburgh. Director of the Colin Rivers Centre, PTSD clinic, Edinburgh and responsible for the Cognitive Behavioural Psychotherapy Unit, Royal Edinburgh Hospital. Chairman, Royal College Research Committee.

Mr Andrew Buchan - Leading barrister for PTSD; Junior Counsel in the ground-breaking Walker stress case; Counsel in the Long v Mercury Mobile Communications: £327,500 for a first breakdown caused by bullying. Author of 'Personal Injury Practice' and 'Procedure and Personal Injury Schedules'. Authority on stress, bullying and PTSD cases, and has lectured on bullying and stress to IRS, IBC and Euroforum.

Chair

Simon Wessely - Professor of Epidemiological and Liaison Psychiatry (IoP); Honorary Consultant Psychiatrist, King's and Maudsley Hospitals; Co-Director, Gulf War Illnesses Research Unit.

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March 2002

This house believes that human rights standards do not protect the dignity

 Supporting the motion:

Professor Frank Furedi Professor of Sociology Darwin College University of Kent at Canterbury

Professor Nigel Eastmann Head of Forensic Psychiatry St Georges Hospital Medical School

Opposing the motion:

Professor Michael Gunn Head of Department and Associate Dean, Department of Academic Legal Studies, Nottingham Law School, The Nottingham Trent University

Lucy Scott-Moncrieff Senior Partner Scott, Moncrieff, Harbour and Sinclair

January 2002

This house believes that the public's reaction to terrorism is more irrational than the terrorists' motivation and behaviour

Speaking in favour of the motion:

SIMON WESSELY - Professor of Epidemiological and Liaison Psychiatry, GKT School of Medicine and Institute of Psychiatry
ADRIAN GROUNDS - Senior Lecturer in Forensic Psychiatry, Institute of Criminology, Cambridge University

Speaking against the motion:

RAJ PERSAUD - Consultant Psychiatrist, South London & Maudsley NHS Trust, and mental health commentator
KEVIN TOOLIS - Journalist and author of 'Rebel Hearts - Journeys within the IRA's soul'

The meeting will be chaired by TOM FAHY, Professor of Forensic Mental Health, GKT School of Medicine

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November 2001

This house believes that the NHS Plan will transform psychiatric care in England for the better

Speakers

Prof. Louis Appleby, National Director of Mental Health
Cliff Prior, Chief Executive of the National Schizophrenia Fellowship.

Speaking against the motion were:-

Prof Sir David Goldberg, formerly Professor of Psychiatry at the Institute, and long-time advisor to the Department of Health
Dr Tony Pelosi, a consultant psychiatrist in a deprived area near Glasgow

Descrption

The NHS Plan has been described as "the most fundamental and far-reaching programme of reform in the history of the NHS." Mental Health is one of three priority areas. The proposals include massive expansion of forensic services, treatment centres for "dangerous severe personality disorder", assertive outreach and crisis teams, "graduate mental health workers" in primary care, and women-only day centres.

Many have welcomed the proposals, particularly the promise of greater financial investment in mental health services. But critics regard the Plan as a product of political, rather than clinical, priorities, and argue that many of the proposed reforms are not validated by research evidence. Others have approved of the Plan, but doubt that sufficient resources will be made available to execute the reforms.

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September 2001

This house believes it is worth criminalising the majority to protect the vulnerable minority

Supporting this motion were:-

Dr Colin Drummond, Consultant Psychiatrist. St George's Medical School
Professor Susan Greenfield, Director of the Royal Institution and Professor of Pharmacology, Oxford University

Speaking against the motion were:-

Dr Michael Farrell, National Addiction Centre, Institute of Psychiatry
Dr Leslie Iversen, Director of the Wolfson Centre for Age Related Diseases (King's College London)

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July 2001

 A lively audience of service users, psychiatrists, and health care professionals including the President of the Royal College of Psychiatrists attended the debate, which was chaired by Professor Tom Fahy. Before hearing the arguments of the speakers only 2% of the audience supported the motion and the implementation of the Government White Paper on Mental Health with 61% opposed and a substantial 37% undecided.

Professor Tony Maden of Imperial College opened the debate arguing for the motion. He put forward that the Mental Health White Paper ensured that difficult patients received treatment rather than punishment, and that the governments interest in public protection was valid.

Paul Bowen, a barrister of Doughty St Chambers, opposed this, pointing out that the White Paper severely constrained liberty, expanded the class of people subject to coercion, and breached the Human Rights Act.

Next Dr Chris Burford, a consultant at St Anns Hospital, Tottenham, supported Professor Maden and the motion. He spoke of changes in psychiatry and the difficulties of revolving door admissions; he suggested that the White Paper provided a framework for treating vulnerable people who otherwise missed or evaded treatment.

Finally, Dr Andrew Johns a consultant of forensic psychiatry at the South London and Maudsley NHS Trust, concluded by noting that the White Paper coerced both patients and psychiatrists. He rounded up the debate by reiterating the estimation that 5000 patients would require detention in order to prevent a single homicide by a person with a mental disorder.

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April 2001

The media is being used as a convenient scapegoat for the development of eating disorders. This is the view of Professor Kenneth Nunn from Sydney University, Australia who will be speaking at the ninth in a series of debates on topical issues in psychiatry at the Institute of Psychiatry.

He will argue that evidence suggests that the onset of an eating disorder has little to do with the media and everything to do with individual biological and psychological vulnerabilities.

Vehemently opposing this view will be Melanie Katzman, Consultant Psychologist from the US and the author of many books on eating disorders. She will explain that meta analysis of studies due out this spring reveals that the media is the medium for spreading the social contagents that cause eating disorders. She will also highlight data from Fiji which demonstrates that after the introduction of television, eating disorders emerged.

Eating disorders currently affect around 1.1 million people in the UK. The widely held image of these disorders as slimming diseases belies the seriousness of the conditions: anorexia nervosa has the highest death rate of any psychiatric disorder, with around 1 in 5 sufferers dying within 20 years of the onset of illness.

Also speaking at the debate are W. Bose, Spokesperson for Premier Model Agency Management and Nicky Bryant, Chief Executive of the Eating Disorders Association.

W. Bose will argue that through the use of imagery and the written word, the media can be held accountable for a persistent focus on weight, shape and dieting; negative stereotypes of women and a focus upon image instead of capabilities. This, he says, has served to undermine the self-esteem of generations of women. Nicky Bryant, however, will argue that we are only fashion victims if we allow the fashion industry to dictate thin as the aspirational body shape and size.

Chairing the debate is Janet Treasure, Professor of General Psychiatry, Guys Hospital & Director of the South London and Maudsley NHS Trusts Eating Disorders Unit.

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This House Believes That Psychiatrists Over-Medicate The Exuberance Of Youth

November 2000

This house believes that psychiatric institutions are irretrievably racist

Speakers

Supporting this motion were:
Dr Dele Olajide, Consultant Psychiatrist, South London and Maudsley NHS Trust
Mr Chinyere Inyama, Solicitor and Mental Health Act Commissioner

Speaking against the motion were:
Dr David Ndegwa, Consultant Psychiatrist, South London and Maudsley NHS Trust
Mr Malcolm Phillips, Director, Stephen Lawrence Charitable Trust

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October 2000

This house believes that studying the brain tells us little about the mind

June 2000

Keep taking the tabloids: is the media bad for mental health?

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May 2000

What should we do with psychopaths?

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This house believes that there should be no more counselling until it is proved to be safe and effective.

Speakers

Speaking against the motion were: Gladeana McMahon, Fellow of the British Association of Counsellors Adrian Hemmings (TBC), Psychologist and researcher at the University of Sussex

If you wish to download the debate in MP3 format, right click the following link as "Save target as"  Download the 3rd  Maudsley Debate Podcast